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https://www.readbyqxmd.com/read/28086756/concomitant-disseminated-histoplasmosis-and-disseminated-tuberculosis-after-tumor-necrosis-factor-inhibitor-treatment-a-case-report
#1
Juan E Muñoz-Oca, Martha L Villarreal Morales, Aracelis Nieves-Rodriguez, Lemuel Martínez-Bonilla
BACKGROUND: Tumor necrosis factor antagonist inhibitors have transformed the approach to patients with severe autoimmune conditions, such as rheumatoid arthritis. Although the therapy can be highly effective, TNF-α inhibitors are associated with an increased risk of opportunistic infections. CASE PRESENTATION: Here, we report a case of concomitant disseminated histoplasmosis and tuberculosis in a 65-year-old female with rheumatoid arthritis treated with TNF-α inhibitor...
January 13, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28063416/nontuberculous-mycobacterial-infection-in-rheumatoid-arthritis-patients-a-single-center-experience-in-south-korea
#2
Doo-Ho Lim, Yong-Gil Kim, Tae Sun Shim, Kyung-Wook Jo, Byeongzu Ghang, Soo Min Ahn, Seokchan Hong, Chang-Keun Lee, Bin Yoo
Background/Aims: Nontuberculous mycobacteria (NTM) infection has been increasing worldwide in both general population and immunocompromised patients, which has also been reported in rheumatoid arthritis (RA) patients. This study aimed to identify the incidence and clinical characteristics of NTM infection in RA patients living in tuberculosis (TB) infection endemic area. Methods: We performed a retrospective analysis of NTM infection cases in our RA registry at a tertiary referral center from January 1995 to December 2013...
January 6, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28058538/factors-influencing-the-choice-of-first-and-second-line-biologic-therapy-for-the-treatment-of-rheumatoid-arthritis-real-life-data-from-the-italian-lorhen-registry
#3
Sara Monti, Catherine Klersy, Roberto Gorla, Piercarlo Sarzi-Puttini, Fabiola Atzeni, Raffaele Pellerito, Enrico Fusaro, Giuseppe Paolazzi, Pier Andrea Rocchetta, Ennio Giulio Favalli, Antonio Marchesoni, Roberto Caporali
According to international recommendations, the selection of the biologic disease modifying anti-rheumatic drug (bDMARD) for rheumatoid arthritis (RA) is mainly left to the clinician's preference. We analyzed the real-life factors influencing the first-line choice or the switching strategy, focusing on the prescription of abatacept (ABA) or tocilizumab (TCZ) compared to TNFα inhibitors (TNFi). Patients enrolled in the Lombardy Rheumatology Network (LORHEN) Registry after January 1, 2010, when all considered bDMARD agents were available, were included...
January 5, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28012936/results-of-daily-oral-dosing-with-up-to-60-000-international-units-iu-of-vitamin-d3-for-2-to-6-years-in-3-adult-males
#4
REVIEW
Patrick McCullough, Jeffrey Amend
In the 1930's and 1940's, vitamin D was reported to be an effective treatment for a number of diseases, including asthma, psoriasis, rheumatoid arthritis, rickets and tuberculosis. High doses were used, 60,000 to 300,000 IU a day for asthma, and 200,000 to 600,000 IU a day for rheumatoid arthritis. Toxicity from hypercalcemia occurred after prolonged oral dosing with these supraphysiologic doses. Assays for measuring vitamin D in the blood were not available, and blood levels of vitamin D associated with hypercalcemia were unknown...
December 21, 2016: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/27993829/filgotinib-glpg0634-gs-6034-an-oral-jak1-selective-inhibitor-is-effective-in-combination-with-methotrexate-mtx-in-patients-with-active-rheumatoid-arthritis-and-insufficient-response-to-mtx-results-from-a-randomised-dose-finding-study-darwin-1
#5
R Westhovens, P C Taylor, R Alten, D Pavlova, F Enríquez-Sosa, M Mazur, M Greenwald, A Van der Aa, F Vanhoutte, C Tasset, P Harrison
OBJECTIVES: To evaluate the efficacy and safety of different doses and regimens of filgotinib, an oral Janus kinase 1 inhibitor, as add-on treatment to methotrexate (MTX) in patients with active rheumatoid arthritis (RA) and inadequate response to MTX. METHODS: In this 24-week phase IIb study, patients with moderate-to-severe active RA receiving a stable dose of MTX were randomised (1:1:1:1:1:1:1) to receive placebo or 50, 100 or 200 mg filgotinib, administered once daily or twice daily...
