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Therapeutic Advances in Chronic Disease

John W Frew, Jason E Hawkes, James G Krueger
Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin, manifesting in chronic, recurrent painful pustules, nodules, boils and purulent draining abscesses. Our current understanding of the pathogenesis of the disease is incomplete. This review aims to identify available treatment options in HS and discuss the pharmacological mechanisms through which such agents function. Identifying common pathways may inform our understanding of the pathogenesis of HS as well as identify future therapeutic targets...
2019: Therapeutic Advances in Chronic Disease
Lucía Gato-Calvo, Joana Magalhaes, Cristina Ruiz-Romero, Francisco J Blanco, Elena F Burguera
Platelet-rich plasma (PRP) is defined as a volume of plasma with a platelet concentration higher than the average in peripheral blood. Many basic, preclinical and even clinical case studies and trials report PRP's ability to improve musculoskeletal conditions including osteoarthritis, but paradoxically, just as many conclude it has no effect. The purpose of this narrative review is to discuss the available relevant evidence that supports the clinical use of PRP in osteoarthritis, highlighting those variables we perceive as critical...
2019: Therapeutic Advances in Chronic Disease
(no author information available yet)
No abstract text is available yet for this article.
2019: Therapeutic Advances in Chronic Disease
Abhinav Vasudevan, Asiri Arachchi, Cian Scanlon, Jarrod Greenhalgh, Daniel R Van Langenberg
Background: Early intervention for acute severe ulcerative colitis (ASUC) improves outcomes. Outcomes and healthcare costs for an infliximab-first and colectomy-first approach were compared. Methods: This single-center retrospective cohort study of inpatients with steroid-refractory ASUC who received infliximab 5 mg/kg (1-3 doses without maintenance) or initial colectomy between 2004 and 2014 assessed long-term healthcare utilization and direct costs following infliximab or colectomy, using admission coding data until 31 December 2016...
2019: Therapeutic Advances in Chronic Disease
Nicolas Audag, Christophe Goubau, Michel Toussaint, Gregory Reychler
Background: The purpose of this systematic review was to summarize the different dysphagia screening and evaluation tools, and to identify their measurement properties in adults with neuromuscular diseases (NMDs). Methods: A systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search strategy was conducted across three databases ( PubMed, CINAHL and ScienceDirect ). Measurement properties of each tools and the Quality Index, developed by Downs and Black, were considered for the different investigated studies...
2019: Therapeutic Advances in Chronic Disease
Ali Mahdavi Fard, Sangita P Patel, Leili Pourafkari, Nader D Nader
Bacground: The aim of this study was to conduct a meta-analysis to compare the overall intraocular pressure (IOP)-lowering effect of iStent or CyPass as isolated procedures or in combination with cataract extraction. Materials and methods: Cochrane review manager 5.3 software (RevMan® 5.3) was used for a meta-analysis of IOPs and the number of antiglaucoma medications in six groups according to the type and number of stents and whether the procedure was isolated or in combination with cataract extraction...
2019: Therapeutic Advances in Chronic Disease
Ruth Peters
Background: Hypertension is prevalent in older adults. Hypertension has also been associated with an increased risk of cognitive decline. However, evidence relating to the impact of antihypertensive use is mixed. Calcium-channel blockers (CCB) have been suggested as the most beneficial class of antihypertensive for protection of cognition in older adults, however, to date, there have been no cohort studies designed to examine this. Methods: Community-dwelling treated hypertensive adults aged 80 and over were recruited from general practice sites and followed for 1 year...
