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etanercept and sepsis

Annalisa Boscolo, Eugenia Menin, Beatrice Zelaschi, Laura Albertoni, Giacomo Zanus, Fabio Baratto
Graft-versus-host-disease after orthotopic liver transplant is a rare and life-threatening complication. The diagnosis is challenging and usually confirmed by chimerism and skin biopsies. The most common cause of death is sepsis (60%), and broad-spectrum antibiotics and antifungal prophylaxis are strongly recommended. We present a case of a 61-year-old man with hepatocellular carcinoma and a previous history of metabolic and alcoholic cirrhosis who underwent orthotopic liver transplant. The immunosuppression regimen consisted of corticosteroids, calcineurin inhibitor, and mammalian target of rapamycin complex 1 inhibitor...
April 4, 2018: Experimental and Clinical Transplantation
N Ilhan, S Susam, H F Gul, R Bardas, N Ilhan
OBJECTIVE: We aimed to investigate the protective effect of selected treatment agents on liver injury in lipopolysaccharide (LPS)-induced rat sepsis model. BACKGROUND: The sepsis includes complex inflammatory responses between a microbial pathogen and the host immune system, and leads to organ failure and also death. METHODS: This study was performed with 29 male Wistar Albino rats. Rats were divided randomly into five groups: Sham group, LPS-treated sepsis group, LPS+thalidomide treated group, LPS+etanercept treated group and LPS+thalidomide+etanercept treated group, respectively...
2017: Bratislavské Lekárske Listy
Sara Verazza, Sergio Davì, Alessandro Consolaro, Francesca Bovis, Antonella Insalaco, Silvia Magni-Manzoni, Rebecca Nicolai, Denise Pires Marafon, Fabrizio De Benedetti, Valeria Gerloni, Irene Pontikaki, Francesca Rovelli, Rolando Cimaz, Achille Marino, Francesco Zulian, Giorgia Martini, Serena Pastore, Chiara Sandrin, Fabrizia Corona, Marta Torcoletti, Giovanni Conti, Claudia Fede, Patrizia Barone, Marco Cattalini, Elisabetta Cortis, Luciana Breda, Alma Nunzia Olivieri, Adele Civino, Rosanna Podda, Donato Rigante, Francesco La Torre, Gianfranco D'Angelo, Mauro Jorini, Romina Gallizzi, Maria Cristina Maggio, Rita Consolini, Alessandro De Fanti, Valentina Muratore, Maria Giannina Alpigiani, Nicolino Ruperto, Alberto Martini, Angelo Ravelli
BACKGROUND: Data from routine clinical practice are needed to further define the efficacy and safety of biologic medications in children with juvenile idiopathic arthritis (JIA). The aim of this analysis was to investigate the disease status, reasons for discontinuation and adverse events in Italian JIA patients treated with etanercept (ETN). METHODS: In 2013, all centers of the Italian Pediatric Rheumatology Study Group were asked to make a census of patients given ETN after January 2000...
December 20, 2016: Pediatric Rheumatology Online Journal
Rosa María Fernández-Torres, Sabela Paradela, Eduardo Fonseca
BACKGROUND: There are numerous clinical trials proving efficacy and safety profiles of etanercept. Newer studies, however, include patients with significant comorbidities, unstable psoriasis, or concomitant treatments. OBJECTIVE: The objective of this study was to provide data on long-term response to etanercept and estimate the cost in daily practice. METHODS: This is an observational retrospective study including patients with plaque-type psoriasis receiving etanercept 50 mg/wk for more than 6 months at the Dermatology Department of the University Hospital of La Coruña (Spain)...
December 2015: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Veronica L Massey, Lauren G Poole, Deanna L Siow, Edilson Torres, Nikole L Warner, Robin H Schmidt, Jeffrey D Ritzenthaler, Jesse Roman, Gavin E Arteel
BACKGROUND: It is well known that liver and lung injury can occur simultaneously during severe inflammation (e.g., multiple organ failure). However, whether these are parallel or interdependent (i.e., liver-lung axis) mechanisms is unclear. Previous studies have shown that chronic ethanol (EtOH) consumption greatly increases mortality in the setting of sepsis-induced acute lung injury (ALI). The potential contribution of subclinical liver disease in driving this effect of EtOH on the lung remains unknown...