December 19, 2016: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/27993828/filgotinib-glpg0634-gs-6034-an-oral-selective-jak1-inhibitor-is-effective-as-monotherapy-in-patients-with-active-rheumatoid-arthritis-results-from-a-randomised-dose-finding-study-darwin-2
#6
A Kavanaugh, J Kremer, L Ponce, R Cseuz, O V Reshetko, M Stanislavchuk, M Greenwald, A Van der Aa, F Vanhoutte, C Tasset, P Harrison
OBJECTIVES: To evaluate the efficacy and safety of different doses of filgotinib, an oral Janus kinase 1 inhibitor, as monotherapy in patients with active rheumatoid arthritis (RA) and previous inadequate response to methotrexate (MTX). METHODS: In this 24-week phase IIb study, patients with moderately to severely active RA were randomised (1:1:1:1) to receive 50, 100 or 200 mg filgotinib once daily, or placebo, after a ≥4-week washout from MTX. The primary end point was the percentage of patients achieving an American College of Rheumatology (ACR)20 response at week 12...
December 19, 2016: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/27924643/risk-of-infections-using-anti-tnf-agents-in-rheumatoid-arthritis-psoriatic-arthritis-and-ankylosing-spondylitis-a-systematic-review-and-meta-analysis
#7
Silvia Minozzi, Stefanos Bonovas, Theodore Lytras, Valentina Pecoraro, Marien González-Lorenzo, Anan Judina Bastiampillai, Eugenia Maria Gabrielli, Andrea Carlo Lonati, Lorenzo Moja, Michela Cinquini, Valentina Marino, Andrea Matucci, Giuseppe Maria Milano, Giuliano Tocci, Raffaele Scarpa, Delia Goletti, Fabrizio Cantini
Five anti-tumor necrosis factor (anti-TNF) agents have received regulatory approval for use in rheumatology: adalimumab, golimumab, infliximab, certolizumab, and etanercept. Apart from their well-documented therapeutic value, it is still uncertain to what extent they are associated with an increased risk of infectious adverse events. Areas covered: We conducted a systematic review and meta-analysis of published randomized studies to determine the effect of anti-TNF drugs on the occurrence of infectious adverse events (serious infections; tuberculosis; opportunistic infections; any infection)...
December 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27917631/-15-years-experience-with-biological-therapy-of-inflammatory-rheumatic-diseases-in-czech-national-register-attra
#8
Karel Pavelka, Liliana Šedová, Karel Hejduk, Ladislav Dušek
The publication is summarizing application of biological DMARDs in autoimmune inflammatory rheumatic diseases.Up to now conventional therapy, which for example in rheumatoid arthritis was application of methotrexate (MTx) in combination with glucocorticoids, was effective, but the remission as a target was achieved in small proportion of patients and also there was little effect on structural progression of diseases. Biological therapy was great advance because response was achieved in ¾ patients who failed MTx...
2016: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/27882832/geographic-variation-in-the-quality-and-cost-of-care-for-patients-with-rheumatoid-arthritis
#9
Jason Shafrin, Arijit Ganguli, Yuri Sanchez Gonzalez, Jin Joo Shim, Seth A Seabury
BACKGROUND: There is considerable push to improve value in health care by simultaneously increasing quality while lowering or containing costs. However, for diseases that are best treated with comparatively expensive treatments, such as rheumatoid arthritis (RA), there could be tension between these aims. In this study, we measured geographic variation in quality, access, and cost for patients with RA, a disease with effective but costly specialty treatments. OBJECTIVE: To assess the geographic differences in the quality, access, and cost of care for patients with RA...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27861525/elevated-neopterin-levels-are-associated-with-increased-tuberculosis-risk-in-rheumatoid-arthritis-patients-with-quantiferon-conversion-during-biologic-therapy
#10
Der-Yuan Chen, Ju-Pi Li, Yi-Ming Chen, Tsai-Ling Liao, Hsin-Hua Chen, Chia-Wei Hsieh, Yea-Wen Yeh, Joung-Liang Lan
QuantiFERON-TB-Gold (QFT-G) conversion is frequently observed in rheumatoid arthritis (RA) patients receiving biologic therapy. However, there have not been any known biomarkers available for detecting tuberculosis (TB) in QFT-G converters. We aimed to evaluate clinical utility of cytokines/chemokines for detecting TB in patients with QFT-G conversion. Among a total of 227 RA patients who underwent QFT-G assay, 187 QFT-G-negative patients received biologic therapy without isoniazid prophylaxis. QFT-G assay was repeated at week 52 of biologic therapy or at the time of TB diagnosis...
