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https://www.readbyqxmd.com/read/28932376/pulmonary-nodules-in-a-patient-with-rheumatoid-arthritis-which-diagnostic-approach-is-the-most-appropriate
#1
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
#2
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
#3
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...
August 9, 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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28740962/the-effect-of-corticosteroid-treatment-on-bilateral-idiopathic-granulomatous-mastitis
#8
Fatih Çiftci, İbrahim Abdurrahman, Zeynep Tatar
Idiopathic granulomatous mastitis (IGM) is the commonly encountered form of granulomatous mastitis that may result into repetitive infections and/or abscess formation. Mastitis may develop secondary to a systemic disorder such as tuberculosis, diabetes mellitus, or rheumatoid arthritis, or it may develop as an idiopathic disorder. Idiopathic granulomatous mastitis is the most frequent form of all granulomatous diseases affecting the breast. This disorder frequently presents as painful and fast-growing mass in the breast...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28739353/incidence-of-tuberculosis-among-patients-with-rheumatoid-arthritis-using-tnf-blockers-in-brazil-data-from-the-brazilian-registry-of-biological-therapies-in-rheumatic-diseases-registro-brasileiro-de-monitora%C3%A3-%C3%A3-o-de-terapias-biol%C3%A3-gicas-biobadabrasil
#9
Claudia Leiko Yonekura, Rene Donizeti Ribeiro Oliveira, David C Titton, Roberto Ranza, Aline Ranzolin, André L Hayata, Ângela Duarte, Inês G Silveira, Hellen M da S de Carvalho, Júlio C Bertacini de Moraes, Mirhelen Mendes de Abreu, Valéria Valim, Washington Bianchi, Claiton Viegas Brenol, Ivanio A Pereira, Izaias Costa, José C Macieira, José R S Miranda, Luiz S Guedes-Barbosa, Manoel B Bertolo, Maria Fátima Lobato da C Sauma, Marília B G Silva, Marlene Freire, Morton A Scheinberg, Roberto A Toledo, Sheila K F Oliveira, Vander Fernandes, Marcelo M Pinheiro, Glaucio Castro, Walber Pinto Vieira, Cesar Emile Baaklini, Antonio Ruffino-Netto, Geraldo da Rocha Castelar Pinheiro, Ieda Maria Magalhães Laurindo, Paulo Louzada-Junior
OBJECTIVES: To assess the incidence of tuberculosis and to screen for latent tuberculosis infection among Brazilians with rheumatoid arthritis using biologics in clinical practice. PATIENTS AND METHODS: This cohort study used data from the Brazilian Registry of Biological Therapies in Rheumatic Diseases (Registro Brasileiro de Monitoração de Terapias Biológicas - BiobadaBrasil), from 01/2009 to 05/2013, encompassing 1552 treatments, including 415 with only synthetic disease-modifying anti-rheumatic drugs, 942 synthetic DMARDs combined with anti-tumor necrosis factor (etanercept, infliximab, adalimumab) and 195 synthetic DMARDs combined with other biologics (abatacept, rituximab and tocilizumab)...
2017: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/28736556/ras-signaling-inhibitors-attenuate-disease-in-adjuvant-induced-arthritis-via-targeting-pathogenic-antigen-specific-th17-type-cells
#10
Morad Zayoud, Victoria Marcu-Malina, Einav Vax, Jasmine Jacob-Hirsch, Galit Elad-Sfadia, Iris Barshack, Yoel Kloog, Itamar Goldstein
The Ras family of GTPases plays an important role in signaling nodes downstream to T cell receptor and CD28 activation, potentially lowering the threshold for T-cell receptor activation by autoantigens. Somatic mutation in NRAS or KRAS may cause a rare autoimmune disorder coupled with abnormal expansion of lymphocytes. T cells from rheumatoid arthritis (RA) patients show excessive activation of Ras/MEK/ERK pathway. The small molecule farnesylthiosalicylic acid (FTS) interferes with the interaction between Ras GTPases and their prenyl-binding chaperones to inhibit proper plasma membrane localization...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28734675/safety-and-effectiveness-of-tocilizumab-in-treating-patients-with-rheumatoid-arthritis-a-three-year-study-in-taiwan
#11
Ching-Tsai Lin, Wen-Nan Huang, Chia-Wei Hsieh, Yi-Ming Chen, Der-Yuan Chen, Tsu-Yi Hsieh, Yi-Hsing Chen
OBJECTIVE: To evaluate the long-term safety and effectiveness of tocilizumab (TCZ) for the treatment of rheumatoid arthritis (RA) in a real-world clinical setting in Taiwan. METHOD: All refractory RA patients who initiated intravenous TCZ between August 2012 and March 2015 were enrolled. Data on patient characteristics, drug safety and effectiveness were collected. RESULTS: A total of 114 RA patients were recruited. Despite the majority of them (93%) had previous biologic failure, 43...
