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Discontinuation anti-TNF

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https://www.readbyqxmd.com/read/27849614/epipolymorphisms-associated-with-the-clinical-outcome-of-autoimmune-arthritis-affect-cd4-t-cell-activation-pathways
#1
Roberto Spreafico, Maura Rossetti, John W Whitaker, Wei Wang, Daniel J Lovell, Salvatore Albani
Multifactorial diseases, including autoimmune juvenile idiopathic arthritis (JIA), result from a complex interplay between genetics and environment. Epigenetic mechanisms are believed to integrate such gene-environment interactions, fine-tuning gene expression, and possibly contributing to immune system dysregulation. Although anti-TNF therapy has strongly increased JIA remission rates, it is not curative and up to 80% of patients flare upon treatment withdrawal. Thus, a crucial unmet medical and scientific need is to understand the immunological mechanisms associated with remission or flare to inform clinical decisions...
November 29, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27808043/optimizing-biological-treatment-in-rheumatoid-arthritis-with-the-aid-of-therapeutic-drug-monitoring
#2
Grith Petersen Eng
The treatment of rheumatoid arthritis (RA) has greatly improved with the use of biological TNF inhibitors (TNFi). These biopharmaceuticals target the inflammatory cytokine TNF, and hereby decrease the autoimmune inflammation, which may otherwise lead to permanent joint damage in the afflicted patients. Although TNFi decrease clinical disease activity in the majority of the treated patients, they are not always effective. Some patients have a partial response, some lose their initial response to treatment, and others never experience effect at all...
November 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27785551/the-effect-of-pre-operative-optimization-on-post-operative-outcome-in-crohn-s-disease-resections
#3
Alaa El-Hussuna, Igors Iesalnieks, Nir Horesh, Sabah Hadi, Yael Dreznik, Oded Zmora
BACKGROUND: The timing of surgical intervention in Crohn's disease (CD) may depend on pre-operative optimization (PO) which includes different interventions to decrease the risk for unfavourable post-operative outcome. The objective of this study was to investigate the effect of multi-model PO on the post-operative outcome in CD. METHOD: This is a multicentre retrospective cohort study. The primary outcome was 30-day post-operative complications. Secondary outcomes were intra-abdominal septic complications, surgical site infection (SSI), re-operation, length of post-operative stay in a hospital and re-admission...
October 26, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27783331/psoriasiform-eruption-and-worsening-of-pustulosis-palmoplantaris-after-treatment-with-two-anti-tnf-%C3%AE-inhibitors-followed-by-successful-treatment-with-ustekinumab
#4
Nathalie A Bogaards, Menno A de Rie
INTRODUCTION: Tumor necrosis factor (TNF)-α inhibitors are widely used for the treatment of inflammatory diseases. One of the side effects of TNF-inhibitors is the development of a psoriatiform eruption, also known as paradoxical psoriasis. In this case report, we describe a patient with this side effect after treatment with adalimumab and etanercept. CASE REPORT: A 45-year-old female was treated with adalimumab 40 mg once every 2 weeks for pustulosis palmoplantaris and psoriatic arthritis...
December 2016: Dermatology and Therapy
https://www.readbyqxmd.com/read/27769591/pegloticase-failure-and-a-possible-solution-immunosuppression-to-prevent-intolerance-and-inefficacy-in-patients-with-gout
#5
Adey A Berhanu, Svetlana Krasnokutsky, Robert T Keenan, Michael H Pillinger
INTRODUCTION: Pegloticase is a highly effective therapy for patients with refractory and/or tophaceous gout, but has a high discontinuation rate (30-50%) due to development of anti-drug antibodies causing loss of efficacy and risk of infusion reactions. OBJECTIVE: To describe the use of azathioprine or other immunosuppressive therapies as a pegloticase adjunct to prevent pegloticase immunogenicity when treating gout. METHODS: Case report of azathioprine use in a patient receiving pegloticase therapy for refractory tophaceous gout, and review of the literature for the impact of immunosuppressive agents on development of anti-drug antibodies...