2016: PloS One
https://www.readbyqxmd.com/read/27849414/clinical-features-and-complications-of-scleritis-in-chinese-patients
#11
Peizeng Yang, Zi Ye, Jihong Tang, Liping Du, Qingyun Zhou, Jian Qi, Liang Liang, Lili Wu, Chaokui Wang, Mei Xu, Yuan Tian, Aize Kijlstra
PURPOSE: To characterize the clinical features of scleritis in Chinese patients. METHODS: The history, demographics, ocular findings, auxiliary examination findings, complications, systemic diseases and therapeutic effects were analyzed retrospectively. RESULTS: The study included 124 male and 169 female patients with scleritis. Anterior and posterior scleritis were, respectively, found in 243 and 42 patients. The other eight patients had both anterior and posterior involvement...
November 16, 2016: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/27832150/one-year-tuberculosis-risk-in-rheumatoid-arthritis-patients-starting-their-first-tumor-necrosis-factor-inhibitor-therapy-from-2008-to-2012-in-taiwan-a-nationwide-population-based-cohort-study
#12
Chong-Hong Lim, Ching-Heng Lin, Der-Yuan Chen, Yi-Ming Chen, Wen-Cheng Chao, Tsai-Ling Liao, Hsin-Hua Chen
OBJECTIVE: To investigate the risk of tuberculosis (TB) among rheumatoid arthritis (RA) patients within 1 year after initiation of tumor necrosis factor inhibitor (TNFi) therapy from 2008 to 2012. METHODS: We used the 2003-2013 Taiwanese National Health Insurance Research Database to identify RA patients who started any RA-related medical therapy from 2008 to 2012. Those who initiated etanercept or adalimumab therapy during 2008-2012 were selected as the TNFi group and those who never received biologic disease-modifying anti-rheumatic drug therapy were identified as the comparison group after excluding the patients who had a history of TB or human immunodeficiency virus infection/acquired immune deficiency syndrome...
2016: PloS One
https://www.readbyqxmd.com/read/27817127/the-conversion-rate-of-tuberculosis-screening-tests-during-biological-therapies-in-patients-with-rheumatoid-arthritis
#13
Giovanna Cuomo, Virginia D'Abrsca, Daniela Iacono, Ilenia Pantano
Screening for active tuberculosis (TB) and latent TB infection (LTBI) is mandatory to the initiation of biological therapy in patients with rheumatic diseases. To determine the prevalence of LTBI in patients with rheumatoid arthritis before treatment with biological therapy (anti-TNF, abatacept, and tocilizumab) and the rate of TB conversion during treatment in rheumatoid arthritis (RA) patients, we evaluated the file of 275 patients with RA treated with biological agents. We considered patients with negative baseline TB screening (tuberculin skin test (TST); quantiferon TB gold in tube (QFT-GIT); chest x-ray) and with rescreening for a TB assay every year...
November 5, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27803138/five-year-safety-data-from-5-clinical-trials-of-subcutaneous-golimumab-in-patients-with-rheumatoid-arthritis-psoriatic-arthritis-and-ankylosing-spondylitis
#14
Jonathan Kay, Roy Fleischmann, Edward Keystone, Elizabeth C Hsia, Benjamin Hsu, Yiying Zhou, Neil Goldstein, Jürgen Braun
OBJECTIVE: Assess 5-year golimumab (GOL) safety in rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). METHODS: Subcutaneous (SC) GOL (50 mg or 100 mg every 4 weeks) was evaluated in phase 3 trials of patients with active RA, PsA, and AS. Safety data through Year 5 were pooled across 3 RA trials [1 each evaluating methotrexate (MTX)-naive, MTX-experienced, and antitumor necrosis factor (TNF)-experienced patients], 1 PsA trial, and 1 AS trial...