October 2015: Alcoholism, Clinical and Experimental Research
Yoshio Watanabe, Rei Shibata, Noriyuki Ouchi, Takahiro Kambara, Koji Ohashi, Li Jie, Yoko Inoue, Toyoaki Murohara, Kimihiro Komori
BACKGROUND: Obesity is a risk factor for cardiovascular disease. Increasing evidence suggests that reduced levels of the adipocyte-derived plasma protein adiponectin are associated with an increased cardiovascular risk. Here, we examined the effects of adiponectin on lipopolysaccharide- (LPS-) induced acute cardiac injury in vivo. METHODS AND RESULTS: A single dose of LPS (10 mg/kg) was intraperitoneally injected into wild-type (WT) and adiponectin-knockout (APN-KO) mice...
2014: BioMed Research International
Huifeng Yun, Fenglong Xie, Elizabeth Delzell, Lang Chen, Emily B Levitan, James D Lewis, Kenneth G Saag, Timothy Beukelman, Kevin Winthrop, John W Baddley, Jeffrey R Curtis
BACKGROUND: The risk of subsequent infections in rheumatoid arthritis (RA) patients who receive biologic therapy after a serious infection is unclear. OBJECTIVE: To compare the subsequent risk of hospitalised infections associated with specific biologic agents among RA patients previously hospitalised for infection while receiving anti-tumour necrosis factor (anti-TNF) therapy. METHODS: Using 2006-2010 Medicare data for 100% of beneficiaries with RA enrolled in Medicare, we identified patients hospitalised with an infection while on anti-TNF agents...
June 2015: Annals of the Rheumatic Diseases
J R Curtis, S Yang, N M Patkar, L Chen, J A Singh, G W Cannon, T R Mikuls, E Delzell, K G Saag, M M Safford, S DuVall, K Alexander, P Napalkov, Kevin L Winthrop, M J Burton, A Kamauu, J W Baddley
OBJECTIVE: The comparative risk of infection associated with non-anti-tumor necrosis factor (anti-TNF) biologic agents is not well established. Our objective was to compare risk for hospitalized infections between anti-TNF and non-anti-TNF biologic agents in US veterans with rheumatoid arthritis (RA). METHODS: Using 1998-2011 data from the US Veterans Health Administration, we studied RA patients initiating rituximab, abatacept, or anti-TNF therapy. Exposure was based upon days supplied (injections) or usual dosing intervals (infusions)...
July 2014: Arthritis Care & Research
Brendon P Scicluna, Cornelis van 't Veer, Max Nieuwdorp, Karen Felsmann, Britta Wlotzka, Erik S G Stroes, Tom van der Poll
TNFα has been implicated in the pathogenesis of various inflammatory diseases. Different strategies to inhibit TNFα in patients with sepsis and chronic inflammatory conditions have shown contrasting outcomes. Although TNFα inhibitors are widely used in clinical practice, the impact of TNFα antagonism on white blood cell gene expression profiles during acute inflammation in humans in vivo has not been assessed. We here leveraged the established model of human endotoxemia to examine the effect of the TNFα antagonist, etanercept, on the genome-wide transcriptional responses in circulating leukocytes induced by intravenous LPS administration in male subjects...
2013: PloS One
Ting Zhang, Xiangru Lu, Jenny Li, Peter Chidiac, Stephen M Sims, Qingping Feng
Tumor necrosis factor-α (TNF-α) is a major pro-inflammatory cytokine that causes cardiac dysfunction during sepsis. Na/K-ATPase regulates intracellular Ca(2+), which activates mammalian target of rapamycin (mTOR), a regulator of protein synthesis. The aim of this study was to investigate the role of Na/K-ATPase/mTOR signaling in myocardial TNF-α expression during endotoxemia. Results showed that treatment with LPS decreased Na/K-ATPase activity in the myocardium in vivo and in cultured neonatal cardiomyocytes...
