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Leflunomide

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https://www.readbyqxmd.com/read/27891379/rare-occurrence-of-drug-induced-subacute-cutaneous-lupus-erythematosus-with-leflunomide-therapy
#1
Harpreet Singh, Gagandeep Sukhija, Vikram Tanwar, Sameer Arora, Jaikrit Bhutani
Leflunomide is an immunomodulatory drug exhibiting anti-inflammatory, anti-proliferative and immunosuppressive effects. It has been widely used for treatment of active rheumatoid arthritis. Despite its good safety profile cutaneous side effects like alopecia, eczema, pruritis and dry skin have been reported with Leflunomide use. Skin ucleration, vasculitis, lichenoid drug rash and Subacute Cutaneous Lupus Erythematosus (SCLE) have been rarely reported with its use. A rare case of Leflunomide induced SCLE is being reported in a female patient with rheumatoid arthritis...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27888342/putting-recommendations-into-practice-australian-rheumatologists-opinions-on-leflunomide-use-in-rheumatoid-arthritis
#2
Ashley M Hopkins, Michael D Wiese, Catherine E O'Doherty, Susanna M Proudman
Leflunomide is the most recently introduced conventional disease-modifying anti-rheumatic drugs in Australia. It has several unique methods for initiation, unique monitoring recommendations and a distinctive cessation protocol in the event of serious toxicity. The aim of this study was to evaluate initiation and monitoring practices of Australian rheumatologists using leflunomide. A survey was emailed twice, approximately 3 months apart to 332 rheumatologist members of the Australian Rheumatology Association...
November 25, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27886691/pharmacotherapy-pearls-for-the-geriatrician-focus-on-oral-disease-modifying-antirheumatic-drugs-including-newer-agents
#3
REVIEW
Ann J Biehl, James D Katz
Providing safe and effective pharmacotherapy to the geriatric patients with rheumatological disorders is an ongoing struggle for the rheumatologist and geriatrician alike. Cohesive communication and partnership can improve the care of these patients and subvert adverse outcomes. Disease-modifying antirheumatic drugs, including methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide, and the newest oral agent for treatment of rheumatoid arthritis, tofacitinib, have distinctive monitoring and adverse effect profiles...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27886444/incidence-and-classification-of-cutaneous-manifestations-in-rheumatoid-arthritis
#4
Mirjana Ziemer, Anne-Katrin Müller, Gert Hein, Peter Oelzner, Peter Elsner
BACKGROUND AND OBJECTIVE: There have only been few studies examining rheumatoid arthritis (RA)-related skin manifestations in larger patient populations. Herein, we present current data on the prevalence and spectrum of cutaneous lesions in RA, addressing disease activity scores, anti-CCP antibodies as well as novel pharmacological approaches. PATIENTS AND METHODS: Between November 2006 and July 2007, 214 patients with RA treated at the Division of Rheumatology, University Hospital Jena, Germany, were prospectively examined...
November 25, 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/27869736/circulating-il-27-is-elevated-in-rheumatoid-arthritis-patients
#5
Xiaofei Lai, Hongxu Wang, Ju Cao, Ying Li, Yubing Dai, Yu Xiang, Liping Zhang
Cytokines are key immunoregulatory molecules that regulate T lymphocyte-mediated immune responses and inflammatory reactions. We determined whether there is aberrant expression of interleukin-27 (IL-27) in rheumatoid arthritis (RA) patients and investigated the clinical significance of these changes. IL-27 is a key cellular factor that regulates the differentiation of CD4+ T cells, which can secrete interleukin-10 (IL-10) and interleukin-17 (IL-17) in vivo. Concentrations of serum IL-27 in 67 RA patients, and 36 sex- and age-matched control subjects were measured by enzyme-linked immunosorbent assay (ELISA)...
