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methotrexate and long term effects

Tomona Hiyama, Yosuke Harada, Yoshiaki Kiuchi
Purpose: Sympathetic ophthalmia (SO) is an autoimmune, bilateral, granulomatous panuveitis, which occurs following penetrating eye injury or eye surgery. We report two cases of refractory SO in patients with a history of trabeculectomy, which were treated effectively with adalimumab. Observations: Case 1: A 69-year-old male with a history of trabeculectomy for rubeotic glaucoma of the right eye, secondary to diabetic retinopathy 8 years prior, presented with a decrease in visual acuity of the left eye due to SO...
June 2019: American Journal of Ophthalmology Case Reports
Johan Törlén, Ahmed Gaballa, Mats Remberger, Lisa-Mari Mörk, Berit Sundberg, Jonas Mattsson, Michael Uhlin
Lymphocyte reconstitution is pivotal for successful long-term outcome after allogeneic hematopoietic stem cell transplantation (HSCT), and conditioning and post-transplant immunosuppression constitute risk factors for prolonged immunodeficiency. Nevertheless, the effect of different immunosuppressive protocols on lymphocyte output and replicative capacity has not been investigated. Here, we assessed T-cell receptor excision circles (TREC), kappa-deleting recombination excision circles (KREC), and T-cell telomere length (TL) as proxy markers for immune reconstitution in patients in a prospective randomized trial comparing graft-versus-host disease (GVHD) prophylaxis after transplantation (cyclosporine/methotrexate vs...
January 30, 2019: Biology of Blood and Marrow Transplantation
Francesca Bonifazi, Carlos Solano, Christine Wolschke, Mariarosaria Sessa, Francesca Patriarca, Francesco Zallio, Arnon Nagler, Carmine Selleri, Antonio Maria Risitano, Giuseppe Messina, Wolfgang Bethge, Pilar Herrera, Anna Sureda, Angelo Michele Carella, Michele Cimminiello, Stefano Guidi, Jürgen Finke, Roberto Sorasio, Christelle Ferra, Jorge Sierra, Domenico Russo, Edoardo Benedetti, Giuseppe Milone, Fabio Benedetti, Marion Heinzelmann, Domenico Pastore, Manuel Jurado, Elisabetta Terruzzi, Franco Narni, Andreas Völp, Francis Ayuk, Tapani Ruutu, Nicolaus Kröger
BACKGROUND: We previously showed that human anti-T-lymphocyte globulin (ATLG) plus ciclosporin and methotrexate given to patients with acute leukaemia in remission, having allogeneic haemopoietic stem-cell transplantation with peripheral blood stem cells from an HLA-identical sibling donor after myeloablative conditioning, significantly reduced 2-year chronic graft-versus-host disease (cGVHD) incidence and severity, without increasing disease relapse and infections, and improves cGVHD-free and relapse-free survival (cGRFS)...
February 2019: Lancet Haematology
H Dickel, T Bruckner, S Höxtermann, B Dickel, E Trinder, P Altmeyer
BACKGROUND: Fumaric acid esters (FAEs) are used to treat psoriasis and are known to cause lymphopenia in roughly 60% of the patients. Much remains to be elucidated about the biological effects of FAEs on lymphocytes. OBJECTIVE: To evaluate the influence of long-term FAE (Fumaderm® ) treatment on peripheral blood CD4+ and CD8+ T cells, CD19+ B cells and CD56+ natural killer (NK) cells in psoriasis. METHODS: In this single-centre retrospective observational subcohort study, we obtained leucocyte and lymphocyte subset counts before initiating FAE therapy in 371 psoriasis patients (mean age, 47...
January 24, 2019: Journal of the European Academy of Dermatology and Venereology: JEADV
Anes Yang, Minhee Kim, Philip Craig, Dedee F Murrell
A 49-year-old man with recalcitrant mechanobullous epidermolysis bullosa acquisita (EBA) with significant esophageal involvement was treated with rituximab. EBA is a chronic autoimmune subepidermal bullous disease. It is characterized by skin fragility and scarring caused by circulating and tissue bound antibodies to type VII collagen. EBA is often unresponsive or poorly responsive to conventional immunosuppressive therapies such as corticosteroids, methotrexate, and cyclosporine. The burden of long-term use of immunosuppressants also limits their use in the treatment of chronic autoimmune diseases such as EBA...