September 20, 2016: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/27749779/repeated-intensified-infliximab-induction-results-from-an-11-year-prospective-study-of-ulcerative-colitis-using-a-novel-treatment-algorithm
#6
Kay-Martin Johnsen, Rasmus Goll, Vegard Hansen, Trine Olsen, Renathe Rismo, Richard Heitmann, Mona D Gundersen, Jan M Kvamme, Eyvind J Paulssen, Hege Kileng, Knut Johnsen, Jon Florholmen
BACKGROUND: Anti-tumour necrosis factor (TNF) agents play a pivotal role in the treatment of moderate to severe ulcerative colitis (UC), and yet, no international consensus on when to discontinue therapy exists. OBJECTIVE: The aim of this study is to study the long-term performance of a treatment algorithm of repeated intensified induction therapy with infliximab (IFX) to remission, followed by discontinuation in patients with UC. PATIENTS AND METHODS: Patients with moderate to severe UC were enroled in an open prospective study design...
January 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27749223/necessity-of-tnf-alpha-inhibitor-discontinuation-in-rheumatoid-arthritis-is-predicted-by-smoking-and-number-of-previously-used-biological-dmards
#7
Bart V J Cuppen, Johannes W G Jacobs, Evert-Jan Ter Borg, Anne C A Marijnissen, Johannes W J Bijlsma, Floris P J G Lafeber, Jacob M van Laar
OBJECTIVES: Despite the success of TNF-alpha inhibitor (TNFi) treatment in rheumatoid arthritis (RA), a substantial number of patients necessitate discontinuation. Prediction thereof would be clinically relevant and guide the decision whether to start TNFi treatment. METHODS: Data were used from the observational BiOCURA cohort, in which patients initiating biological treatment were enrolled and followed up for one year. In the model development cohort (n=192), a model predicting TNFi discontinuation was built using Cox-regression with backward selection (p<0...
October 7, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27747532/use-of-anti-tumor-necrosis-factor-therapy-a-retrospective-study-of-monotherapy-and-adherence-to-combination-therapy-with-non-biologic-disease-modifying-anti-rheumatic-drugs
#8
Nicole M Engel-Nitz, Sarika Ogale, Mahesh Kulakodlu
INTRODUCTION: This study examined the use of anti-tumor necrosis factor (anti-TNF) monotherapy, adherence with non-biologic disease-modifying anti-rheumatic drugs (nbDMARDs) in patients receiving a combination of anti-TNF therapies and nbDMARDs, and the impact of nbDMARD adherence on anti-TNF persistence among patients with rheumatoid arthritis (RA). METHODS: Patients with RA (aged ≥18 years) from a US commercial health plan with claims for anti-TNFs (2006-2010) were defined as either biologic-naive or -exposed anti-TNF initiators based on previous nbDMARD use...
December 2015: Rheumatology and Therapy
https://www.readbyqxmd.com/read/27739352/preterm-birth-in-women-with-inflammatory-bowel-disease-the-association-with-disease-activity-and-drug-treatment
#9
Gabriella Bröms, Fredrik Granath, Olof Stephansson, Helle Kieler
BACKGROUND: The inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC) have been associated with an increased risk of preterm birth. MATERIAL AND METHODS: We identified all 246 singleton preterm births among women with IBD between July 2006 and December 2010 as cases and an equal number of controls with IBD from the Swedish national health registers, matched by maternal age, parity and IBD diagnosis (CD/UC). From register data and medical charts, we obtained information on reproductive history, comorbidity, disease activity and drug treatment (corticosteroids, 5-aminosalicylates, sulfasalazine, thiopurines and anti-TNF) as risk factors for preterm birth...
December 2016: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27738572/infliximab-associated-psoriasiform-dermatitis-case-report-and-review-of-a-seemingly-paradoxical-inflammatory-response
#10
Tiffany Y Loh, Philip R Cohen
BACKGROUND: Tumor necrosis factor-α (TNF-α) inhibitors, such as infliximab, adalimumab, and certolizumab pegol are effective agents in the treatment of inflammatory bowel disease. Some individuals undergoing anti-TNF-α therapy for Crohn's disease or ulcerative colitis develop psoriasiform lesions. This is a paradoxical finding, as classical psoriasis is known to respond to these agents. PURPOSE: The clinical features of anti-TNF-α-induced psoriatic dermatitis are described...
