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high dose methotrexate

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https://www.readbyqxmd.com/read/28215362/efficacy-and-safety-of-sirukumab-in-patients-with-active-rheumatoid-arthritis-refractory-to-anti-tnf-therapy-sirround-t-a-randomised-double-blind-placebo-controlled-parallel-group-multinational-phase-3-study
#1
Daniel Aletaha, Clifton O Bingham, Yoshiya Tanaka, Prasheen Agarwal, Regina Kurrasch, Paul P Tak, Sharon Popik
BACKGROUND: Sirukumab, a human monoclonal antibody that selectively binds to the interleukin-6 cytokine with high affinity, is under development for the treatment of rheumatoid arthritis and other diseases. We aimed to assess the efficacy and safety of sirukumab for rheumatoid arthritis in a phase 3 study (SIRROUND-T). METHODS: We did a randomised, double-blind, placebo-controlled, parallel-group, multicentre study at 183 hospitals and private rheumatology clinics in 20 countries (Argentina, Australia, Austria, Belgium, Canada, France, Germany, Italy, Japan, Lithuania, Mexico, Netherlands, Poland, Portugal, Russia, South Korea, Spain, Taiwan, UK, and USA)...
February 15, 2017: Lancet
https://www.readbyqxmd.com/read/28211579/impact-of-treatment-variability-on-survival-in-immuno-competent-and-immuno-compromised-patients-with-primary-central-nervous-lymphoma
#2
Reem Karmali, Chadi Nabhan, Adam M Petrich, Jeffrey Raizer, David Peace, Rimas Lukas, Leo I Gordon, Sanjib Basu, Vineela Chukkapalli, Parameswaran Venugopal
Patients with primary central nervous system lymphoma (PCNSL) treated in the 'real-world' setting do not represent those treated on clinical trials and might not be treated similarly. We studied characteristics and variability in care for 113 newly diagnosed PCNSL patients treated at 5 institutions in the Chicago area between 2000 and 2012. In 111 patients, single modality therapy with a high dose methotrexate (HD-MTX) regimen +/- rituximab, was most commonly employed (n = 65), and 34 underwent radiotherapy (+/- systemic therapy)...
February 17, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28211077/severe-bullous-pemphigoid-associated-with-pembrolizumab-therapy-for-metastatic-melanoma-with-complete-regression
#3
O Rofe, G Bar-Sela, Z Keidar, T Sezin, C D Sadik, R Bergman
Bullous pemphigoid (BP) is considered to be a humorally mediated autoimmune disease, but autoreactive T-cells and T-regulatory cells (Tregs) have also been implicated in this disease. Tregs and the programmed death-1 (PD-1) : programmed death ligand (PD-L) pathway are both critical in terminating immune response, and elimination of either can result in breakdown of tolerance and development of autoimmunity. We report a patient with metastatic malignant melanoma (MM), who underwent pembrolizumab (anti-PD-1) therapy following unsuccessful treatment with ipilimumab [anti-cytotoxic T-lymphocyte-associated protein (CTLA)-4]...
February 16, 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/28209661/non-topical-management-of-recalcitrant-paediatric-atopic-dermatitis
#4
REVIEW
Jin Ho Chong, Mark Jean Aan Koh
Atopic dermatitis (AD) is a common chronic, pruritic skin disease in children. As the incidence of AD increases, especially in high-income countries, paediatricians may see an increasing number of recalcitrant AD cases in their practice. Although these cases are principally managed by paediatric dermatologists, it is important for paediatricians to be aware of the use and side effects of non-topical treatment like phototherapy and systemic agents as well as the evidence for alternative treatment, which caregivers may ask about...
February 16, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28197276/percutaneous-coronary-intervention-safety-of-methotrexate-and-its-possible-benefits-on-restenosis-after-bare-metal-stent-deployment
#5
Viviane Gouveia, Dinaldo C Oliveira, Emmanuele Tenorio, Norma Brito, Emanuel Sarinho
BACKGROUND: Percutaneous coronary intervention (PCI) revolutionized treatment of coronary artery disease. Drug-eluting stents are effective and safe but their cost is high, especially for some countries. The primary objective was to evaluate the safety of methotrexate (MTX) in patients who underwent PCI and the secondary goal was to evaluate the possibility that MTX has an impact on restenosis. METHODS: This was a transversal, prospective and descriptive study that recruited 16 patients in whom PCI was planned...