2019: Therapeutic Advances in Chronic Disease
Heather J MacKinnon, Thomas J Wilkinson, Amy L Clarke, Douglas W Gould, Thomas F O'Sullivan, Soteris Xenophontos, Emma L Watson, Sally J Singh, Alice C Smith
Objective: People with nondialysis-dependent chronic kidney disease (CKD) and renal transplant recipients (RTRs) have compromised physical function and reduced physical activity (PA) levels. Whilst established in healthy older adults and other chronic diseases, this association remains underexplored in CKD. We aimed to review the existing research investigating poor physical function and PA with clinical outcome in nondialysis CKD. Data sources: Electronic databases (PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials) were searched until December 2017 for cohort studies reporting objective or subjective measures of PA and physical function and the associations with adverse clinical outcomes and all-cause mortality in patients with nondialysis CKD stages 1-5 and RTRs...
November 2018: Therapeutic Advances in Chronic Disease
Elizabeth V Arkema, Yvette C Cozier
Sarcoidosis is a granulomatous inflammatory disease with unknown etiology. Epidemiological studies have contributed greatly to our knowledge about sarcoidosis, providing critical information on the determinants and distribution of the disease. In this review, we summarize recently published findings from epidemiological studies on sarcoidosis. We review the epidemiological tools used, the incidence and prevalence of disease, mortality and cancer risk after sarcoidosis and nongenetic risk factors for sarcoidosis...
November 2018: Therapeutic Advances in Chronic Disease
Charles Badu-Boateng, Robert Jennings, Daniel Hammersley
Heart failure represents a major global cause of morbidity and mortality. Ivabradine is a selective funny current (If ) inhibitor, which acts on the sinoatrial node, resulting in a reduction in heart rate. Ivabradine is currently licensed for use in patients with symptomatic heart failure with reduced ejection fraction and a heart rate persistently at least 70 beats per minute in spite of otherwise optimal prognostic heart failure pharmacotherapy. In this review article, we examine the mechanism of action of ivabradine, evaluate the clinical trials underpinning its application in heart failure and discuss its current recommended clinical use in this capacity...
November 2018: Therapeutic Advances in Chronic Disease
Isobel Dobbin-Sears, Janet Roberts, Darren D O'Rielly, Proton Rahman
Psoriatic arthritis (PsA) is an inflammatory arthritis that commonly occurs with psoriasis and is attributed to genetic, immunologic and environmental factors. The T-helper (Th)-17 pathway and the interleukin (IL)-23/IL-17 axis have become prominent players in PsA and considerably increased our understanding of disease pathogenesis. In this review article, we will focus on the emerging role of IL-12/23 and its blockade, in the pathogenesis and management of PsA as well as of psoriasis and inflammatory bowel disease...
October 2018: Therapeutic Advances in Chronic Disease
Katy E Trinkley, Heather D Anderson, Kavita V Nair, Daniel C Malone, Joseph J Saseen
Background: Despite strong recommendations to use metformin as first-line therapy for type 2 diabetes (T2DM), its use has been suboptimal, likely due to concerns of lactic acidosis. This study compared the association of acidosis in patients with T2DM prescribed metformin with those prescribed other antihyperglycemic medications or no medications. Methods: This was a retrospective cohort study of patients with newly diagnosed T2DM utilizing an administrative database, which includes medical and prescription claims...
September 2018: Therapeutic Advances in Chronic Disease
Cher Y Enderby, Charles Burger
Background: Treprostinil is a prostacyclin analogue that directly vasodilates pulmonary and systemic arterial vascular beds. The United States Food and Drug Administration approved inhaled treprostinil in July 2009 for the treatment of group 1 pulmonary arterial hypertension. Inhaled treprostinil avoids issues with continuous infusion prostanoids. This study describes a single institutional experience with inhaled treprostinil. Methods: This was a retrospective review of group 1 pulmonary arterial hypertension patients receiving inhaled treprostinil from July 2009 through September 2015...