March 2012: Basic Research in Cardiology
Barış Ekici, Kubilay Aydın, Serdar Cantez, Yakup Ergül, Burak Tatlı
Adverse events were reported in various patients treated with etanercept, including infections (sepsis and tuberculosis), malignancies (e.g., lymphoma), demyelinating disorders, and autoimmune diseases. Only two adult patients with etanercept-related encephalopathy were previously reported. We describe a 7-year-old patient who developed encephalopathy immediately after his third dose of etanercept. To the best of our knowledge, ours is the first report of a pediatric patient with a diagnosis of systemic arthritis and who developed etanercept-related encephalopathy...
October 2011: Pediatric Neurology
Cándido Díaz-Lagares, Roberto Pérez-Alvarez, Francisco J García-Hernández, María M Ayala-Gutiérrez, José Luis Callejas, Agustín Martínez-Berriotxoa, Javier Rascón, Luis Caminal-Montero, Albert Selva-O'Callaghan, Joaquim Oristrell, Carmen Hidalgo, Ricardo Gómez-de-la-Torre, Luis Sáez, Jesús Canora-Lebrato, María-Teresa Camps, Norberto Ortego-Centeno, María-Jesús Castillo-Palma, Manuel Ramos-Casals
INTRODUCTION: The purpose of this observational study was to analyze the rates, characteristics and associated risk factors of severe infections in patients with systemic autoimmune diseases (SAD) who were treated off-label with biological agents in daily practice. METHODS: The BIOGEAS registry is an ongoing Spanish prospective cohort study investigating the long-term safety and efficacy of the off-label use of biological agents in adult patients with severe, refractory SAD...
2011: Arthritis Research & Therapy
Andrew Smyth, Diarmaid D Houlihan, Helen Tuite, Catherine Fleming, Thomas A O'Gorman
INTRODUCTION: Necrotising fasciitis is a severe infection characterised by the fulminant destruction of tissue with associated systemic signs of sepsis and toxicity. Etanercept is a fully human fusion protein that inhibits tumor necrosis factor and the inflammatory cascade. It is effective in the treatment of many disorders but concerns regarding severe life threatening infections have been raised in multiple reports. CASE PRESENTATION: We present the case of a 39-year-old Caucasian man, who presented with sudden onset of severe and progressive neck and left shoulder pain, with a two-year history of seronegative rheumatoid arthritis treated with azathoprine and etanercept...
November 17, 2010: Journal of Medical Case Reports
Michael E Weinblatt, Joan M Bathon, Joel M Kremer, Roy M Fleischmann, Michael H Schiff, Richard W Martin, Scott W Baumgartner, Grace S Park, Edward L Mancini, Mark C Genovese
OBJECTIVE: To evaluate the long-term safety and efficacy of etanercept therapy in rheumatoid arthritis (RA) patients. METHODS: Adult patients with early RA or longstanding RA received etanercept in open-label extension studies following initial double-blind trials of etanercept. RESULTS: Of 558 early RA patients and 714 longstanding RA patients who received at least 1 dose of etanercept, a total of 194 early RA patients and 217 longstanding RA patients were treated with 25 mg of etanercept twice weekly through 10 years...
March 2011: Arthritis Care & Research
M Ribera, L Leal, J Luelmo
The biological treatments for psoriasis, mainly the tumor necrosis factor-alpha inhibitors (TNF-alpha), have demonstrated their efficacy and safety beginning with the clinical trials up to their subsequent marketing. However, pharmacovigilance studies have detected a mild increase in infections. For the management of infectious risk in patients with psoriasis being treated with etanercept or other anti-TNF medications, an evaluation should be made of the adequacy of its use in patients infected by HCV, HBV, HIV, with localized or generalized infections, with risk of sepsis (carriers of intravenous catheter and indwelling urinary catheter) or with underlying disorders that could predispose them to infections (diabetes, hemodialysis)...