November 18, 2016: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/27862987/einsatz-und-wirksamkeit-von-systemtherapien-bei-erwachsenen-mit-schwerer-neurodermitis-erste-ergebnisse-des-deutschen-neurodermitis-registers-treatgermany
#6
Jochen Schmitt, Susanne Abraham, Freya Trautmann, Victoria Stephan, Regina Fölster-Holst, Bernhard Homey, Thomas Bieber, Natalija Novak, Michael Sticherling, Matthias Augustin, Andreas Kleinheinz, Peter Elsner, Stephan Weidinger, Thomas Werfel
HINTERGRUND: Versorgungsregister dienen der Erfassung des Einsatzes und der Wirksamkeit von Therapien unter realen Versorgungsbedingungen und sind als Basis einer evidenzbasierten Gesundheitsversorgung unverzichtbar. METHODIK: Das deutsche Neurodermitis-Register TREATgermany wurde als weltweit erstes Register für Patienten mit schwerer Neurodermitis 2011 initiiert. Erwachsene mit schwerer Neurodermitis (aktuelle/frühere antientzündliche Systemtherapie und/oder objektiver SCORAD ≥ 40) werden über einen Zeitraum von 24 Monaten prospektiv beobachtet...
November 10, 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/27862093/bioanalytical-method-for-the-estimation-of-co-administered-esomeprazole-leflunomide-and-ibuprofen-in-human-plasma-and-in-pharmaceutical-dosage-forms-using-micellar-liquid-chromatography
#7
Wael Talaat
The present study represents a connection between basic science and clinical applied science through providing a bioanalytical method for the analysis of certain co-administered drugs used for the treatment of rheumatoid arthritis. The studied drugs are esomeprazole, leflunomide and ibuprofen. The proposed bioanalytical method is a simple reversed phase high performance liquid chromatographic method using micellar mobile phase. The method is conducted using a Shim-pack VP-ODS (150 mm × 4.6 mm ID) stainless steel column at ambient temperature with ultraviolet detection at 285 nm...
October 13, 2016: Biomedical Chromatography: BMC
https://www.readbyqxmd.com/read/27823373/clinical-features-and-pathological-joint-changes-in-dogs-with-erosive-immune-mediated-polyarthritis-13-cases-2004-2012
#8
Magen L Shaughnessy, Susannah J Sample, Carter Abicht, Caitlin Heaton, Peter Muir
OBJECTIVE To evaluate the clinical features and pathological joint changes in dogs with erosive immune-mediated polyarthritis (IMPA). DESIGN Retrospective case series. ANIMALS 13 dogs with erosive IMPA and 66 dogs with nonerosive IMPA. PROCEDURES The medical record database of a veterinary teaching hospital was reviewed to identify dogs with IMPA that were examined between October 2004 and December 2012. For each IMPA-affected dog, information extracted from the medical record included signalment, diagnostic test results, radiographic findings, and treatments administered...
November 15, 2016: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/27819170/efficacy-of-leflunomide-combined-with-prednisone-in-the-treatment-of-refractory-nephrotic-syndrome
#9
Yuping Liu, Xiaolong Qu, Weidong Chen, Yan Zhang, Lei Liu
OBJECTIVE: To assess the safety and clinical efficacy of leflunomide (LEF) and prednisone on refractory nephrotic syndrome (RNS). METHODS: A total of 52 patients with RNS were treated for 24 weeks between 2010 and 2014 in our hospital. In the treated group, 26 patients were treated with LEF and prednisone, and, in the control group, 26 patients were treated with cyclophosphamide (CTX) and prednisone. During the treatment, 24 h urinary protein excretion and the serum levels of albumin and cholesterol, and kidney function were assayed before and after the therapy...
November 6, 2016: Renal Failure
https://www.readbyqxmd.com/read/27779824/5-amino-3-methyl-4-isoxazolecarboxylic-acid-hydrazide-derivatives-with-in-vitro-immunomodulatory-activities
#10
Angelika Drynda, Bożena Obmińska-Mrukowicz, Ewa Zaczyńska, Michał Zimecki, Iwona Kochanowska, Stanisław Ryng, Marcin Mączyński
Isoxazoles are an important class of compounds of potential therapeutic value. The aim of this study was to determine immunotropic effects of 5-amino-3-methyl-4-isoxazolecarboxylic acid hydrazide derivatives on spontaneous and mitogen-induced lymphocyte proliferation in young and old mice, cytokine production by peritoneal cells as well as possible mechanism of action in a model of Jurkat cells. Three month and thirteen month old BALB/c mice were used as donors of the cells from a thymus, a spleen, mesenteric lymph nodes and a peritoneal cavity...
