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prednisone long term effects

Liang Wang, Lei Xu, Hongyuan Hao, A J Gerard Jansen, Guoqiang Liu, Honglei Li, Xinguang Liu, Yajing Zhao, Jun Peng, Ming Hou
Immune thrombocytopenia (ITP) is an autoimmune disease with a mild to severe risk of bleeding complications. First line treatment includes corticosteroids, immunoglobulins, or other. In this large cohort study, first-line strategies for treatment-naive adult primary ITP was studied in a real-world setting. Records from all adult ITP patients who received first-line treatment between January 2010 and December 2017 at Qilu Hospital were reviewed retrospectively (n = 699). During the study period, 271 patients were treated with high-dose dexamethasone (HDD) and 289 patients were treated with conventional prednisone (alone or in combination with other drugs)...
February 11, 2019: Platelets
Iliana Doycheva, Kymberly D Watt, Aliya F Gulamhusein
Autoimmune hepatitis (AIH) is a rare immune-mediated liver disease with few major advances in treatment options over the last several decades. Available options are effective in most patients albeit are imprecise in their mechanisms. Novel and more tolerable induction regimens and alternative options for management of patients intolerant or with suboptimal response to traditional therapies including in the post-transplant setting remain an important unmet need. This review aims to summarize recent data on pharmacological options and investigational drugs in development for patients with AIH...
February 4, 2019: Liver International: Official Journal of the International Association for the Study of the Liver
Gil I Wolfe, Henry J Kaminski, Inmaculada B Aban, Greg Minisman, Hui-Chien Kuo, Alexander Marx, Philipp Ströbel, Claudio Mazia, Joel Oger, J Gabriel Cea, Jeannine M Heckmann, Amelia Evoli, Wilfred Nix, Emma Ciafaloni, Giovanni Antonini, Rawiphan Witoonpanich, John O King, Said R Beydoun, Colin H Chalk, Alexandru C Barboi, Anthony A Amato, Aziz I Shaibani, Bashar Katirji, Bryan R F Lecky, Camilla Buckley, Angela Vincent, Elza Dias-Tosta, Hiroaki Yoshikawa, Márcia Waddington-Cruz, Michael T Pulley, Michael H Rivner, Anna Kostera-Pruszczyk, Robert M Pascuzzi, Carlayne E Jackson, Jan J G M Verschuuren, Janice M Massey, John T Kissel, Lineu C Werneck, Michael Benatar, Richard J Barohn, Rup Tandan, Tahseen Mozaffar, Nicholas J Silvestri, Robin Conwit, Joshua R Sonett, Alfred Jaretzki, John Newsom-Davis, Gary R Cutter
BACKGROUND: The Thymectomy Trial in Non-Thymomatous Myasthenia Gravis Patients Receiving Prednisone (MGTX) showed that thymectomy combined with prednisone was superior to prednisone alone in improving clinical status as measured by the Quantitative Myasthenia Gravis (QMG) score in patients with generalised non-thymomatous myasthenia gravis at 3 years. We investigated the long-term effects of thymectomy up to 5 years on clinical status, medication requirements, and adverse events. METHODS: We did a rater-blinded 2-year extension study at 36 centres in 15 countries for all patients who completed the randomised controlled MGTX and were willing to participate...
January 25, 2019: Lancet Neurology
G S Alarcón, M F Ugarte-Gil, G Pons-Estel, L M Vilá, J D Reveille, G McGwin
OBJECTIVE: The objective of this report is to determine the impact of remission and low disease activity state (LDAS) on damage accrual and mortality in systemic lupus erythematosus (SLE) patients. PATIENTS AND METHODS: Visits from the Lupus in Minority populations: Nature vs. Nurture (LUMINA) cohort were categorized into remission (Systemic Lupus Activity Measure (SLAM) score = 0 and prednisone ≤ 5 mg/day and no immunosuppressants), LDAS ((not on remission), SLAM score ≤ 3, prednisone ≤ 7...
January 24, 2019: Lupus
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
Zenya Saito, Yugo Kaneko, Tsukasa Hasegawa, Masahiro Yoshida, Kyuto Odashima, Tsugumi Horikiri, Akira Kinoshita, Keisuke Saitoh, Kazuyoshi Kuwano
BACKGROUND: Relapse of cryptogenic organizing pneumonia (COP) may lead to poor long-term prognosis and necessitates multiple rounds of steroid treatment with potential adverse effects. The objective of this study is to identify predictive factors of COP relapse by comparing demographic and clinical variables between relapse and non-relapse groups. METHODS: During 2008-2013, 33 COP patients were treated, of which 23 (69.7%) and 10 patients (30.3%) were assigned to the non-relapse and relapse group, respectively...
