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https://www.readbyqxmd.com/read/28422003/efficacy-and-safety-of-leflunomide-as-an-adjuvant-drug-in-refractory-dermatomyositis-with-primarily-cutaneous-activity
#1
Renata C de Souza, Fernando H C de Souza, Renata Miossi, Samuel K Shinjo
OBJECTIVES: To evaluate leflunomide as an adjuvant drug in refractory dermatomyositis (DM) with primarily cutaneous activity. METHODS: A retrospective, single-centre, cohort study including 18 adult patients with DM (classical or clinically amyopathic DM) and cutaneous activity from 2001 to 2016 was conducted. Patients were dependent on glucocorticoid and refractory to at least two full-dose immunosuppressants/immunomodulators or presented previous adverse events with immunobiological drugs...
April 18, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28421991/patterns-in-use-and-costs-of-conventional-and-biologic-disease-modifying-anti-rheumatic-drugs-in-australia
#2
Ellen Donges, Christine Staatz, Helen Benham, Paul Kubler, Samantha A Hollingworth
OBJECTIVES: The aim of this study was to characterise the use and costs of subsidising conventional disease-modifying anti-rheumatic drugs (DMARDs) and biologic DMARDs in Australia from 2004-2014 through pharmaceutical benefits schemes. METHODS: Dispensing and expenditure data on conventional and biologic DMARDs were extracted from Medicare Australia and temporal trends were analysed. Medicine use was standardised in terms of the defined daily dose (DDD) per 1,000 population per day (DDD/1,000 population/day)...
April 18, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28418334/juvenile-idiopathic-arthritis
#3
Kenan Barut, Amra Adrovic, Sezgin Şahin, Özgür Kasapçopur
Juvenile idiopathic arthritis is the most common chronic rheumatic disease of unknown aetiology in childhood and predominantly presents with peripheral arthritis. The disease is divided into several subgroups, according to demographic characteristics, clinical features, treatment modalities and disease prognosis. Systemic juvenile idiopathic arthritis, which is one of the most frequent disease subtypes, is characterized by recurrent fever and rash. Oligoarticular juvenile idiopathic arthritis, common among young female patients, is usually accompanied by anti-nuclear antibodie positivity and anterior uveitis...
April 5, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28415636/comparison-of-combined-leflunomide-and-low-dose-corticosteroid-therapy-with-full-dose-corticosteroid-monotherapy-for-progressive-iga-nephropathy
#4
Lulin Min, Qin Wang, Liou Cao, Wenyan Zhou, Jiangzi Yuan, Minfang Zhang, Xiajing Che, Shan Mou, Wei Fang, Leyi Gu, Mingli Zhu, Ling Wang, Zanzhe Yu, Jiaqi Qian, Zhaohui Ni
IgA nephropathy is the most common primary glomerulonephritis and one of the leading causes of end-stage renal disease. We performed a randomized, controlled, prospective, open-label trial to determine whether leflunomide combined with low-dose corticosteroid is safe and effective for the treatment of progressive IgA nephropathy, as compared to full-dose corticosteroid monotherapy. Biopsy-proved primary IgA nephropathy patients with an estimated glomerular filtration rate ≥ 30 ml/min/1.73m2 and proteinuria ≥1...
March 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28405598/clearance-of-bk-virus-nephropathy-by-combination-antiviral-therapy-with-intravenous-immunoglobulin
#5
Kathy Kable, Carmen D Davies, Philip J O'connell, Jeremy R Chapman, Brian John Nankivell
BACKGROUND: Reactivation of BK polyoma virus causes a destructive virus allograft nephropathy (BKVAN) with graft loss in 46%. Treatment options are limited to reduced immunosuppression and largely ineffective antiviral agents. Some studies suggest benefit from intravenous immunoglobulin (IVIG). METHODS: We evaluated effectiveness of adjuvant IVIG to eliminate virus from blood and tissue, in a retrospective, single-center cohort study, against standard-of-care controls...
April 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28405135/severe-bone-marrow-suppression-accompanying-pulmonary-infection-and-hemorrhage-of-the-digestive-tract-associated-with-leflunomide-and-low-dose-methotrexate-combination-therapy
#6
Caihong Qu, Ying Lu, Weimin Liu
A 60-year-old male patient developed hyperpyrexia, cough, expectoration with blood-stained sputum, mouth ulcers, and suppurative tonsillitis after receiving 35 days of combination treatment with leflunomide (LEF) and low-dose methotrexate (MTX) for active rheumatoid arthritis. On admission, routine blood tests showed severe thrombocytopenia, agranulocytosis, and decreased hemoglobin concentration compared with the relatively normal results of 1 month previously during the first hospitalization. Chest radiography revealed inflammation in both lungs, and a fecal occult blood test was positive...