July 1, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28730751/tuberculosis-and-biologics-in-rheumatology-india-a-special-situation
#12
REVIEW
Rohini Handa, Sundeep Upadhyaya, Sanjiv Kapoor, Ramesh Jois, Bimlesh D Pandey, Anuj K Bhatnagar, Ashwani Khanna, Vishal Goyal, Kamal Kumar
India has a huge patient burden of rheumatic diseases (RDs) including rheumatoid arthritis. The use of biologics has transformed the treatment paradigm for RD; however, biologic treatment-related infections (especially tuberculosis [TB]) are an area of potential concern for TB-endemic nations like India. Anti-tumor necrosis factor (TNF) therapy impairs the physiological TNF-mediated signaling and may cause reactivation and dissemination of latent TB infection (LTBI). Careful screening is, thus, crucial in RD patients who are about to commence anti-TNF treatment...
July 21, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28695274/real-world-clinical-experience-of-biological-disease-modifying-anti-rheumatic-drugs-in-malaysia-rheumatoid-arthritis-patients
#13
Bee Eng Tan, Ai Lee Lim, Sow Lai Kan, Chong Hong Lim, Esther Ee Ling Tsang, Shereen Suyin Ch'ng, Nadiah Mohd Noor, Nurulraziquin Mohd Jamid, Cheng Lay Teh, Rachel Joshua Thundyil, Yet Lin Loh, Hwee Cheng Chong, Swee Gaik Ong, Asmahan Mohamed Ismail, Yvonne Y L Lee, Suk Chyn Gun
The effect of biologic disease modifying anti-rheumatic drugs (bDMARDs) in treating rheumatoid arthritis (RA) in real-world clinical practice remains unknown in Southeast Asia. We aimed to assess the efficacy and safety of bDMARDs among Malaysian RA patients treated in routine clinical practice. A retrospective medical chart review of RA patients from 11 government hospitals were conducted from January 2003 to January 2014. A standardized questionnaire was used to abstract patient's demographic, clinical and treatment data...
July 10, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28681585/a-simple-method-for-removing-low-density-granulocytes-to-purify-t-lymphocytes-from-peripheral-blood-mononuclear-cells
#14
Si-Gong Zhang, Yu-Xin Song, Xiao-Ming Shu, Hai-Li Shen, Han-Bo Yang, Rui-Xue Duo, Guo-Chun Wang
OBJECTIVE: Low-density granulocytes (LDGs) can form neutrophil extracellular traps (NETs) spontaneously and excessively. When peripheral blood mononuclear cells (PBMCs) are used for studying T lymphocytes, LDGs contained in the PBMCs may decrease the threshold of activating T lymphocytes by forming NETs. This study focused on the profiles of LDGs in common autoimmune diseases and methods for removing LDGs from PBMCs. METHODS: The percentages of LDGs in PBMCs from 55 patients with dermatomyositis (DM), 15 with polymyositis (PM), 42 with rheumatoid arthritis (RA), 25 with systemic lupus erythematosus (SLE), and 19 healthy controls were determined by flow cytometry...
July 2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28659665/risk-of-tuberculosis-reactivation-in-patients-with-rheumatoid-arthritis-ankylosing-spondylitis-and-psoriatic-arthritis-receiving-non-anti-tnf-targeted-biologics
#15
REVIEW
Fabrizio Cantini, Carlotta Nannini, Laura Niccoli, Linda Petrone, Giuseppe Ippolito, Delia Goletti
Tuberculosis (TB) still represents an important issue for public health in underdeveloped countries, but the use of antitumor necrosis factor agents (anti-TNF) for the treatment of inflammatory rheumatic disorders has reopened the problem also in countries with low TB incidence, due to the increased risk of TB reactivation in subjects with latent tuberculosis infection (LTBI). Over the last 5 years, several non-anti-TNF-targeted biologics have been licensed for the treatment of rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28599946/a-58-year-old-man-with-fatigue-weight%C3%A2-loss-and-diffuse-miliary-pulmonary%C3%A2-opacities
#16
Udit Chaddha, Rebekah English, Jessica Daniels, Rajat Walia, Atul C Mehta, Tanmay S Panchabhai
A 58-year-old man presented with a 6-month history of profound fatigue and a weight loss of 35 to 40 pounds. He reported occasional night sweats and mildly painful knees and elbows without swelling or redness. He denied respiratory symptoms, rashes, or fevers. He had no respiratory symptoms. The patient's history was significant for rheumatoid arthritis (with arthralgias and joint involvement), paroxysmal atrial fibrillation, and hypothyroidism. His medications included digoxin and metoprolol. He had been taking methotrexate and low-dose prednisone (5 mg) for approximately 10 years but discontinued taking these medications 2 years prior to current presentation...