December 2018: Acta Dermatovenerologica Croatica: ADC
Emma C de Moel, Veerle F A M Derksen, Leendert A Trouw, Holger Bang, Gerard Collée, Leroy R Lard, Sofia Ramiro, Tom W J Huizinga, Cornelia F Allaart, René E M Toes, Diane van der Woude
BACKGROUND: Rheumatoid arthritis (RA) is characterized by the presence of autoantibodies like rheumatoid factor (RF), anti-cyclic citrullinated peptide-2 (anti-CCP2), and anti-carbamylated protein (anti-CarP) antibodies. It is currently unclear whether changes in autoantibody levels are associated with disease activity/treatment outcomes and whether they are modified by treatment intensity. Therefore, we determined longitudinal changes in RA-autoantibody levels, the association between these changes and activity score (DAS) and treatment outcomes, and the effect of intensity of immunosuppressive treatment on levels...
January 18, 2019: Arthritis Research & Therapy
Miriam Frenken, Christoph Schleich, Ralph Brinks, Daniel Benjamin Abrar, Christine Goertz, Matthias Schneider, Benedikt Ostendorf, Philipp Sewerin
BACKGROUND: The aim of the study was to evaluate a simplified version of the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) for five joints of the hand (RAMRIS-5) in patients with early rheumatoid arthritis (RA) before and after the initiation of methotrexate (MTX) therapy using high-resolution, 3-T magnetic resonance imaging (MRI). METHODS: Twenty-eight patients with a seropositive, early RA (disease duration of less than 6 months (range 2-23 weeks)) according to 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria (mean age 56...
January 14, 2019: Arthritis Research & Therapy
Yi-Cheng Wang, Ming-Tsung Wu, Feng-Yao Tang, Der-Yuan Chen, Hsin-An Ko, Barry Shane, Wen-Nan Huang, En-Pei Chiang
OBJECTIVE:  Currently no guidelines are established for pharmacogenomic testing involving folate metabolic genes in long-term disease-modifying antirheumatic drugs (DMARD) therapies. We carefully investigated how common genetic variations in methylenetetrahydrofolate reductase ( MTHFR ) influence cellular metabolic kinetics in response to methotrexate (MTX). DESIGNS: Two distinct cell models: HepG2 with stabilized MTHFR  inhibition using shRNA delivered by a Lentiviral vector; and Epstein-Barr virus transformed human lymphoblasts expressing MTHFR polymorphic allele 677C and 677T were used...
January 3, 2019: Clinical Science (1979-)
Stefan Mark Nidorf, Peter Lindsay Thompson
PURPOSE: Colchicine is a widely available, inexpensive drug with a range of antiinflammatory properties that may make it suitable for the secondary prevention of atherosclerosis. This review examines how past and contemporary approaches to antiinflammatory therapy for atherosclerosis have led to a better understanding of the nature of the disease and sets out the reasons why colchicine has the potential to become a cornerstone therapy in its management. METHODS: We performed a literature search using PubMed, the Cochrane library, and clinical trial registries to identify completed and ongoing clinical studies on colchicine in coronary artery disease, and a PubMed search to identify publications on the mechanism of action of colchicine relevant to atherosclerosis...
December 24, 2018: Clinical Therapeutics
Joost Swart, Gabriella Giancane, Gerd Horneff, Bo Magnusson, Michael Hofer, Еkaterina Alexeeva, Violeta Panaviene, Brigitte Bader-Meunier, Jordi Anton, Susan Nielsen, Fabrizio De Benedetti, Sylvia Kamphuis, Valda Staņēviča, Maria Tracahana, Laura Marinela Ailioaie, Elena Tsitsami, Ariane Klein, Kirsten Minden, Ivan Foeldvari, Johannes Peter Haas, Jens Klotsche, Anna Carin Horne, Alessandro Consolaro, Francesca Bovis, Francesca Bagnasco, Angela Pistorio, Alberto Martini, Nico Wulffraat, Nicolino Ruperto
BACKGROUND: The availability of methotrexate and the introduction of multiple biological agents have revolutionized the treatment of juvenile idiopathic arthritis (JIA). Several international and national drug registries have been implemented to accurately monitor the long-term safety/efficacy of these agents. This report aims to present the combined data coming from Pharmachild/PRINTO registry and the national registries from Germany (BiKeR) and Sweden. METHODS: Descriptive statistics was used for demographic, clinical data, drug exposure, adverse events (AEs) and events of special interest (ESIs)...