May 2010: Actas Dermo-sifiliográficas
Lisa C Zaba, Mayte Suárez-Fariñas, Judilyn Fuentes-Duculan, Kristine E Nograles, Emma Guttman-Yassky, Irma Cardinale, Michelle A Lowes, James G Krueger
BACKGROUND: TNF inhibitors have revolutionized the treatment of psoriasis vulgaris as well as psoriatic and rheumatoid arthritis and Crohn disease. Despite our understanding that these agents block TNF, their complex mechanism of action in disease resolution is still unclear. OBJECTIVE: To analyze globally the genomic effects of TNF inhibition in patients with psoriasis, and to compare genomic profiles of patients who responded or did not respond to treatment. METHODS: In a clinical trial using etanercept TNF inhibitor to treat psoriasis vulgaris (n = 15), Affymetrix gene arrays were used to analyze gene profiles in lesional skin at multiple time points during drug treatment (baseline and weeks 1, 2, 4, and 12) compared with nonlesional skin...
November 2009: Journal of Allergy and Clinical Immunology
Lena Thin, Gerry Macquillan, Leon Adams, George Garas, Cynthia Seow, Paul Cannell, Bradley Augustson, Andrew Mitchell, Luc Delriveire, Gary Jeffrey
Acute graft-versus-host disease following orthotopic liver transplantation is a rare but feared complication arising in 1% to 2% of cases with a dismal prognosis. It most often presents as fever, rash, and diarrhea with or without pancytopenia. Patients die from complications of marrow failure such as sepsis or bleeding. Because of its low incidence, there is no clear treatment protocol for this complication. Both increasing and withdrawing immunosuppression have been attempted with variable success. Although anti-tumor necrosis factor alpha therapy has been widely used for the treatment of steroid-resistant acute graft-versus-host disease in the hematopoietic stem cell transplant setting, there previously have been no reported cases of its use in liver transplantation...
April 2009: Liver Transplantation
James M Shehan, Deba P Sarma
Mycobacterium mucogenicum is a recently characterized organism that rarely may cause human infections. This rapidly growing mycobacterium is commonly identified in tap water. Both immunosuppressed and immunocompetent patients may develop infections from Mycobacterium mucogenicum. Some patients have experienced lethal disease, including sepsis. Infections occurring in the skin and soft tissues have been described only after a preceding injury. We present the first case of infection with Mycobacterium mucogenicum occurring in a patient on the TNF-alpha antagonist etanercept and without any prior soft tissue injury...
2008: Dermatology Online Journal
David J MacEwan
Tumour necrosis factor (TNF) ligand members and their associated TNF receptor (TNFR) superfamilies have many diverse physiological roles. TNF is thought to play a critical role in the pathophysiology of a range of diseases including refractory asthma, sepsis, ankylosing spondylitis, lupus, type II diabetes, multiple sclerosis and psoriasis. The recent continued expansion of the novel anti-TNF therapeutic agents (etanercept and infliximab) has seen major improvements in the treatment of some inflammatory-based human diseases including notably rheumatoid arthritis and Crohn's disease, with other conditions currently being trialled using anti-TNF agents...
April 2008: Neurochemical Research
Sheila Knupp Feitosa de Oliveira, Rozana Gasparello de Almeida, Adriana Rodrigues Fonseca, Marta Cristine Félix Rodrigues, Flavio Sztajnbok, Christianne Diniz
OBJECTIVE: To report the efficacy and adverse events with the use of anti-TNFalpha agents in pediatric patients with rheumatic diseases. PATIENTS AND METHODS: Retrospective, observational clinical case series of patients with rheumatic diseases refractory to the conventional treatment. Infliximab and etanercept were the the drugs used. RESULTS: Thirty patients received anti-TNFalpha therapy: Juvenile Idiopathic Arthritis (18), chronic idiopathic anterior uveitis (2), juvenile dermatomyositis (4), Blau syndrome (1), relapsing polychondritis (2), CINCA syndrome (1), and microscopic polyangiitis (1)...
April 2007: Acta Reumatológica Portuguesa
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