June 2017: Chest
https://www.readbyqxmd.com/read/28589321/latent-tuberculosis-infection-and-tuberculosis-in-patients-with-rheumatic-diseases-treated-with-anti-tumor-necrosis-factor-agents
#17
Giovana Garziera, André Luis Bittencourt Morsch, Felipe Otesbelgue, Fernanda Luiza Staub, Penélope Esther Palominos, Claiton Viegas Brenol, Denise Rossato Silva
The introduction of biological agents, especially the tumor necrosis factor inhibitors (anti-TNF), for the treatment of rheumatic diseases increased the risk of developing tuberculosis (TB). Screening for latent TB infection (LTBI) is strongly recommended before starting therapy with anti-TNF agents. The objective of this study was to identify the prevalence of LTBI and TB among patients with rheumatic diseases on anti-TNF agents. This is a cross-sectional study. The electronic medical records of all adult patients (≥18 years old) undergoing anti-TNF treatment were reviewed...
August 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28570568/the-risk-of-tuberculosis-disease-in-rheumatoid-arthritis-patients-on-biologics-and-targeted-therapy-a-15-year-real-world-experience-in-taiwan
#18
Chong Hong Lim, Hsin-Hua Chen, Yi-Hsing Chen, Der-Yuan Chen, Wen-Nan Huang, Jaw-Ji Tsai, Tsu-Yi Hsieh, Chia-Wei Hsieh, Wei-Ting Hung, Ching-Tsai Lin, Kuo-Lung Lai, Kuo-Tung Tang, Chih-Wei Tseng, Yi-Ming Chen
The objective of this study is to determine the risk of tuberculosis (TB) disease in biologics users among rheumatoid arthritis (RA) patients in Taiwan from 2000 to 2015. This retrospective cohort study enrolled adult RA patients initiated on first biologics at Taichung Veterans General Hospital. TB risks were determined as hazard ratio (HR) with 95% confidence interval (CI) using cox regression. A total of 951 patients were recruited; etanercept (n = 443), adalimumab (n = 332), abatacept (n = 74), golimumab (n = 60), tocilizumab (n = 31) and tofacitinib (n = 11)...
2017: PloS One
https://www.readbyqxmd.com/read/28539862/risk-of-tuberculosis-reactivation-with-rituximab-therapy
#19
Amjad Alkadi, Najla Alduaiji, Ali Alrehaily
BACKGROUND: Tuberculosis (TB) is one of the world's deadliest diseases, and one-third of the world's population is infected with it. The link between antitumor necrosis factor therapy and reactivation of latent TB is well recognized. However, only limited studies have evaluated the risk of TB with rituximab, a B-cell-targeting therapeutic agent used recently for rheumatological diseases, primarily rheumatoid arthritis. Moreover, no studies have assessed this risk in TB endemic regions with a high incidence and prevalence of TB (e...
April 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28535545/portuguese-recommendations-for-the-use-of-methotrexate-in-rheumatic-diseases-2016-update
#20
Ana Catarina Duarte, Daniela Santos-Faria, Maria João Gonçalves, Alexandre Sepriano, Ana Filipa Mourão, Cátia Duarte, Joana Sousa Neves, Ana Filipa Águeda, Pedro Avila Ribeiro, Alexandra Daniel, Adriano Neto, Ana Cordeiro, Ana Rodrigues, Anabela Barcelos, Cândida Silva, Cristina Ponte, Elsa Vieira-Sousa, Filipa Teixeira, Filipa Oliveira-Ramos, Filipe Araújo, Filipe Barcelos, Helena Canhão, Helena Santos, João Ramos, Joaquim Polido-Pereira, José Tavares-Costa, José António Melo Gomes, Luís Cunha-Miranda, Lúcia Costa, Marcos Cerqueira, Margarida Cruz, Maria José Santos, Miguel Bernardes, Paula Oliveira, Pedro Abreu, Ricardo Figueira, Rita Barros, Sandra Falcão, Patrícia Pinto, Sofia Pimenta, Susana Capela, Vitor Teixeira, João Eurico Fonseca
BACKGROUND: Methotrexate (MTX) is the first-line drug in the treatment of rheumatoid arthritis (RA) and the most commonly prescribed disease modifying anti-rheumatic drug. Moreover, it is also used as an adjuvant drug in patients under biologic therapies, enhancing the efficacy of biologic agents. OBJECTIVES: To review the literature and update the Portuguese recommendations for the use of MTX in rheumatic diseases first published in 2009. METHODS: The first Portuguese guidelines for the use of MTX in rheumatic diseases were published in 2009 and were integrated in the multinational 3E Initiative (Evidence Expertise Exchange) project...
April 2017: Acta Reumatológica Portuguesa
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