June 2016: Cardiology Research
https://www.readbyqxmd.com/read/28190982/dermatomyositis-leading-to-necrotizing-vasculitis-a-perfect-response-to-applied-therapy
#6
Mahmood Akbaryan, Farideh Darabi, Zahra Soltani
Dermatomyositis is an idiopathic inflammatory myopathy that cause skin and muscle complications. The ethiology is not understood well yet. Released cytokines including interferon and interleukins are suggested to make inflammatory responses in the skin or muscle. Muscle weakness and skin lesions including heliotrope rash, shawl sign and Gottron's papules are the most common symptoms. A biopsy (muscle or skin) is always the most reliable method for diagnosis. Corticosteroids in association with immunosuppressive agents are used as standard treatment...
December 2016: International Journal of Biomedical Science: IJBS
https://www.readbyqxmd.com/read/28190872/upper-airway-obstruction-requiring-emergent-tracheostomy-secondary-to-laryngeal-sarcoidosis-a-case-report
#7
Changwan Ryu, Erica L Herzog, Hongyi Pan, Robert Homer, Mridu Gulati
BACKGROUND Laryngeal sarcoidosis is a rare extrapulmonary manifestation of sarcoidosis, accounting for 0.33-2.1% of cases. A life-threatening complication of laryngeal sarcoidosis is upper airway obstruction. In this report we describe our experience in the acute and chronic care of a patient who required an emergent tracheostomy, with the aim to provide further insight into this difficult to manage disease. CASE REPORT A 37-year-old African American female with a 10-year history of stage 1 sarcoidosis presented with severe dyspnea...
February 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28176199/effects-of-antirheumatic-drug-underutilization-on-rheumatoid-arthritis-disease-activity
#8
Mohammad A Y Alqudah, Sayer Al-Azzam, Karem Alzoubi, Mohammad Alkhatatbeh, Khaldoon Alawneh, Ola Alazzeh, Bayan Ababneh
BACKGROUND: Following the recommended guidelines is crucial for achieving patient remission in rheumatoid arthritis. The aim of this study was to assess the effect of proper drug utilization of antirheumatic drugs on disease activity and drug safety in Jordan. METHODS: In a retrospective cross-sectional study, patient's demographics, clinical variables, drug regimens and side effects were recorded and the 28-joint disease activity scores were calculated. Patients were stratified into high, moderate, low disease activity or remission group...
February 8, 2017: Inflammopharmacology
https://www.readbyqxmd.com/read/28167509/results-from-a-phase-i-ii-open-label-dose-finding-study-of-pralatrexate-and-oral-bexarotene-in-patients-with-relapsed-refractory-cutaneous-t-cell-lymphoma
#9
Madeleine Duvic, Youn H Kim, Pier Luigi Zinzani, Steven Horwitz
PURPOSE: Pralatrexate is a folic acid analog metabolic inhibitor similar to methotrexate,that has shown tolerability and efficacy with an overall response rate of 45% in a phase 1 dose de-escalation study of patients with relapsed/refractory cutaneous T-cell lymphoma CTCL. EXPERIMENTAL DESIGN: The object of this phase I/II open-label, multi-center clinical trial was to determine the maximum tolerated dose (MTD) and recommended dose of pralatrexate plus oral bexarotene in 34 patients with relapsed/refractory CTCL who had failed prior systemic therapies...
February 6, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28152740/understanding-efficiency-of-chemotherapy-delivery-for-planned-chemotherapy-admission-at-columbia-university-medical-center
#10
Jason Dennis Wright, Sowmya Vasan, Alfred I Neugut, Jim Hu, Dawn L Hershman
: 206 Background: Delays in administration of planned in-patient chemotherapy can lead to prolonged length of stay (LOS), resulting in increased cost and risk of nosocomial infections and other complications. METHODS: We conducted a retrospective analysis of cancer patients admitted to Columbia University Medical Center, a tertiary care center, for planned chemotherapy from January 1, 2014 through December 31, 2014. Eligible patients were identified as cancer patients (via ICD9 codes) who were admitted directly to the inpatient hematology/oncology service with intravenous chemotherapy orders submitted within 24 hours of the admission...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28138903/the-treatment-of-giant-cell-arteritis
#11
REVIEW
Imran Jivraj, Madhura Tamhankar
Giant cell arteritis (GCA) is a systemic inflammatory vasculitis affecting medium and large vessels with potentially sight and life-threatening complications. Early diagnosis and prompt treatment are imperative in order to prevent vision loss and progression of the disease. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are inflammatory markers which are elevated in the majority of patients and support the diagnosis of GCA among patients who present with typical symptoms. GCA is confirmed with superficial temporal artery biopsy which demonstrates characteristic pathological findings...
