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https://www.readbyqxmd.com/read/29317823/european-perspective-on-the-management-of-rheumatoid-arthritis-clinical-utility-of-tofacitinib
#1
REVIEW
Paweł Kawalec, Katarzyna Śladowska, Iwona Malinowska-Lipień, Tomasz Brzostek, Maria Kózka
Xeljanz® (tofacitinib) is an oral small-molecule inhibitor that reversibly inhibits Janus-activated kinase (JAK)-dependent cytokine signaling, thus reducing inflammation. As a result of these mechanisms, effects on the immune system such as a moderate decrease in the total lymphocyte count, a dose-dependent decrease in natural killer (NK) cell count, and an increase in B-cell count have been observed. Therefore, tofacitinib provides an innovative approach to modulating the immune and inflammatory responses in patients with rheumatoid arthritis (RA), which is especially important in individuals who do not respond to tumor necrosis factor inhibitors or show a loss of response over time...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29294598/rapid-onset-of-efficacy-predicts-response-to-therapy-with-certolizumab-plus-methotrexate-in-patients-with-active-rheumatoid-arthritis
#2
Young Mo Kang, Young-Eun Park, Won Park, Jung-Yoon Choe, Chul-Soo Cho, Seung-Cheol Shim, Sang Cheol Bae, Chang-Hee Suh, Hoon-Suk Cha, Eun Mi Koh, Yeong-Wook Song, Bin Yoo, Shin-Seok Lee, Min-Chan Park, Sang-Heon Lee, Catherine Arendt, Willem Koetse, Soo-Kon Lee
Background/Aims: The objective of this study was to determine the efficacy and safety of add-on therapy with certolizumab pegol (CZP) in active rheumatoid arthritis (RA) patients of a single ethnicity. Methods: In this 24-week, phase 3, randomized, double-blind, placebo-controlled trial, eligible patients (n = 127) were randomized 2:1 to subcutaneous CZP + methotrexate (MTX; 400 mg at week 0, 2, and 4 followed by 200 mg every 2 weeks) or placebo + MTX. Results: At week 24, the American College of Rheumatology criteria for 20% (ACR20) response rate was significantly greater with CZP + MTX than with placebo (66...
January 5, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29277097/systemic-review-agreement-between-the-latent-tuberculosis-screening-tests-among-patients-with-rheumatic-diseases
#3
Junhee Pyo, Soo-Kyung Cho, Dam Kim, Yoon-Kyoung Sung
Background/Aims: To estimate the level of agreement and positivity rates of latent tuberculosis infection (LTBI) tests prior to the use of tumor necrosis factor (TNF) inhibitors in relation to underlying rheumatic diseases and endemic tuberculosis levels. Methods: The Ovid-Medline, Embase, and Cochrane Libraries were searched for articles before October 2013 involving LTBI screening in rheumatic patients, including rheumatoid arthritis (RA), ankylosing spondylitis (AS), juvenile idiopathic arthritis (JIA), and psoriatic arthritis...
December 28, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29228529/efficacy-of-bronchial-washing-and-brushing-cytology-in-the-diagnosis-of-non-neoplastic-lung-diseases
#4
Rahil Giti, Massood Hosseinzadeh
Flexible fiberoptic bronchoscopy is often the initial technique for diagnosis of lung and bronchial tumors. Many studies have shown the high accuracy rate of bronchial washing and brushing cytology in the evaluation of neoplastic and non-neoplastic bronchopulmonary lesions. The aim of this study is to emphasize the value of the bronchial cytologic findings for diagnosis of non-neoplastic bronchopulmonary lesions. In a cross-sectional study, we retrieved all cases with bronchial washing and brushing cytology from 21 Mach 2014 to 21 December 2015...
October 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/29225201/3-bromopyruvate-as-a-potential-pharmaceutical-in-the-light-of-experimental-data
#5
Izabela Szczuka, Andrzej Gamian, Grzegorz Terlecki
3-Bromopyruvate (3-BrPA) is an halogenated analogue of pyruvic acid known for over four decades as an alkylating agent reacting with thiol groups of many proteins. It enters animal cells like a lactate: via monocarboxylic acid transporters. Increasing interest in this compound, in recent times, is mainly due to hopes associated with its anticancer action. It is based on the impairment of energy metabolism of tumor cells by inhibiting enzymes in the glycolysis pathway (hexokinase II, glyceraldehyde 3-phosphate dehydrogenase, phosphoglycerate kinase) and the oxidative phosphorylation (succinate dehydrogenase)...