January 2017: Journal of Pharmacology & Pharmacotherapeutics
https://www.readbyqxmd.com/read/28403797/is-the-treatment-with-biological-or-non-biological-dmards-a-modifier-of-periodontal-condition-in-patients-with-rheumatoid-arthritis
#7
Consuelo Romero-Sanchez, Constanza Rodríguez, Pedro Santos, Ana María Mesa, Gloria Inés Lafaurie, Sebastian Giraldo, Juliette De Avila, Diana Marcela Castilla, Michelle Durán, Philippe Chalem, Juan Manuel Bello, Rafael Valle
BACKGROUND AND OBJECTIVE: Experimental models suggest the use of different therapy protocols in rheumatoid arthritis (RA) as modulators on periodontal condition. This study evaluated the effects of conventional drug treatment and anti-TNF therapy in patients with RA on microbiological and periodontal condition, establishing the association of markers of periodontal infection with indexes of rheumatic activity. MATERIALS AND METHODS: One hundred seventy nine individuals with RA were evaluated (62 with anti-TNF-α and 115 with only DMARDs)...
April 7, 2017: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/28389629/inhibition-of-p70-s6-kinase-s6k1-activity-by-a77-1726-the-active-metabolite-of-leflunomide-induces-autophagy-through-tak1-mediated-ampk-and-jnk-activation
#8
Xiulong Xu, Jing Sun, Ruilong Song, Michelle E Doscas, Ashley J Williamson, Jingsong Zhou, Jun Sun, Xinan Jiao, Xiufan Liu, Yi Li
mTOR activation suppresses autophagy by phosphorylating ULK1 at S757 and suppressing its enzymatic activity. Here we report that feedback activation of mTOR in the PI-3 kinase pathway by two p70 S6 kinase (S6K1) inhibitors (PF-4708671 and A77 1726, the active metabolite of an immunosuppressive drug leflunomide) or by S6K1 knockdown did not suppress but rather induced autophagy. Suppression of S6K1 activity led to the phosphorylation and activation of AMPK, which then phosphorylated ULK1 at S555. While mTOR feedback activation led to increased phosphorylation of ULK1 at S757, this modification did not the disrupt ULK1-AMPK interaction nor dampen ULK1 S555 phosphorylation and the induction of autophagy...
March 31, 2017: Oncotarget
https://www.readbyqxmd.com/read/28388816/adipose-tissue-macrophages-in-rheumatoid-arthritis-prevalence-disease-related-indicators-and-associations-with-cardiometabolic-risk-factors
#9
Jon T Giles, Antony W Ferrante, Rachel Broderick, Afshin Zartoshti, Janine Rose, Kendall Downer, Hui-Zhu Zhang, Robert J Winchester
Objective Adipose tissue macrophages (ATMs) are a potent source of inflammatory cytokines with profound effects on adipose tissue function, yet their potential role in rheumatoid arthritis (RA) pathobiology is largely unstudied. Methods Periumbilical subcutaneous adipose tissue was obtained from 36 RA patients and 22 non-RA controls frequency matched on demographics and BMI. Samples were stained for the macrophage marker CD68 and the average proportion of ATMs, crown-like structures (CLSs: peri-adipocyte aggregates of three or more ATMs), and fibrosis were compared between groups...
April 7, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28376538/-hepatic-manifestation-of-a-macrophage-activation-syndrome-mas
#10
Michael Nagel, Andreas Schwarting, Beate K Straub, Peter R Galle, Tim Zimmermann
Background Elevated liver values are the most common pathological laboratory result in Germany. Frequent findings, especially in younger patients, are nutritive- or medicamentous- toxic reasons, viral or autoimmune hepatitis. A macrophage activation syndrome (MAS) may manifest like a viral infectious disease with fever, hepatosplenomegaly and pancytopenia and is associated with a high mortality. It is based on an enhanced activation of macrophages with increased cytokine release, leading to organ damage and multi-organ failure...