January 9, 2019: BMC Pulmonary Medicine
Michele Merli, Marco Frigeni, Laurent Alric, Carlo Visco, Caroline Besson, Lara Mannelli, Alice Di Rocco, Angela Ferrari, Lucia Farina, Mario Pirisi, Francesco Piazza, Véronique Loustaud-Ratti, Annalisa Arcari, Dario Marino, Antonello Sica, Maria Goldaniga, Chiara Rusconi, Massimo Gentile, Emanuele Cencini, Francesco Benanti, Maria Grazia Rumi, Virginia Valeria Ferretti, Paolo Grossi, Manuel Gotti, Roberta Sciarra, Maria Chiara Tisi, Isabel Cano, Valentina Zuccaro, Francesco Passamonti, Luca Arcaini
BACKGROUND: International guidelines suggest hepatitis C virus (HCV) eradication by direct-acting antivirals (DAAs) after first-line immunochemotherapy (I-CT) in patients with HCV-positive diffuse large B-cell lymphoma (DLBCL), although limited experiences substantiate this recommendation. Moreover, only a few data concerning concurrent administration of DAAs with I-CT have been reported. SUBJECTS, MATERIALS, AND METHODS: We analyzed hematological and virological outcome and survival of 47 consecutive patients with HCV-positive DLBCL treated at 23 Italian and French centers with DAAs either concurrently (concurrent cohort [ ConC ]: n = 9) or subsequently (sequential cohort [ SeqC ]: n = 38) to first-line I-CT (mainly rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone [R-CHOP]-like)...
December 14, 2018: Oncologist
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
Silvia Nastasio, Marco Sciveres, Lorenza Matarazzo, Cristina Malaventura, Francesco Cirillo, Silvia Riva, Giuseppe Maggiore
BACKGROUND: Cyclosporine (CSA) is an alternative treatment for autoimmune hepatitis (AIH), however, its unknown long-term safety and efficacy have limited its use. AIMS: Examine the long-term outcome of children and young adults with AIH treated with CSA for at least 4 years. METHODS: Twenty patients were included in this retrospective study: 15 with classical AIH and 5 with autoimmune hepatitis/autoimmune sclerosing cholangitis overlap syndrome (ASC)...
November 3, 2018: Digestive and Liver Disease
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
Sandra Eketorp Sylvan, Anna Asklid, Hemming Johansson, Jenny Klintman, Jenny Bjellvi, Staffan Tolvgård, Eva Kimby, Stefan Norin, Per-Ola Andersson, Claes Karlsson, Karin Karlsson, Birgitta Lauri, Mattias Mattsson, Anna Bergendahl Sandstedt, Maria Strandberg, Anders Österborg, Lotta Hansson
The aim of this study was to investigate long-term outcome following first line therapy in consecutive chronic lymphocytic leukemia patients in a well defined geographic area (Sweden). All patients diagnosed with chronic lymphocytic leukemia (2007-2013) (n=3672) were identified from national registries, screening of patient files identified all (100%) first line treated (n=1053) and for those, depth analysis was performed. Endpoints were overall response rate, progression-free survival, overall survival and safety...
November 22, 2018: Haematologica
Jia Zhu, Gaixiu Su, Jianming Lai, Boya Dong, Min Kang, Shengnan Li, Zhixuan Zhou, Fengqi Wu
OBJECTIVE: To follow up the refractory juvenile dermatomyositis (JDM) with autologous hematopoietic stem cell transplantation (AHSCT) in a long time and to investigate whether AHSCT is effective and safe to treat refractory JDM. METHODS: We collected the AHSCT and follow-up data of three patients with refractory JDM who received autologous peripheral blood CD34+ cell transplantation in our hospital between June 2004 and July 2015. Those data include: hight, weight, routine blood and urine tests, ESR, CK, ALT, AST, LDH, renal functional tests, lymphocyte subpopulations, HRCT and muscle MRI...