December 8, 2017: Postȩpy Higieny i Medycyny Doświadczalnej
https://www.readbyqxmd.com/read/29195024/tuberculosis-risk-in-ankylosing-spondylitis-other-spondyloarthritis-and-psoriatic-arthritis-in-sweden-a-population-based-cohort-study
#6
Mirjam K de Vries, Elizabeth V Arkema, Jerker Jonsson, Judith Bruchfeld, Lennart Th Jacobsson, Johan Askling
OBJECTIVES: Rheumatoid arthritis (RA) is a risk factor for tuberculosis (TB), particularly following treatment with biologicals. Since these therapies are increasingly used in ankylosing spondylitis (AS), other types of spondyloarthritis (SpA) and psoriatic arthritis (PsA), we investigated the corresponding TB risks in these patients. METHODS: We identified individuals with AS/SpA/PsA, and non-AS/SpA/PsA comparators by linking Swedish national Patient, Population, TB and Rheumatology registers, and followed them for TB occurrence...
December 1, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/29193951/-disseminated-tuberculosis-in-a-patient-with-overlap-syndrome-challenges-in-preventing
#7
Sergio García-Méndez, Lamberto Miguel Caballero-Zavala, Imelda García-Olivera, Fortunato Vásquez-Manuel, Gerardo Pérez-Bustamante, Fabián Tafoya-Ramírez
Patients with autoimmune rheumatic diseases are at increased risk for developing infections and these are associated with increased morbidity and mortality from these diseases, especially in patients with systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis and autoimmune inflammatory myopathies. The objective of this paper is to address the challenges in detecting latent tuberculosis in immunosuppressed patients and the initiation of prophylactic treatment because currently there are no well-defined guidelines indicating what action to take for detection and treatment; so far the available scientific evidence is scarce and some methodological shortcomings...
September 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29184553/tumor-necrosis-factor-alpha-targeting-can-protect-against-arthritis-with-low-sensitization-to-infection
#8
Nadia Belmellat, Luca Semerano, Noria Segueni, Diane Damotte, Patrice Decker, Bernhard Ryffel, Valérie Quesniaux, Marie-Christophe Boissier, Eric Assier
Tumor necrosis factor-alpha (TNF-α) blockade is an effective treatment for rheumatoid arthritis (RA) and other inflammatory diseases, but in patients, it is associated with reduced resistance to the infectious agents Mycobacterium tuberculosis and Listeria monocytogenes, among others. Our goal was to model infection and arthritis in mice and to compare etanercept, a currently used anti-TNF-α inhibitor, to an anti-TNF-α vaccine. We developed a murine surrogate of the TNF-α kinoid and produced an anti-murine TNF-α vaccine (TNFKi) composed of keyhole limpet hemocyanin conjugated to TNF-α, which resulted in anti-TNF-α antibody production in mice...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29150737/risk-of-active-tuberculosis-in-patients-with-inflammatory-arthritis-receiving-tnf-inhibitors-a-look-beyond-the-baseline-tuberculosis-screening-protocol
#9
Alina Soare, Ana Maria Gheorghiu, Victoria Aramă, Dragoș Bumbăcea, Rucsandra Dobrotă, Raida Oneaţă, Simona Pintilie, Mihaela Milicescu, Ioan Ancuţa, Andrei Martin, Mariana Sasu, Claudia Ciofu, Liviu Macovei, Victor Stoica, Mihai Bojincă, Carina Mihai
Tuberculosis (TB) is a major concern in patients receiving TNF inhibitors (TNFi). This study aimed to assess the incidence of active TB and the efficacy of TB prevention measures used over the years, and to determine risk factors for developing TB, in a single-centre cohort of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) receiving TNFi. Data of all patients in whom treatment with TNFi was initiated in our rheumatology clinic until December 1st 2014 have been retrospectively analysed...
November 17, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/29092064/perspectives-on-polycystic-ovary-syndrome-is-polycystic-ovary-syndrome-research-underfunded
#10
Soumia Brakta, Daria Lizneva, Kateryna Mykhalchenko, Adonis Imam, Walidah Walker, Michael P Diamond, Ricardo Azziz
Context: The Polycystic Ovary Syndrome (PCOS) is a common endocrine-metabolic abnormality with a worldwide prevalence of 4%-21%, depending on diagnostic criteria. The National Institutes of Health (NIH) is the largest single funding agency in the world, invests nearly $30.0 billion annually in biomedical research. Evidence Acquisition: Utilizing the NIH RePorter system we searched for all grants awarded by the NIH for PCOS and three other disorders with comparable degrees of morbidity, and similar or lower mortality and prevalences (i...