October 25, 2016: Chemical Biology & Drug Design
https://www.readbyqxmd.com/read/27773517/primary-cardiac-b-cell-lymphoma-manifestation-of-felty-s-syndrome-or-tnf%C3%AE-antagonist
#11
Nazim Benzerdjeb, Fatima Ameur, Jean-Fortune Ikoli, Henri Sevestre
Primary cardiac B cell lymphoma is rare. To date, fewer than 90 cases have been described in the literature. We report a 67-year-old woman with a 30-year history of rheumatoid arthritis, who had received treatment with leflunomide for 10 years and infliximab for 2 years. Secondary Felty's syndrome appeared. She was admitted to the hospital for abdominal pain. Investigations disclosed a 5cm cardiac mass in the right atrium. Histopathologic examination of tissue specimens obtained at surgical myocardial biopsy demonstrated primary cardiac B cell lymphoma...
December 2016: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27771177/cost-effectiveness-analysis-of-treatment-sequence-initiating-with-etanercept-compared-with-leflunomide-in-rheumatoid-arthritis-impact-of-reduced-etanercept-cost-with-patent-expiration-in-south-korea
#12
Sun-Kyeong Park, Seung-Hoo Park, Min-Young Lee, Ji-Hyun Park, Jae-Hong Jeong, Eui-Kyung Lee
PURPOSE: In south Korea, the price of biologics has been decreasing owing to patent expiration and the availability of biosimilars. This study evaluated the cost-effectiveness of a treatment strategy initiated with etanercept (ETN) compared with leflunomide (LFN) after a 30% reduction in the medication cost of ETN in patients with active rheumatoid arthritis (RA) with an inadequate response to methotrexate (MTX-IR). METHODS: A cohort-based Markov model was designed to evaluate the lifetime cost-effectiveness of treatment sequence initiated with ETN (A) compared with 2 sequences initiated with LFN: LFN-ETN sequence (B) and LFN sequence (C)...
October 19, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27749226/update-on-malignancies-in-children-with-juvenile-idiopathic-arthritis-in-the-german-biker-registry
#13
Gerd Horneff, Ariane Klein, Prasad T Oommen, Anton Hospach, Ivan Foeldvari, Isa Feddersen, Kirsten Minden
OBJECTIVES: While tumour necrosis factor (TNF)-α-inhibitor treatment improved outcome of juvenile idiopathic arthritis (JIA) management markedly, concerns have been raised about an association of TNF-α-inhibitor treatment and an increased risk for malignancies especially lymphoma. METHODS: Cases of suspected malignancies documented in the German Biker Registry are reviewed in detail. RESULTS: Until Dec 31, 2015, 3695 JIA patients were prospectively followed with a total of more than 13,198 observation years...
September 8, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27748636/influence-of-5-amino-3-methyl-4-isoxazolecarbohydrazide-on-selective-gene-expression-in-caco-2-cultured-cells
#14
Paulina Płoszaj, Andrzej Regiec, Stanisław Ryng, Agnieszka Piwowar, Marian L Kruzel
The 5-amino-3-methyl-4-isoxazolecarboxylic acid hydrazide (HIX) is a synthetic isoxazole derivative with a potential for development as an anti-inflammatory drug candidate. The goal of this study was to explore in vitro autoimmune and inflammatory gene modulation by HIX in human Caco-2 cultured cells. The effect of low dose of HIX was tested on the expression level of RNA in 24h Caco-2 cultures using the QIAGEN Th17 for Autoimmunity & Inflammation RT(2) Profiler PCR Array. We choose the PCR technology as the most reliable and sensitive gene expression profiling method for analyzing specific gene regulatory networks...
October 17, 2016: Immunopharmacology and Immunotoxicology
https://www.readbyqxmd.com/read/27747512/chronic-diarrhea-associated-with-high-teriflunomide-blood-concentration
#15
André Duquette, Anne Julie Frenette, Maxime Doré
OBJECTIVE: To report the case of a patient treated with leflunomide that presented with chronic diarrhea associated with high teriflunomide blood concentration. An 84-year-old woman taking leflunomide 20 mg once daily for the past 2 years to treat rheumatoid arthritis (RA) was investigated for severe chronic diarrhea that had been worsening for the past 5 months. The patient's general condition progressively deteriorated and included electrolyte imbalances and a transient loss of consciousness...