December 27, 2018: Arthritis Research & Therapy
Ratchaya Lertnawapan, Soonthorn Chonprasertsuk, Sith Siramolpiwat
BACKGROUND: Methotrexate (MTX) is recommended by recent American College of Rheumatology and European League against Rheumatism guidelines as a first-line drug for rheumatoid arthritis (RA). Liver fibrosis, which occurs as a long-term side effect is of major concern. Monitoring aminotransferase and albumin is suggested in the guidelines, unfortunately this method is unreliable for detecting liver fibrosis. We try to find the association between clinical parameters, cumulative MTX dosage, liver fibrosis scoring systems and the presence of liver fibrosis assessed by transient elastography (TE; Fibroscan®)...
November 22, 2018: International Journal of Rheumatic Diseases
Rieke Alten, Max Mischkewitz
70 years after their first use, low-dose glucocorticoids are a common part of pharmacological rheumatoid arthritis treatment. This is due to their well-proven capacities in symptom severity and disease activity reduction, in particular when combined with a disease-modifying anti-rheumatic drug, such as methotrexate. Nevertheless, glucocorticoid administration, in long-term especially, is also seen critically because of its potential adverse conditions. In order to achieve a reduction in treatment-related adverse events, modern therapy regimes should take into consideration patients' risk factors and therefore be individual...
December 5, 2018: Joint, Bone, Spine: Revue du Rhumatisme
A D Irvine, A P Jones, P Beattie, S Baron, F Browne, F Ashoor, L O'Neill, A Rosala-Hallas, T Sach, C Spowart, L Taams, C Walker, M Wan, N Webb, P Williamson, C Flohr
Atopic eczema is a skin disease affecting around 20% of UK children, 16% of whom have moderate to severe disease. Severe atopic eczema can cause sleep disturbance, poor school attendance and social withdrawal, as well as attention-deficit hyperactivity disorder, anxiety and clinical depression. Skin can become infected and this can be a reason for hospital admission. Although most cases of atopic eczema can be treated with emollients, topical anti-inflammatory treatments and/or ultraviolet (UV) therapy, around 2% of children require oral (taken by mouth) immuno-suppressive treatment...
December 2018: British Journal of Dermatology
Elias Jabbour, Nicholas J Short, Farhad Ravandi, Xuelin Huang, Naval Daver, Courtney D DiNardo, Marina Konopleva, Naveen Pemmaraju, William Wierda, Guillermo Garcia-Manero, Koji Sasaki, Jorge Cortes, Rebecca Garris, Joseph D Khoury, Jeffrey Jorgensen, Nitin Jain, Joie Alvarez, Susan O'Brien, Hagop Kantarjian
BACKGROUND: The combination of chemotherapy and ponatinib in Philadelphia chromosome-positive acute lymphoblastic leukaemia has the potential to be a new standard of care for the disease; however, long-term efficacy and safety data are needed. Our aim was to evaluate the long-term efficacy and safety of this regimen in patients with newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukaemia in this ongoing phase 2 trial. METHODS: In our single-centre, phase 2, single-arm trial in the USA, adult patients with previously untreated Philadelphia chromosome-positive acute lymphoblastic leukaemia were sequentially enrolled...
December 2018: Lancet Haematology
Yasmeen Thandar, Rivesh Maharajh, Firoza Haffejee, Anisa Mosam
BACKGROUND: Although numerous medications are available for the treatment of cutaneous lichen planus (CLP), recurrence is common and there is a lack of evidence of efficacy of many treatment options. Part 1 reviewed consolidated evidence from topical therapies and phototherapy. In Part 2, all systemic treatments are assessed. METHODS: All English studies, regardless of design, investigating the outcome of systemic treatment for CLP, until January 2018, were included...
