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refractory anca vasculitis

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https://www.readbyqxmd.com/read/28539536/remission-induction-therapy-with-rituximab-for-microscopic-polyangiitis-a-feasibility-study
#1
Ayako Saito, Yoichi Takeuchi, Saeko Kagaya, Yoshie Ojima, Hirotaka Fukami, Hiroyuki Sato, Ken Matsuda, Tasuku Nagasawa
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is systemic vascular inflammation. Microscopic polyangiitis (MPA) is a major type of AAV in Japan. MPA often affects the kidneys and lungs, leading to death if untreated. Induction therapy (i.e., initial treatment) for MPA has not been optimized, although methylprednisolone and cyclophosphamide are commonly used. Recently, rituximab (RTX) (a monoclonal antibody against the protein CD20) has also been used to treat refractory AAV. RTX at 375 mg/m(2)/week for 4 weeks (i...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28508096/-off-label-biologic-therapy-of-anca-associated-and-non-anca-associated-small-vessel-vasculitis-efficacy-and-safety-analysis-of-a-national-registry-graid2
#2
N Venhoff, F Proft, H Schulze-Koops, J Holle, R E Voll, C Iking-Konert, A M Jacobi, J Henes, L Unger, O Kneitz, T Dörner, J Thiel
OBJECTIVE: To evaluate the clinical efficacy and safety of off-label biological therapies in patients with ANCA-associated vasculitis (AAV) and non-ANCA-associated small-vessel vasculitis (nAAV) in clinical practice. METHODS: The German Registry in Autoimmune Diseases 2 (GRAID2) is a national, retrospective, non-interventional, multicentre observational study (August 2006 until December 2013) on patients with autoimmune diseases refractory to standard immunosuppressive therapy treated with off-label biologicals...
May 15, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28453594/-shock-as-an-adverse-reaction-to-rituximab-case-report
#3
Estefanía Palma, Vicente González, Daniela Grünholz, María Landaeta, María Mallea, José Pérez, Tomás Armstrong
Rituximab is a plausible alternative first-line treatment of ANCA-associated vasculitis. Adverse effects related to its infusion are common and usually have a benign course. However, there have been reports of refractory cardiogenic shock simulating septic shock. We report an 81-year-old male with the diagnosis of ANCA associated vasculitis. Rituximab 500 mg was administered intravenously for a relapse. The infusion proceeded without incident. However, 24 hours after its administration the patient began with fever, chills, coughing and strong malaise...
February 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28391344/is-there-a-role-for-tnf%C3%AE-blockade-in-anca-associated-vasculitis-and-glomerulonephritis
#4
Stephen P McAdoo, Charles D Pusey
Tumour necrosis factor alpha (TNFα) is a cytokine that is pivotal in the inflammatory response. Blockade of TNFα has been shown to be effective in a number of human autoimmune diseases, including rheumatoid arthritis, raising the question of whether this approach may be effective in inflammatory kidney disease, such as ANCA-associated vasculitis (AAV). In AAV, there is considerable evidence for the role of TNFα in the pathophysiology of disease, including increased expression of TNFα mRNA in leucocytes and in renal tissue...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28214498/vasculitic-and-autoimmune-wounds
#5
REVIEW
Victoria K Shanmugam, Divya Angra, Hamza Rahimi, Sean McNish
OBJECTIVE: Chronic wounds are a major cause of morbidity and mortality. Approximately 20% to 23% of nonhealing wounds that are refractory to vascular intervention have other causes, including vasculitis, pyoderma gangrenosum, and other autoimmune diseases. The purpose of this article was to review the literature across medical and surgical specialties with regard to refractory chronic wounds associated with vasculitis and autoimmune diseases and to delineate clinical outcomes of these wounds in response to vascular and other interventions...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28062909/paediatric-anti-neutrophil-cytoplasmic-antibody-anca-associated-vasculitis-an-update-on-renal-management
#6
REVIEW
Lucy A Plumb, Louise Oni, Stephen D Marks, Kjell Tullus
The anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a group of disorders characterized by necrotizing inflammation of the small to medium vessels in association with autoantibodies against the cytoplasmic region of the neutrophil. Included in this definition are granulomatosis with polyangiitis (GPA, formerly known as Wegener's granulomatosis), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome). AAV are chronic, often relapsing diseases that can be organ or life threatening...
January 6, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28040331/therapeutic-plasma-exchange-in-rheumatic-diseases-a-university-hospital-experience
#7
Juan Pablo Córdoba, Carolina Larrarte, Cristina Estrada, Daniel G Fernández-Ávila
INTRODUCTION: Each day, evidence accumulates related to the use of therapeutic plasma exchange (TPE) in patients with rheumatic diseases. San Ignacio University Hospital has recorded all of the TPE sessions performed by the institution's apheresis group. OBJECTIVE: To describe the TPE experience of patients with rheumatologic diseases in a hospital setting (?). METHODS: Descriptive, observational, retrospective analysis. This study included analyses of the TPE sessions that were performed in patients with rheumatic diseases from November 2009 to November 2013...