September 2018: Therapeutic Advances in Chronic Disease
Lieneke F M Ariëns, Daphne S Bakker, Jorien van der Schaft, Floor M Garritsen, Judith L Thijs, Marjolein S de Bruin-Weller
Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases. The prevalence of AD is increasing and is currently estimated at 10-20% in adults worldwide. In the majority of patients, AD can be adequately controlled with topical treatment or ultraviolet light therapy, but there is a high unmet need for effective and safe therapeutics in patients with more severe or difficult to treat AD. During the past decade, new advances in the understanding of the underlying immune pathogenesis of AD have led to the development of new, more targeted therapies...
September 2018: Therapeutic Advances in Chronic Disease
Paul Sator
Biologic therapies like adalimumab are the gold standard for psoriasis treatment with efficacy and safety profiles allowing for long-term treatment. However, adalimumab cannot be used in all patients and may cause adverse drug reactions. This study reviews conditions that might limit the use of adalimumab under real-life conditions. Local injection site reactions affect 12-37% of patients but rarely require specific therapy. Dermatological adverse events (AEs) include the paradoxical psoriasis and tend to respond to adequate therapy without adalimumab discontinuation...
August 2018: Therapeutic Advances in Chronic Disease
Huei-Wen Lim, Benny Yiu Wong, David Elkowitz, Keith Sultan
An 85-year-old woman presented with 9.1 kg (20 lb) weight loss over 5 months and an acute onset crampy abdominal pain. Examination revealed a diffusely tender abdomen, with gastric wall thickening noted on CT scan. Upper endoscopy showed diffuse severe erythema and friability. Histologic examination with hematoxylin and eosin staining revealed collagenous gastritis characterized by active chronic inflammation with sub-epithelial collagen deposition and erosion. The patient was started on steroid therapy with rapid clinical improvement and tapered off over 2...
August 2018: Therapeutic Advances in Chronic Disease
Alendia Hartshorn, Barbara Jobst
Stimulation devices are considered in patients with drug-resistant epilepsy and who are not surgical candidates. Responsive neurostimulation (RNS) is a cortically based stimulator activated by electrocorticography (ECoG) patterns. Stimulation is applied directly to the seizure focus. The vagal nerve stimulator AspireSR 106 is also a responsive device which, in addition to basal stimulation, is activated by tachycardia. Deep brain stimulation of the anterior nucleus of the thalamus is used in Europe for intractable epilepsy and yields similar response rates to RNS using duty cycle stimulation...
July 2018: Therapeutic Advances in Chronic Disease
Joaquin de Haro, Javier Rodriguez-Padilla, Silvia Bleda, Cristina Cañibano, Ignacio Michel, Francisco Acin
Background: Although the management of carotid disease is well established for symptomatic lesions ⩾70%, carotid revascularization for symptomatic low-grade (⩽50%) stenosis is not actually supported by data from randomized clinical trials. Such patients may occasionally have recurrent neurological symptoms despite optimal medical treatment owing to vulnerable plaques. In such cases, carotid artery stenting (CAS) may represent an option for treatment but this has not been tested in clinical trials...
June 2018: Therapeutic Advances in Chronic Disease
Maria Rendina, Nicola Maurizio Castellaneta, Giuseppe Losurdo, Antonino Castellaneta, Annamaria Cazzolla, Claudia Chialà, Francesca D'Errico, Alfredo Di Leo
No abstract text is available yet for this article.
June 2018: Therapeutic Advances in Chronic Disease
Tom C Chan, Jason E Hawkes, James G Krueger
Plaque psoriasis is one of the most common autoimmune skin diseases and is characterized by erythematous, scaly plaques. Many highly effective, targeted therapies have been developed as a result of an improved understanding of the pathogenesis of psoriasis. Using agents that target the central interleukin (IL)-23/IL-17 immune axis, this once difficult-to-treat disease is now among the most effectively treated autoimmune diseases with major clinical improvements possible in around 90% of patients. In this article, we outline the immune mechanisms responsible for the development of psoriasis and provide an overview of the novel IL-23 antagonists being used to manage this chronic skin disease...
May 2018: Therapeutic Advances in Chronic Disease
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