September 9, 2016: Curēus
https://www.readbyqxmd.com/read/27718254/immune-response-of-healthy-adults-to-the-ingested-probiotic-lactobacillus-casei-shirota
#11
Laurence S Harbige, Eva Pinto, Judith Allgrove, Linda V Thomas
Daily ingestion of a probiotic drink containing Lactobacillus casei Shirota (LcS; 1.3 x 10(10) live cells) by healthy adults for (i) 4-weeks LcS, (ii) 6-weeks discontinuation of LcS, and (iii) a final 4-weeks of LcS, was investigated. There was a significant increase in expression of the T-cell activation marker CD3(+) CD69(+) in ex vivo unstimulated blood cells at weeks 10 and 14 and a significant increase in the NK cell marker CD3(+) CD16/56(+) in ex vivo unstimulated blood cells at weeks 4, 10 and 14. Expression of the NK cell activation marker CD16/56(+) CD69(+) in ex vivo unstimulated blood cells was 62% higher at week 10 and 74% higher at week 14...
October 8, 2016: Scandinavian Journal of Immunology
https://www.readbyqxmd.com/read/27709443/safety-and-efficacy-of-etanercept-and-adalimumab-in-children-aged-2-to-4%C3%A2-years-with-juvenile-idiopathic-arthritis
#12
D Windschall, G Horneff
The TNF inhibitors etanercept (ETA) and adalimumab (ADA) are approved for treating patients older than 2 years with polyarticular juvenile idiopathic arthritis (JIA). Because long-term experience of treating children younger than 4 years is limited, we evaluated the efficacy and safety of ETA or ADA in patients aged 2-4 years. This prospective, long-term, observational registry study documented baseline demographics, clinical characteristics, disease activity parameters, and safety of patients treated with ETA or ADA...
October 5, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27699578/re-initiation-of-biologics-after-the-development-of-tuberculosis-under-anti-tnf-therapy
#13
Yesim Ozguler, Gulen Hatemi, Serdal Ugurlu, Emire Seyahi, Melike Melikoglu, Sermin Borekci, Ersan Atahan, Gul Ongen, Vedat Hamuryudan
The use of anti-TNF agents is associated with an increased risk of tuberculosis (TB) and anti-TNF agents are stopped when active TB develops. However, discontinuation of treatment can result in flare of the underlying disease. The charts of 22 patients who developed active TB among a cohort of 2754 patients using anti-TNF agents between 2001 and 2013 were reviewed retrospectively. Patients restarting biologics during further follow-up were identified. One patient with miliary TB died within 1 month. A biologic agent was restarted in 16 of the remaining 21 patients (76 %)...
December 2016: Rheumatology International
https://www.readbyqxmd.com/read/27679471/adalimumab-effectiveness-in-beh%C3%A3-et-s-disease-short-and-long-term-data-from-a-multicenter-retrospective-observational-study
#14
Antonio Vitale, Giacomo Emmi, Giuseppe Lopalco, Stefano Gentileschi, Elena Silvestri, Claudia Fabiani, Maria Letizia Urban, Bruno Frediani, Mauro Galeazzi, Florenzo Iannone, Donato Rigante, Luca Cantarini
Our aim was to evaluate the effectiveness of adalimumab (ADA) during a 24-month study period in patients affected with Behçet's disease (BD). Clinical and therapeutic data from 100 consecutive BD patients treated with ADA were retrospectively collected and statistically analyzed. At 12-week follow-up, ADA induced clinical efficacy in 81 patients, with a mean time to response of 7.63 ± 3.43 weeks; 25 (30.9 %) patients underwent a disease relapse after 22.17 ± 1.57 months, but treatment adjustments allowed a recovery of efficacy in 11 cases...
September 27, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27663754/infectious-risk-associated-to-orthopaedic-surgery-for-rheumatoid-arthritis-patients-treated-by-anti-tnfalpha
#15
Charlotte Mabille, Yannick Degboe, Arnaud Constantin, Thomas Barnetche, Alain Cantagrel, Adeline Ruyssen-Witrand
INTRODUCTION: Although biotherapy has greatly improved the prognosis of RA many patients have still recourse to an orthopaedic surgery. The current recommendation for scheduled surgery is to discontinue administration of the biological agent two to six weeks before surgery. Reinitiating anti-TNF therapy is proposed when the patient has healed. We wanted to know whether patients treated with anti-TNFα were exposed to an infectious risk undergoing a surgical procedure and if discontinuation of anti-TNFα therapy altered the risk of surgical infection...