December 16, 2016: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/27851530/1895-rituximab-therapy-in-refractory-diffuse-alveolar-hemorrhage-associated-with-anca-vasculitis
#8
Sahil Pandya, Mona Vashi, Robert Balk
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27684357/systemic-vasculitis-and-the-gut
#9
Ibrahim Hatemi, Gulen Hatemi, Aykut F Çelik
PURPOSE OF REVIEW: Gastrointestinal system can be involved in primary and secondary vasculitides. The recent data regarding the pathophysiology, clinical findings, diagnosis, management, and outcome of gastrointestinal involvement in different types of vasculitis are reviewed. RECENT FINDINGS: Diagnosis of gastrointestinal vasculitis may be difficult and relies mostly on imaging, because biopsy samples are hard to obtain and superficial mucosal biopsies have a low yield...
January 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/27446313/anti-neutrophil-cytoplasmic-antibodies-in-cholesterol-embolism-a-case-report-and-literature-review
#10
Jun Zhang, Heng-Yuan Zhang, Shi-Zhi Chen, Ji-Yi Huang
Cholesterol embolism is a multisystemic disorder with clinical manifestations that resemble vasculitis. Anti-neutrophil cytoplasmic antibodies (ANCA) are a defining feature of ANCA-associated vasculitis, and the presence of ANCA in cholesterol embolism complicates its differential diagnosis and treatment. At present, the role of ANCA in cholesterol embolism remains unclear and no effective treatment is currently available. The present study reports the case of an Asian male who presented with spontaneous cholesterol embolism with proteinase 3 (PR3)-specific ANCA, subacute interstitial nephritis and late-developing skin lesions...
August 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27408429/successful-management-of-refractory-dialysis-independent-wegener-s-granulomatosis-with-combination-of-therapeutic-plasma-exchange-and-rituximab
#11
Sheetal Malhotra, Hari Krishan Dhawan, Ratti Ram Sharma, Neelam Marwaha, Aman Sharma
Wegeners granulomatosis (WG) is an autoimmune, antineutrophil cytoplasmic antibody mediated necrotizing vasculitis involving renal, and upper and lower respiratory systems. Treatment relies on a combination of immunosuppressive drugs and tapering regimen of glucocorticoids. Therapeutic plasma exchange (TPE) has been recognized as a second line treatment. We report the successful use of TPE in combination with rituximab in achieving remission in a patient with WG (dialysis independent) not responding to conventional therapy...
June 2016: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/27316915/french-intensive-care-society-international-congress-r%C3%A3-animation-2016
#12
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27055639/-clinical-analysis-of-43-patients-with-eosinophilic-granulomatosis-with-polyangiitis
#13
Jie Li, Liming Zhang, Wen Zhao, Min Zhu, Yi Xue, Huaping Dai
OBJECTIVE: To describe the clinical features of eosinophilic granulomatosis with polyangiitis (EGPA). METHODS: Patients who fulfilled the criteria for EGPA managed at the Beijing Chaoyang Hospital of Capital Medical University between May 2005 and Feb 2014 were retrospectively investigated. Patients' characteristics were compared according to antineutrophil cytoplasmic antibody (ANCA) status.Patients were followed up in outpatient service or by telephone to evaluate the treatment result...
March 15, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/26894931/cyclophosphamide-treatment-induced-leukopenia-rates-in-anca-associated-vasculitis-are-influenced-by-variant-cyp450-2c9-genotypes
#14
Jan Henrik Schirmer, Jan Phillip Bremer, Frank Moosig, Julia Ulrike Holle, Peter Lamprecht, Stefan Wieczorek, Sierk Haenisch, Ingolf Cascorbi
AIM: Correlation of outcomes of cyclophosphamide (CP) therapy in antineutrophil cytoplasmic antibody-associated vasculitis with genotype polymorphisms in prodrug activating cytochrome P450 enzyme genes CYP2C9 and CYP2C19. PATIENTS & METHODS: One hundred and ninety six patients with antineutrophil cytoplasmic antibody-associated vasculitis treated with CP, either as intravenous pulse or as daily oral medication, were included. Genotypes of CYP2C9 and CYP2C19 were correlated with clinical outcomes (leukopenia, infection, urotoxicity and treatment response)...