January 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28131495/multiple-dose-and-double-dose-versus-single-dose-administration-of-methotrexate-for-the-treatment-of-ectopic-pregnancy-a-systematic-review-and-meta-analysis
#12
REVIEW
Chun Yang, Jing Cai, Yuhong Geng, Ying Gao
In this systematic review and meta-analysis, the effectiveness and safety among different dosage of methotrexate protocols for the treatment of unruptured tubal ectopic pregnancy was evaluated. Six studies of randomized contorlled trials were identified through searches conducted on PubMed, Embase and Cochrane Library between January 1974 and March 2016. The overall success rate of multiple-dose protocol was similar to the single-dose protocol (RR 1.07, 95% CI 0.99 to 1.17, I(2) = 0%). The difference between double-dose and single-dose groups was not significant (RR 1...
January 17, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28122960/countermeasures-against-methotrexate-intolerance-in-juvenile-idiopathic-arthritis-instituted-by-parents-show-no-effect
#13
Andrea Scheuern, Pascal N Tyrrell, Johannes-Peter Haas, Boris Hügle
OBJECTIVES: A high proportion of children with JIA will develop intolerance to MTX with anticipatory and associative gastrointestinal adverse effects. Parents and physicians frequently try to alleviate these symptoms with a variety of countermeasures. The objective of this study was to investigate the course of MTX intolerance within a 6 month period, and the effects of countermeasures on MTX intolerance severity. METHODS: We performed a prospective study of 196 consecutive JIA patients treated with MTX...
January 24, 2017: Rheumatology
https://www.readbyqxmd.com/read/28118621/high-dose-methotrexate-and-cytarabine-based-multi-agent-chemotherapy-modified-bonn-protocol-for-systemic-lymphoma-with-cns-involvement
#14
Kento Umino, Shin-Ichiro Fujiwara, Kazuya Sato, Daisuke Minakata, Hirofumi Nakano, Ryoko Yamasaki, Yasufumi Kawasaki, Miyuki Sugimoto, Chihiro Yamamoto, Kaoru Hatano, Kiyoshi Okazuka, Iekuni Oh, Ken Ohmine, Takahiro Suzuki, Kazuo Muroi, Yoshinobu Kanda
The prognosis of patients with systemic lymphoma with central nervous system (CNS) involvement is very poor and there is no established standard therapy. We retrospectively analyzed 18 patients (4 untreated and 14 relapsed) with systemic lymphoma with CNS involvement who received methotrexate and cytarabine-based multiagent chemotherapy (modified Bonn protocol). Complete and partial responses were achieved in 56 and 22% of the patients, respectively. The 1-year overall survival (OS) and progression-free survival (PFS) was 81...
January 25, 2017: Acta Haematologica
https://www.readbyqxmd.com/read/28116918/standard-and-biological-treatment-in-large-vessel-vasculitis-guidelines-and-current-approaches
#15
Francesco Muratore, Nicolò Pipitone, Carlo Salvarani
Giant cell arteritis and Takayasu arteritis are the two major forms of idiopathic large vessel vasculitis. High doses of glucocorticoids are effective in inducing remission in both conditions, but relapses and recurrences are common, requiring prolonged glucocorticoid treatment with the risk of the related adverse events. Areas covered: In this article, we will review the standard and biological treatment strategies in large vessel vasculitis, and we will focus on the current approaches to these diseases. Expert commentary: The results of treatment trials with conventional immunosuppressive agents such as methotrexate, azathioprine, mycophenolate mofetil, and cyclophosphamide have overall been disappointing...