November 17, 2018: Journal of Dermatological Treatment
Fabio Cacciapaglia, Maria Grazia Anelli, Angela Rinaldi, Marco Fornaro, Giuseppe Lopalco, Crescenzio Scioscia, Giovanni Lapadula, Florenzo Iannone
Rheumatoid arthritis (RA) patients are at high risk of cardiovascular (CV) events, and the chronic inflammatory state may generate quantitative and qualitative changes in lipoprotein fractions. The anti-IL-6 receptor tocilizumab (TCZ), even if effective in inflammation and joint damage prevention, determined significant alterations to RA patients' lipid levels in randomized controlled trials, but real-world data are lacking. We evaluated the changes in lipid fraction levels and disease activity in a longitudinal cohort of RA patients on long-term treatment with tocilizumab (TCZ) in a community setting...
2018: Mediators of Inflammation
Brian Liu, Robert A Schwartz
Psoriasis management can be challenging, complicated sometimes by being associated with other systematic inflammatory diseases including metabolic syndrome, myocardial infarction, hypertension, obesity, diabetes mellitus, and hyperlipidemia. Of particularly concern is its cardiovascular linkage. It is noteworthy and reassuring that some therapeutic options for psoriasis may be cardio-protective. We highlight phototherapy, methotrexate, and TNF alpha inhibitors and other biological agents for psoriasis that may lower the risk of cardiovascular events...
October 2018: Acta Dermatovenerologica Croatica: ADC
Laila M Sherief, Reda Sanad, Alaa ElHaddad, Adel Shebl, Elhamy R Abdelkhalek, Eman R Elsafy, Tamer H Hassan, Nelly Raafat, Naglaa M Kamal, Eman I Attia
Introduction: Subtle neurocognitive deficits have been recently observed in Acute Lymphoblastic Leukemia (ALL) survivors. Aim: We aim to assess the neurocognitive functions of ALL survivors who had been treated with chemotherapy only using two different protocols, and to identify treatment-related risk factors. Patients and Methods: We carried a multicenter study involving 3 pediatric oncology centers on 100 children who were treated for ALL. Fifty patients were treated by the modified Children’s Cancer Group (CCG) 1991 protocol with low dose methotrexate and 50 children were treated by Total XV protocol with high dose methotrexate...
October 31, 2018: Current Pediatric Reviews
Maria V Hernandez, Carlos Sanchez-Piedra, Blanca Garcia-Magallon, Eduardo Cuende, Javier Manero, Cristina Campos-Fernandez, Raquel Martin-Domenech, Javier Del Pino-Montes, Sara Manrique, Maria C Castro-Villegas, Dolores Ruiz-Montesinos, Fernando Sanchez-Alonso, Federico Diaz-Gonzalez, Luis Cea-Calvo, Juan J Gómez-Reino
The retention rate of a biological drug (percentage of patients remaining on treatment over time) provides an index of a drug's overall effectiveness. The golimumab retention rate as first-line biological therapy was high in clinical trial extensions lasting 5 years. Real-world studies also indicate good retention rates but have been of shorter duration. The probability of retention with golimumab treatment was assessed, as any line of anti-tumor necrosis factor-alpha therapy, for up to 5 years in patients with rheumatoid arthritis (RA), axial spondyloarthritis (SpA) or psoriatic arthritis (PsA), associated factors were analyzed...
October 24, 2018: Rheumatology International
Saeed Akhlaghi, Maryam Sahebari, Mahmoud Mahmoodi, Mehdi Yaseri, Mohammad Ali Mansournia, Houshang Rafatpanah, Hojjat Zeraati
Purpose: One of the most important long-term side effects of therapy for rheumatoid arthritis (RA) is the elevation of liver function tests, with earlier studies reporting an elevation of more than 1× the upper limit of normal (>1 × ULN). The current study expands the literature by comparing the trends of transaminase changes caused by conventional and biologic disease-modifying antirheumatic drugs (DMARDs). Patients and methods: The drug categories examined were methotrexate (MTX) and all other nonbiologic DMARDs...
2018: Therapeutics and Clinical Risk Management
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