June 2016: Rheumatology and Therapy
https://www.readbyqxmd.com/read/27742727/intracellular-cd3-t-lymphocyte-teriflunomide-concentration-is-poorly-correlated-with-and-has-greater-variability-than-unbound-plasma-teriflunomide-concentration
#16
Ashley M Hopkins, Mahin Moghaddami, David Jr Foster, Susanna M Proudman, Richard N Upton, Michael D Wiese
Leflunomide's active metabolite teriflunomide inhibits dihydro-oroate dehydrogenase (DHODH), an enzyme essential to proliferation of T-lymphocytes. As teriflunomide must reach the target site to have this effect, this study assessed the distribution of teriflunomide into T-lymphocytes, as intracellular concentrations may be a superior response biomarker to plasma concentrations. CD3 MicroBeads (MiltenyiBiotec) were used to extract CD3(+) T-cells from the peripheral blood of patients with rheumatoid arthritis whom were taking a stable dose of leflunomide...
October 14, 2016: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/27738630/the-174g-c-interleukin-6-gene-promoter-polymorphism-as-a-genetic-marker-of-differences-in-therapeutic-response-to-methotrexate-and-leflunomide-in-rheumatoid-arthritis
#17
A J Ruiz-Padilla, J I Gamez-Nava, A M Saldaña-Cruz, J D Murillo-Vazquez, M L Vazquez-Villegas, S A Zavaleta-Muñiz, B T Martín-Márquez, J M Ponce-Guarneros, N A Rodriguez Jimenez, A Flores-Chavez, F Sandoval-Garcia, J C Vasquez-Jimenez, E G Cardona-Muñoz, S E Totsuka-Sutto, L Gonzalez-Lopez
Objective. To evaluate the association of -174G/C IL-6 polymorphism with failure in therapeutic response to methotrexate (MTX) or leflunomide (LEF). This prospective, observational cohort included 96 Mexican-Mestizo patients with moderate or severe rheumatoid arthritis (RA), initiating MTX or LEF, genotyped for IL-6 -174G/C polymorphism by PCR-RFLP. Therapeutic response was strictly defined: only if patients achieved remission or low disease activity (DAS-28 < 3.2). Results. Patients with MTX or LEF had significant decrement in DAS-28 (p < 0...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27733490/therapeutic-management-of-patients-with-rheumatoid-arthritis-and-associated-interstitial-lung-disease-case-report-and-literature-review
#18
Andrea Picchianti Diamanti, Milica Markovic, Giuseppe Argento, Simonetta Giovagnoli, Alberto Ricci, Bruno Laganà, Raffaele D'Amelio
Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that can present different extrarticular manifestations involving heart, lungs and kidneys. In recent years there has been a growing awareness of the central role played by the lungs in the onset and progression of RA. In particular interstitial lung disease (ILD) is a common pulmonary manifestation that may be related to the inflammatory process itself, infectious complications and to the treatments used. Management of patients with ILD/RA is still a challenge for clinicians, both synthetic [mainly methotrexate (MTX), leflunomide] and biologic immunosuppressors [mainly anti-tumor necrosis factor (TNF)α] have in fact been related to the onset or worsening of lung diseases with conflicting data...
October 12, 2016: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27726125/interventions-for-idiopathic-steroid-resistant-nephrotic-syndrome-in-children
#19
REVIEW
Elisabeth M Hodson, Sophia C Wong, Narelle S Willis, Jonathan C Craig
BACKGROUND: The majority of children who present with their first episode of nephrotic syndrome achieve remission with corticosteroid therapy. Children who fail to respond may be treated with immunosuppressive agents including calcineurin inhibitors (cyclosporin or tacrolimus) and with non-immunosuppressive agents such as angiotensin-converting enzyme inhibitors (ACEi). Optimal combinations of these agents with the least toxicity remain to be determined. This is an update of a review first published in 2004 and updated in 2006 and 2010...
October 11, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27721903/combination-leflunomide-and-methotrexate-in-refractory-rheumatoid-arthritis-a-biologic-sparing-approach
#20
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
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