February 6, 2017: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/28107255/high-methotrexate-triglutamate-level-is-an-independent-predictor-of-adverse-effects-in-asian-indian-rheumatoid-arthritis-patients-a-preliminary-study
#16
Amit Sandhu, Varun Dhir, Archana Bhatnagar, Veena Dhawan, Jasbinder Kaur, Ankita Sood, Shankar Naidu, Shabeer Ahmad, Neelam Varma, Aman Sharma, Shefali Sharma
BACKGROUND: It is unclear whether erythrocyte methotrexate polyglutamate levels (MTX-glun) are associated with response or adverse effects to methotrexate in rheumatoid arthritis. This preliminary study evaluated their utility in Asian-Indian patients over 24 weeks. METHODS: Rheumatoid arthritis patients were started on oral methotrexate at a dose of 15 mg per week, which was escalated to 25 mg by 12 weeks and continued till 24 weeks. Erythrocyte (RBC) MTX-glu1 to MTX-glu5 levels (nmol/L RBC) were determined at 4, 8, 16, and 24 weeks by using reverse-phase high-performance liquid chromatography...
January 19, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28104300/challenges-and-opportunities-in-primary-cns-lymphoma-a-systematic-review
#17
REVIEW
Mariana N Kerbauy, Fabio Y Moraes, Benjamin H Lok, Jennifer Ma, Lucila N Kerbauy, Daniel E Spratt, Fabio P S Santos, Guilherme F Perini, Alejandro Berlin, Caroline Chung, Nelson Hamerschlak, Joachim Yahalom
BACKGROUND: Historically, high-dose methotrexate (HD-MTX) plus consolidation chemotherapy and/or whole brain radiotherapy (WBRT) has been the gold standard on Primary Central Nervous System Lymphoma (PCNSL) management. We sought to examine and summarize the data, on clinical trial (CT) setting, investigating multi-modality treatment to PCNSL. METHODS: We performed a systematic review of electronic databases (Medline, EMBASE, Cochrane Database and clinicaltrials...
January 16, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28101900/bronchial-thermoplasty-in-severe-asthma-in-australia
#18
David Langton, Joy Sha, Alvin Ing, David Fielding, Erica Wood
BACKGROUND: Bronchial thermoplasty is an approved bronchoscopic intervention for the treatment of severe asthma. However, limited published experience exists outside of clinical trials regarding patient selection and outcomes achieved. Aims To evaluate the effectiveness and safety of bronchial thermoplasty in patients with severe asthma encountered in clinical practice. METHODS: This is a retrospective analysis of the first 'real world' data from Australia. The following outcomes were measured prior to, and 6 months following bronchial thermoplasty: Spirometry, Asthma Control Questionnaire-5 (ACQ-5) score, reliever and preventer medication use, and exacerbation history...
January 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28101356/a-case-report-of-primary-cutaneous-natural-killer-t-cell-lymphoma
#19
Chen Tian, Yong Yu, Yizhuo Zhang
Primary cutaneous extranodal natural killer/T-cell lymphoma, nasal type (ENKL-NT) is a relatively rare disease associated with aggressive tumor-cell behavior and poor prognosis. Progress in immunohistochemistry has improved the identification of ENKL-NT. The present case study reported on a 64-year-old female patient presenting with several red nodular lesions on the neck developed over four months. Cutaneous biopsy revealed these cells were positive for CD3, CD56, CD5, CD8 and negative for CD2, CD34, CD7, CD20 and Granzyme B...
December 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28096535/genetics-of-ancestry-specific-risk-for-relapse-in-acute-lymphoblastic-leukemia
#20
S E Karol, E Larsen, C Cheng, X Cao, W Yang, L B Ramsey, C A Fernandez, J R McCorkle, S W Paugh, R J Autry, E Lopez-Lopez, B Diouf, S Jeha, C-H Pui, E A Raetz, N J Winick, W L Carroll, S P Hunger, M L Loh, M Devidas, W E Evans, J J Yang, M V Relling
The causes of individual relapses in children with acute lymphoblastic leukemia (ALL) remain incompletely understood. We evaluated the contribution of germline genetic factors to relapse in 2225 children treated on Children's Oncology Group trial AALL0232. We identified 302 germline single-nucleotide polymorphisms (SNPs) associated with relapse after adjusting for treatment and ancestry and 715 additional SNPs associated with relapse in an ancestry-specific manner. We tested for replication of these relapse-associated SNPs in external data sets of antileukemic drug pharmacokinetics and pharmacodynamics and an independent clinical cohort...
February 10, 2017: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
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