April 4, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28373917/leflunomide-in-the-treatment-of-a-pseudotumoral-genital-herpes-simplex-virus-infection-in-an-hiv-patient
#11
Marie R Roger, Gregory M Anstead
The patient is a 52-year-old African American man with a past medical history of HIV infection (on antiretroviral therapy, CD4 count 399 cells/µL, and undetectable HIV viral load) and recurrent genital herpes. While on valacyclovir, the patient presented with four tumorous lesions on the perineum and scrotum. A biopsy specimen stained positively with HSV-1 and HSV-2 immunostains and displayed a lymphoplasmacytic infiltrate. The patient received foscarnet and imiquimod for two weeks with minimal improvement...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28365359/leflunomide-prevents-ros-induced-systemic-fibrosis-in-mice
#12
Florence Morin, Niloufar Kavian, Sandrine Chouzenoux, Olivier Cerles, Carole Nicco, Christiane Chéreau, Frédéric Batteux
Systemic sclerosis (SSc) is a connective tissue disorder characterized by fibrosis of the skin and inner organs, vasculopathy and immunological abnormalities. Recent insights into the polarization of macrophages in scleroderma and into the implication of STAT6 and KLF4 in this process have prompted us to investigate the effects of the inhibition of STAT6 signaling pathway by leflunomide in mice. SSc was induced in BALB/c mice by daily subcutaneous injections of hypochlorous acid (HOCl) or bleomycin. Mice were treated (or not) every other day, for 4 or 6 weeks, by leflunomide...
March 30, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28348375/a-redox-mediated-kemp-eliminase
#13
Aitao Li, Binju Wang, Adriana Ilie, Kshatresh D Dubey, Gert Bange, Ivan V Korendovych, Sason Shaik, Manfred T Reetz
The acid/base-catalysed Kemp elimination of 5-nitro-benzisoxazole forming 2-cyano-4-nitrophenol has long served as a design platform of enzymes with non-natural reactions, providing new mechanistic insights in protein science. Here we describe an alternative concept based on redox catalysis by P450-BM3, leading to the same Kemp product via a fundamentally different mechanism. QM/MM computations show that it involves coordination of the substrate's N-atom to haem-Fe(II) with electron transfer and concomitant N-O heterolysis liberating an intermediate having a nitrogen radical moiety Fe(III)-N· and a phenoxyl anion...
March 28, 2017: Nature Communications
https://www.readbyqxmd.com/read/28336160/unexpected-drug-induced-raynaud-phenomenon-analysis-from-the-french-national-pharmacovigilance-database
#14
Émilie Bouquet, Geoffrey Urbanski, Christian Lavigne, Pascale Lainé-Cessac
OBJECTIVE: To estimate the association between exposure to medicinal products and Raynaud phenomenon. METHODS: The study used the data of all adverse drug reactions notified to the French national pharmacovigilance database. All cases reported between 1st January 1995 and 10th December 2012 were selected. A case/non-case method was used to measure disproportionality of the association between drug exposure and Raynaud phenomenon. The cases concerned all observations involving Raynaud phenomenon...
February 22, 2017: Thérapie
https://www.readbyqxmd.com/read/28326649/leflunomide-for-the-treatment-of-trichodysplasia-spinulosa-in-a-liver-transplant-recipient
#15
Rawan Kassar, Janis Chang, An-Wen Chan, Leslie B Lilly, Ayman Al Habeeb, Coleman Rotstein
Trichodysplasia spinulosa (TS) is a rare dermatologic complication associated with the immunosuppressive therapy used in solid organ transplantation. The distinctive clinical manifestation of this condition is spiny follicular papules on the face, ears, extremities, and trunk. Histopathologically, abnormally maturing hair follicles with hyperkeratotic material are noted. The condition is produced by the trichodysplasia spinulosa-associated polyomavirus. Treatment of this condition in the past has entailed a reduction in immunosuppression, topical agents such as cidofovir or retinoidsm or oral valganciclovir...
March 22, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28321964/combination-therapy-of-leflunomide-and-glucocorticoids-for-the-maintenance-of-remission-in-patients-with-igg4-related-disease-a-retrospective-study-and-literature-review
#16
Yiwen Wang, Kunpeng Li, Dai Gao, Gui Luo, Yurong Zhao, Xiuru Wang, Jie Zhang, Jingyu Jin, Zheng Zhao, Chunhua Yang, Jian Zhu, Jianglin Zhang, Feng Huang
BACKGROUND: Although glucocorticoids are effective in IgG4-related disease (IgG4-RD), patients may relapse during or after glucocorticoid tapering. Immunosuppressive agents including leflunomide (LEF) are regarded as steroid-sparing agents in other autoimmune disorders and need to be discussed in the management of IgG4-RD. AIM: To identify the efficacy and safety of combination therapy of LEF and glucocorticoids in IgG4-RD. METHODS: We retrospectively summarized data of patients diagnosed with IgG4-RD between November 2012 and November 2015...