September 20, 2016: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/27633826/comparable-efficacy-of-abatacept-used-as-first-line-or-second-line-biological-agent-for-severe-juvenile-idiopathic-arthritis-related-uveitis
#16
Carolina Birolo, Maria Elisabetta Zannin, Svetlana Arsenyeva, Rolando Cimaz, Elisabetta Miserocchi, Margarita Dubko, Chantal Job Deslandre, Fernanda Falcini, Maria Alessio, Francesco La Torre, Ekaterina Denisova, Giorgia Martini, Irina Nikishina, Francesco Zulian
OBJECTIVE: Abatacept (ABA) has recently been proposed as second-line treatment in patients with juvenile idiopathic arthritis (JIA)-associated uveitis refractory to anti-tumor necrosis factor-α (anti-TNF) agents, but little is known about its efficacy as a first-line approach. The aim of the present study was to compare the safety and efficacy of ABA as a first-line biological agent (ABA-1) with that of ABA as a second-line treatment after 1 or more anti-TNF agents (ABA-2), in patients with severe JIA-related uveitis...
September 15, 2016: Journal of Rheumatology
https://www.readbyqxmd.com/read/27608796/evaluation-of-th9-lymphocytes-in-peripheral-blood-of-rheumatoid-arthritis-patients-and-correlation-with-anti-tumor-necrosis-factor-therapy-results-from-an-in-vitro-pivotal-study
#17
R Talotta, A Berzi, F Atzeni, D Dell'Acqua, P Sarzi Puttini, D Trabattoni
The aim of this study was to determine the prevalence of T helper 9 (Th9) lymphocytes in rheumatoid arthritis (RA) patients and to identify a possible association between the percentage of Th9 and the discontinuation of a biological treatment with an anti-tumor necrosis factor (TNF) (infliximab). We collected peripheral blood mononuclear cells (PBMCs) from 55 consecutive RA outpatients and 10 healthy controls. Among RA patients, 15 were not receiving any immunosuppressive drug, 20 were successfully treated with infliximab and 20 discontinued infliximab because of adverse events or inefficacy and were treated with other biological agents...
2016: Reumatismo
https://www.readbyqxmd.com/read/27607233/psoriatic-arthritis-treated-by-anti-tnfs-a-monocentric-trial-of-102-cases-in-auvergne-france
#18
Martin Soubrier, Bruno Pereira, Thomas Frayssac, Dihya Abdi, Marion Couderc, Coline Daron, Sandrine Malochet-Guinamand, Sylvain Mathieu, Zuzana Tatar, Anne Tournadre, Jean-Jacques Dubost
OBJECTIVES: While several registries have already evaluated the retention of anti-TNF therapy in psoriatic arthritis (PsA), they sometimes reach divergent conclusions. Our study therefore sought to assess therapeutic retention rates and predictive factors of response in a patient cohort from Auvergne, France, followed up in routine clinical practice. METHODS: Medical records of all PsA patients treated from 2002 to May 2015 were analysed. PsA diagnosis was established based on the CASPAR criteria...
August 31, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27591675/sarcoidosis-like-lesions-another-paradoxical-reaction-to-anti-tnf-therapy
#19
Amelie Decock, Gert Van Assche, Séverine Vermeire, Wim Wuyts, Marc Ferrante
BACKGROUND: Since the introduction of anti-tumour necrosis factor [TNF] therapy in inflammatory diseases, paradoxical reactions are increasingly being reported. One of these paradoxical reactions is the development of sarcoidosis-like lesions. This presentation is paradoxical since anti-TNF therapy can also be therapeutic in refractory cases of sarcoidosis. METHODS: We report two cases of sarcoidosis-like lesions under anti-TNF therapy. Both were patients with inflammatory bowel disease [IBD], treated successfully with adalimumab...
September 3, 2016: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/27556964/treatment-persistence-in-patients-with-rheumatoid-arthritis-and-ankylosing-spondylitis
#20
Marina Amaral de Ávila Machado, Cristiano Soares de Moura, Felipe Ferré, Sasha Bernatsky, Elham Rahme, Francisco de Assis Acurcio
OBJECTIVE: To evaluate treatment persistence in patients with rheumatoid arthritis and ankylosing spondylitis who started therapies with disease-modifying antirheumatic drugs (DMARD) and tumor necrosis factor blockers (anti-TNF drugs). METHODS: This retrospective cohort study from July 2008 to September 2013 evaluated therapy persistence, which is defined as the period between the start of treatment until it is discontinued, allowing for an interval of up to 30 days between the prescription end and the start of the next prescription...
August 22, 2016: Revista de Saúde Pública
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