December 2016: Journal of Rheumatology
https://www.readbyqxmd.com/read/27776599/comparative-utility-of-interferon-%C3%AE-release-assay-quantiferon-%C3%A2-tb-git-and-t-spot-%C3%A2-tb-in-rheumatoid-arthritis
#15
R Matsumura, H Igari, T Nakazawa, S Ishikawa, M Tsuyuzaki, K Suzuki, F Yamagishi
SETTING: National hospital for tuberculosis (TB) and rheumatoid arthritis (RA) in Japan. OBJECTIVE: To compare two interferon-γ release assays (IGRAs), QuantiFERON(®)-TB Gold In-Tube (QFT) and T-SPOT(®).TB (T-SPOT), in RA patients for detecting latent tuberculous infection (LTBI). DESIGN: QFT and T-SPOT were conducted concurrently in 230 prospectively enrolled RA patients. RESULTS: There were no active TB patients...
November 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27735145/anti-ccp-antibodies-in-tuberculosis
#16
Vikram Londhey, Meghav M Shah
INTRODUCTION: Anti-cyclic citrullinated peptide (anti-CCP) antibodies have been considered very specific for rheumatoid arthritis (RA). Some studies have shown that these antibodies can be positive in infectious diseases like TB, HIV, etc. METHODS: Fifty patients of tuberculosis both pulmonary and extra-pulmonary were enrolled in the study from inpatient and outpatient departments from May 2012 to November 2013. Anti-CCP antibody test was done in all the patient by ELISA...
May 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27721903/combination-leflunomide-and-methotrexate-in-refractory-rheumatoid-arthritis-a-biologic-sparing-approach
#17
Bridget Hodkinson, Kingsley Ross Magomero, Mohammed Tikly
BACKGROUND: In resource-constrained settings where biologic agents are not widely available, there are limited therapeutic options for patients with rheumatoid arthritis (RA) refractory to other synthetic disease modifying antirheumatic (DMARD) therapies. The aim of this study is to evaluate the effectiveness and safety of leflunomide (LEF) with methotrexate (MTX) in refractory RA. METHODS: A retrospective record review of adult RA patients treated with LEF/MTX...
October 2016: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/27689735/baricitinib-in-patients-with-inadequate-response-or-intolerance-to-conventional-synthetic-dmards-results-from-the-ra-build-study
#18
Maxime Dougados, Désirée van der Heijde, Ying-Chou Chen, Maria Greenwald, Edit Drescher, Jiajun Liu, Scott Beattie, Sarah Witt, Inmaculada de la Torre, Carol Gaich, Terence Rooney, Douglas Schlichting, Stephanie de Bono, Paul Emery
BACKGROUND: Baricitinib is an oral, reversible, selective Janus kinase 1 and 2 inhibitor. METHODS: In this phase III, double-blind 24-week study, 684 biologic disease-modifying antirheumatic drug (DMARD)-naïve patients with rheumatoid arthritis and inadequate response or intolerance to ≥1 conventional synthetic DMARDs were randomly assigned 1:1:1 to placebo or baricitinib (2 or 4 mg) once daily, stratified by region and the presence of joint erosions. Endpoint measures included American College of Rheumatology 20% response (ACR20, primary endpoint), Disease Activity Score (DAS28) and Simplified Disease Activity Index (SDAI) score ≤3...
January 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/27627085/-adverse-effects-of-biological-therapy-in-rheumatology
#19
Marta Olejárová
UNLABELLED: The biological treatment which is the most effective type of therapy for inflammatory rheumatic diseases, has become part of a standard clinical rheumatology practice in recent years. Thousands of patients in the Czech Republic with rheumatoid arthritis, different forms of spondyloarthritides and with psoriatic arthritis are now successfully treated in this way. The following medications are registered in the Czech Republic for the treatment of rheumatic diseases: infliximab, adalimumab, golimumab, certolizumab pegol, etanercept, abatacept, rituximab, tocilizumab and belimumab, newly also secukinumab...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27621864/characteristics-of-patients-with-pseudochylothorax-a-systematic-review
#20
Adriana Lama, Lucía Ferreiro, María E Toubes, Antonio Golpe, Francisco Gude, José M Álvarez-Dobaño, Francisco J González-Barcala, Esther San José, Nuria Rodríguez-Núñez, Carlos Rábade, Carlota Rodríguez-García, Luis Valdés
BACKGROUND: Pseudochylothorax (PCT) (cholesterol pleurisy or chyliform effusion) is a cholesterol-rich pleural effusion (PE) that is commonly associated with chronic inflammatory disorders. Nevertheless, the characteristics of patients with PCT are poorly defined. METHODS: A systematic review was performed across two electronic databases searching for studies reporting clinical findings, PE characteristics, and the most effective treatment of PCT. Case descriptions and retrospective studies were included...
August 2016: Journal of Thoracic Disease
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