March 2016: Pharmacogenomics
https://www.readbyqxmd.com/read/26507398/rituximab-in-the-treatment-of-refractory-scleritis-in-patients-with-granulomatosis-with-polyangiitis-wegener-s
#15
Claudia Recillas-Gispert, Juan Carlos Serna-Ojeda, Luis Felipe Flores-Suárez
PURPOSE: The purpose of this descriptive study was to evaluate the clinical response to rituximab (RTX) in patients with scleritis due to granulomatosis with polyangiitis (GPA), in patients who had proved refractory to treatment with systemic glucocorticoids and immunosuppressive agents. METHODS: Retrospective analysis of interventional case series. Single referral center study. Eight patients (12 affected eyes) due to scleritis secondary to GPA, refractory to conventional treatment were included to receive RTX as therapy for remission induction...
December 2015: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/26318692/rituximab-as-an-alternative-for-patients-with-severe-systemic-vasculitis-refractory-to-conventional-therapy-report-of-seven-cases-and-literature-review
#16
Leonardo Sales da Silva, Karla Valéria Miranda de Campos, Ana Karla Guedes de Melo, Danielle Christinne Soares Egypto de Brito, Alessandra Sousa Braz, Eutilia Andrade Medeiros Freire
The greater understanding of pathophysiology and behavior of systemic vasculitis, together with the development of therapeutic regimens with increasingly better safety and efficacy profiles, dramatically changed the prognosis of patients diagnosed with these clinical entities. Recently, the use of rituximab in the treatment of patients with ANCA-associated vasculitis in randomized clinical trials showed an important alternative in selected cases, especially patients refractory or intolerant to standard therapy with cyclophosphamide and corticosteroids...
November 2015: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/26149512/conventional-induction-and-maintenance-treatment-of-antineutrophil-cytoplasmic-antibodies-associated-vasculitis-still-of-value-for-our-patients
#17
REVIEW
Vladimir Tesar, Zdenka Hruskova
INTRODUCTION: Antineutrophil cytoplasmic antibodies-associated vasculitis (AAV) is a group of autoimmune diseases characterized by the necrotizing inflammation of small vessels and associated with the antineutrophil cytoplasmic antibodies. Treatment of AAV can be divided into the induction phase aimed at achieving remission of the disease and the maintenance phase aimed at prevention of relapses. Long-term outcome of AAV dramatically improved with the introduction of cyclophosphamide...
2015: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/26021670/update-on-the-treatment-of-anca-associated-vasculitis
#18
REVIEW
Rona M Smith
The introduction of glucocorticoids and cyclophosphamide has transformed ANCA associated vasculitis (AAV) from a fatal to a largely treatable condition. Over the past 40 years, considerable progress has been made in refining immunosuppressive regimens with a focus on minimising toxicity. As knowledge of the pathogenesis of AAV grows, it is mirrored by the availability of biological agents. Lymphocyte and cytokine targeted agents have been evaluated for the treatment of AAV and are entering the routine therapeutic arena with the potential to improve patient outcomes...
June 2015: La Presse Médicale
https://www.readbyqxmd.com/read/26000148/intravenous-immunoglobulin-therapy-in-vasculitic-ulcers-a-case-of-polyarteritis-nodosa
#19
Petra M Pego, Inês Aguiar Câmara, José Pedro Andrade, João Matos Costa
INTRODUCTION: Polyarteritis nodosa (PAN) is a systemic necrotizing medium-size-vessel vasculitis with variable clinical manifestations. Diagnosis is confirmed by histology or angiography. The mainstay of treatment is corticosteroids alone or combined with cyclophosphamide (CYF). CASE REPORT: Seventy-one-year-old female, follow-up started in 1997 at the age of 56 for suspected relapsing febrile viral exanthema. Skin biopsy was performed and the diagnosis of lymphomatoid papulosis was made, with complete response to treatment with dapsone...
December 2013: Auto- Immunity Highlights
https://www.readbyqxmd.com/read/25951692/lower-doses-of-rituximab-in-remission-induction-for-refractory-granulomatosis-with-polyangiitis
#20
Katarzyna Wawrzycka-Adamczyk, Anna Zugaj, Anna Włudarczyk, Joanna Kosałka, Jan Sznajd, Stanisława Bazan-Socha, Jacek Musiał
INTRODUCTION: Recently, rituximab (RTX)--monoclonal antibody against the CD20 molecule on the surface of B-lymphocytes is used in the treatment of antineutrophil cytoplasmic antibody (ANCA) associated vasculitides. Efficacy of the drug administered in so-called lymphoma treatment protocol (4 x 375 mg/m2/week) has been shown not to be inferior to cyclophosphamide. However, some data published lately suggest that rituximab could also be effective in much lower doses, which could lead to reducing side effects, but above all, the cost of the therapy...
2014: Przegla̧d Lekarski
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