September 19, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29078639/nodal-upstaging-effects-of-instrumentation-and-three-dimensional-view-in-clinical-stage-i-lung-cancer
#11
REVIEW
Alper Toker, Mehmet Oğuzhan Özyurtkan, Erkan Kaba
Nodal upstaging after surgical intervention for non-small cell lung cancer (NSCLC) is defined as the presence of unsuspected pathologic hilar (pN1) or mediastinal (pN2) disease detected during the final histopathologic evaluation of surgical specimens. The prevalence of pathologic nodal upstaging is used as a quality measure for the definition of the completeness of the nodal dissection. Risk factors for nodal upstaging may be patient-related (history of tuberculosis, rheumatoid arthritis, and diabetes mellitus), or tumor-related (central tumor, higher T stage, higher SUVmax value, or adenocarcinoma)...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29054459/lymphocyte-subset-analysis-in-quantiferon-tb-gold-plus-and-t-spot-tb-for-latent-tuberculosis-infection-in-rheumatoid-arthritis
#12
Hidetoshi Igari, Satoru Ishikawa, Takuya Nakazawa, Yoshihiro Oya, Hidekazu Futami, Mizue Tsuyuzaki, Kiminori Suzuki, Ryutaro Matsumura
Rheumatoid arthritis (RA) is an immune mediated inflammatory disorder, and immune suppressive drugs are prescribed. RA patients receiving treatments are in a kind of immunosuppressive condition that presents increased risk of developing active tuberculosis. Accurate diagnosis of latent tuberculosis infection (LTBI) is recommended for RA. QuantiFERON(®)-TB Gold Plus (QFT-Plus), a novel IGRA, has two tubes (TB1 and TB2). TB2 is designed to elicit both CD4 and CD8 T-cell responses, with expected increased sensitivity...
October 18, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29028148/follow-up-of-1887-patients-receiving-tumor-necrosis-alpha-antagonists-tuberculin-skin-test-conversion-and-tuberculosis-risk
#13
Tulin Cagatay, Zuleyha Bingol, Esen Kıyan, Zeynep Yegin, Gulfer Okumus, Orhan Arseven, Feyza Erkan, Ziya Gulbaran, Mustafa Erelel, Turhan Ece, Penbe Cagatay', Zeki Kılıçaslan
OBJECTIVES: To evaluate the characteristics of patients who developed tuberculosis while receiving tumor necrosis factor-alpha (TNF-α) antagonists and the related factors with tuberculosis. METHODS: Patient's demographics, tuberculin skin test (TST), isoniazid prophylaxis, type of TNF-α antagonist were recorded. TST conversion (>5mm increase) was evaluated for patients who had baseline and 1-year TST. RESULTS: Files of 1887 patients who were receiving TNF-α antagonists between August2005 and June 2015 were evaluated...
October 13, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28932376/pulmonary-nodules-in-a-patient-with-rheumatoid-arthritis-which-diagnostic-approach-is-the-most-appropriate
#14
Ines Mahmoud, Aicha Ben Tekaya, Rawdha Tekaya, Olfa Saidane, Leila Gafsi, Mathilde Benhammou, Fautrel Bruno, Leila Abdelmoula
BACKGROUND: Pulmonary nodular excavation should firstly evoke tuberculosis or necrosis broncho-pulmonary tumor, particularly: epidermoid carcinoma. The case discussed here illustrated these difficulties in patients with rheumatoid arthritis (RA). CASE PRESENTATION: A 63-year-old woman was presented with a-three-year history of RA and a recent discovery of an excavated pulmonary nodule. Initial investigations focused on a rheumatoid origin. The evolution of the disease was worrisome and surgical exploration was deemed mandatory...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28852481/infectious-complications-of-rituximab-therapy-in-renal-disease
#15
Andrew Nixon, Leanne Ogden, Alexander Woywodt, Ajay Dhaygude
Rituximab, an anti-CD20 monoclonal antibody, was originally used to treat B-cell malignancies. Its use has significantly increased in recent years, as it is now also used to treat a variety of autoimmune diseases including rheumatoid arthritis and ANCA-associated vasculitis (AAV). Initial studies suggested that the adverse effects of rituximab were minimal. Though the risk of malignancy with rituximab-based immunosuppressive regimens appears similar to that of the general population, there are now concerns regarding the risk of infectious complications...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28821374/il-17-production-of-neutrophils-enhances-antibacteria-ability-but-promotes-arthritis-development-during-mycobacterium-tuberculosis-infection
#16
Shengfeng Hu, Wenting He, Xialin Du, Jiahui Yang, Qian Wen, Xiao-Ping Zhong, Li Ma
To our knowledge, no studies have examined the role of IL-17 production by neutrophils in immune defense against Mycobacterium tuberculosis (MTB) infection and the pathogenesis of rheumatoid arthritis (RA) caused by MTB infection. Here, we determined that neutrophils express IL-17 in an autocrine IL-6- and IL-23-dependent manner during MTB infection. MTB H37Rv-induced IL-6 production was dependent on the NF-κB, p38, and JNK signaling pathways; however, IL-23 production was dependent on NF-κB and EKR in neutrophils...