March 21, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28317629/mycobacterium-kansasii-infection-in-a-patient-receiving-biologic-therapy-not-all-reactive-interferon-gamma-release-assays-are-tuberculosis
#17
Nasir Saleem, Raya Saba, Srikanth Maddika, Mitchell Weinstein
Mycobacterium kansasii, a nontuberculous mycobacterium, can lead to lung disease similar to tuberculosis. Immunotherapeutic biologic agents predispose to infections with mycobacteria, including M kansasii. T-cell-mediated interferon gamma release assays like QuantiFERON-TB Gold Test (QFT) are widely used by clinicians for the diagnosis of infections with Mycobacterium tuberculosis; however, QFT may also show positive result with certain nontuberculous mycobacterial infections. We report a case of M kansasii pulmonary infection, with a positive QFT, in an immunocompromised patient receiving prednisone, leflunomide and tocilizumab, a humanized anti-interleukin-6 receptor monoclonal antibody...
April 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28293776/long-term-outcomes-of-treat-to-target-strategy-in-established-rheumatoid-arthritis-a-daily-practice-prospective-cohort-study
#18
Nicole Pamplona Bueno de Andrade, Rafael Mendonça da Silva Chakr, Ricardo Machado Xavier, Daniela Viecceli, Ricardo Henrique Bilycz Correa, Cilomar Martins de Oliveira Filho, Claiton Viegas Brenol
To examine disease activity and physical function after implementation of treat-to-target (T2T) strategy in patients with established rheumatoid arthritis (RA) over a long-term period. Patients with RA were started on a T2T strategy in 2005 and followed through 2014. Patients were seen every 3-4 months until remission/low disease activity was achieved and every 6 months thereafter. Disease activity was measured by the DAS28 and CDAI, and physical function by the HAQ-DI. Results were presented as all observed data, without imputation for missing values...
March 14, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28293446/real-life-experience-of-using-conventional-disease-modifying-anti-rheumatic-drugs-dmards-in-psoriatic-arthritis-psa-retrospective-analysis-of-the-efficacy-of-methotrexate-sulfasalazine-and-leflunomide-in-psa-in-comparison-to-spondyloarthritides-other-than-psa
#19
Euthalia Roussou, Aicha Bouraoui
OBJECTIVE: With the aim of assessing the response to treatment with conventional disease-modifying anti-rheumatic drugs (DMARDs) used in patients with psoriatic arthritis (PsA), data on methotrexate, sulfasalazine (SSZ), and leflunomide were analyzed from baseline and subsequent follow-up (FU) questionnaires completed by patients with either PsA or other spondyloarthritides (SpAs). MATERIAL AND METHODS: A single-center real-life retrospective analysis was performed by obtaining clinical data via questionnaires administered before and after treatment...
March 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28286324/effects-of-dihydroorotate-dehydrogenase-dhodh-inhibitors-on-the-growth-of-theileria-equi-and-babesia-caballi-in%C3%A2-vitro
#20
Ketsarin Kamyingkird, Shinuo Cao, Bumduuren Tuvshintulga, Akram Salama, Ahmed Abdelmoniem Mousa, Artemis Efstratiou, Yoshifumi Nishikawa, Naoaki Yokoyama, Ikuo Igarashi, Xuenan Xuan
Theileria equi and Babesia caballi are the causative agents of equine piroplasmosis (EP), which affects equine production in various parts of the world. However, a safe and effective drug is not currently available for treatment of EP. Dihydroorotate dehydrogenase (DHODH) is the fourth enzyme in the de novo pyrimidine synthesis pathway and has been known as a novel drug target for several apicomplexan protozoan parasites. In this study, we evaluated four DHODH inhibitors; atovaquone (ATV), leflunomide (LFN), brequinar (Breq), and 7-hydroxy-5-[1,2,4] triazolo [1,5,a] pyrimidine (TAZ) on the growth of T...
May 2017: Experimental Parasitology
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