September 2017: EBioMedicine
https://www.readbyqxmd.com/read/28811354/safety-and-efficacy-of-baricitinib-through-128-weeks-in-an-open-label-longterm-extension-study-in-patients-with-rheumatoid-arthritis
#17
Edward C Keystone, Mark C Genovese, Douglas E Schlichting, Inmaculada de la Torre, Scott D Beattie, Terence P Rooney, Peter C Taylor
OBJECTIVE: To assess the safety and efficacy of baricitinib in patients with rheumatoid arthritis (RA) up to 128 weeks in a phase IIb study (NCT01185353). METHODS: After a 24-week blinded period, eligible patients entered an initial 52-week open-label extension (OLE); patients receiving 8 mg once daily (QD) continued with that dose and all others received 4 mg QD. Doses could be escalated to 8 mg QD at 28 or 32 weeks at investigator discretion when ≥ 6 tender and ≥ 6 swollen joints were present...
August 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28794078/long-term-efficacy-and-safety-in-patients-with-rheumatoid-arthritis-continuing-on-sb4-or-switching-from-reference-etanercept-to-sb4
#18
Paul Emery, Jiří Vencovský, Anna Sylwestrzak, Piotr Leszczyński, Wieslawa Porawska, Barbara Stasiuk, Joanna Hilt, Zdenka Mosterova, Soo Yeon Cheong, Jeehoon Ghil
OBJECTIVES: SB4 (Benepali, Brenzys) is a biosimilar of reference etanercept (ETN). In a randomised, double-blind, 52-week study, SB4 demonstrated comparable efficacy and safety to ETN in patients with rheumatoid arthritis (RA). The open-label extension period evaluated long-term efficacy, safety and immunogenicity when continuing SB4 versus switching from ETN to SB4. METHODS: In the randomised, double-blind phase, patients received weekly subcutaneous administration of 50 mg SB4 or ETN with background methotrexate for up to 52 weeks...
August 9, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28764227/portal-venous-thrombosis-disseminated-tuberculosis-in-rheumatoid-arthritis
#19
Vasanthi Natarajan, Kevin John, David Jose, Pradeep Kalaiselvan, Ashok Kumar Das
Vascular thrombosis is one of the complications of tuberculosis. Deep vein thrombosis and pulmonary thrombosis have been reported with pulmonary and extrapulmonary tuberculosis. Splenic involvement in abdominal tuberculosis is among the rarest manifestations. Disseminated tuberculosis is predominantly reported in rheumatoid arthritis following ingestion of biological agents. Here, we report a case of disseminated tuberculosis in a rheumatoid arthritis patient who was on steroids and methotrexate for a long period, presenting with multiple splenic lesion and portal vein thrombosis, which was not reported earlier...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28754958/a-study-on-the-risk-of-fungal-infection-with-tofacitinib-cp-690550-a-novel-oral-agent-for-rheumatoid-arthritis
#20
Yong Chen, Fang-Yuan Gong, Zhen-Jun Li, Zheng Gong, Zhe Zhou, Shu-Yan Ma, Xiao-Ming Gao
Tofacitinib (CP-690550), an oral Janus kinase inhibitor, has shown significant efficacy in the treatment of rheumatoid arthritis through blocking the signaling pathways of pro-inflammatory cytokines. However, recent evidence suggests that long-term tofacitinib treatment is associated with increased risk of infection (e.g. tuberculosis) in patients. In the present study, we illustrate that tofacitinib administration significantly reduced the survival rate of mice given lethal or sub-lethal dose challenge with Candida albicans...
July 28, 2017: Scientific Reports
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