November 20, 2018: Pediatric Rheumatology Online Journal
David C Dale, Audrey Anna Bolyard, Tracy Marrero, Merideth L Kelley, Vahagn Makaryan, Emily Tran, Jamie Leung, Laurence A Boxer, Priya S Kishnani, Stephanie Austin, Corbinian Wanner, Iris A Ferrecchia, Dina Khalaf, Dawn Maze, Joanne Kurtzberg, Cornelia Zeidler, Karl Welte, David A Weinstein
PURPOSE OF REVIEW: Glycogen storage disease Ib (GSD Ib) is characterized by hepatomegaly, hypoglycemia, neutropenia, enterocolitis and recurrent bacterial infections. It is attributable to mutations in G6PT1, the gene for the glucose-6-phosphate transporter responsible for transport of glucose into the endoplasmic reticulum. Neutropenia in GSD Ib is now frequently treated with granulocyte colony-stimulating factor (G-CSF). We formed a cooperative group to review outcomes of the long-term treatment of GSD Ib patients treated with G-CSF...
January 2019: Current Opinion in Hematology
Stephen D Smith, Shruti Gandhy, Ajay K Gopal, Prathima Reddy, Mazyar Shadman, Brian G Till, Ryan C Lynch, Sandra Kanan, Andrew Cowan, Lauren Low, Brian T Hill
BACKGROUND: Initial treatment of mantle cell lymphoma (MCL) incorporating autologous stem cell transplantation affords long-term remissions, but relapses still occur. Optimal pretransplant therapy will afford high complete response rates and not impair stem cell collection. Incorporation of bortezomib represents a natural evolution of pretransplant therapy, given its proven first-line efficacy and minimal impact on stem cell collection. PATIENTS AND METHODS: At the University of Washington/Seattle Cancer Care Alliance and the Cleveland Clinic Foundation, we developed modified VR-CAP/R+ara-C (bortezomib, rituximab, cyclophosphamide, doxorubicin, and prednisone, alternating with rituximab and high-dose cytarabine), for transplant-eligible patients with MCL...
October 17, 2018: Clinical Lymphoma, Myeloma & Leukemia
Agnieszka Kalinska-Bienias, Emilia Kowalczyk, Pawel Jagielski, Cezary Kowalewski, Katarzyna Wozniak
BACKGROUND: Bullous pemphigoid (BP) is an autoimmune blistering disease associated with preexisting comorbidities and higher mortality. The interest in using therapy other than oral steroids in BP management results from severe complications and increased risk of death. The efficacy of oral doxycycline or whole-body application of topical clobetasol has been proven in randomized controlled trials. The case series study suggested that combination of tetracycline, nicotinamide, and lesionally administered clobetasol may also be useful...
October 22, 2018: International Journal of Dermatology
Ikjae Lee, Henry J Kaminski, Tarrant McPherson, Michelle Feese, Gary Cutter
Objective: Prednisone is a first-line immunosuppressive treatment for myasthenia gravis (MG), whereas short-term and long-term adverse effects (AEs) are a limiting factor in its usage. Method: The MG patient registry is a patient-driven, nation-wide database with patients of age ≥18 years, who were diagnosed with MG and live in the United States. Custom-designed "prednisone-steroid use and MG" survey was sent out to MG registry participants as part of semi-annual follow-up...
November 2018: Neurology® Neuroimmunology & Neuroinflammation
Xiangling Li, Zhengqi Lu, Yanqiang Wang
BACKGROUND: Besides CSF-flow obstruction, syringomyelia is associated with inflammatory spinal cord lesions. However, syringomyelia-like syndrome concomitant with neuromyelitis optica spectrum disorder (NMOSD) and primary Sjogren's syndrome (pSS) is extremely rare. Here, we would like to report a case of a patient with syringomyelia-like syndrome in NMOSD complicated with Sjogren's Syndrome. CASE PRESENTATION: A 64-old male Han Chinese, presented with three episodes of acute demyelinating processes in the central nervous system within 5 years...
October 9, 2018: BMC Neurology
Julia Gesing, Julia Hoppmann, Roman Gebauer, Roland Pfäffle, Astrid Bertsche, Wieland Kiess
Amiodarone-induced hyperthyroidism is a known side effect of amiodarone treatment. In the pediatric population, long-term amiodarone treatment is rarely indicated because of its severe side effects including thyroid function impairment. Treatment is therefore restricted to therapy-resistant arrhythmias. In the literature, scarce data are available on the management and therapy of amiodarone-induced thyroid dysfunction at a young age. We present three adolescent patients developing amiodarone-induced thyrotoxicosis in the months after amiodarone therapy...
December 2018: Pediatric Cardiology
Yan-Zhi Liu, Mohammed P Akhter, Xiang Gao, Xiao-Yan Wang, Xiao-Bei Wang, Gang Zhao, Xin Wei, Hao-Jun Wu, Hang Chen, Dong Wang, Liao Cui
Background: The objective of the study was to investigate the effects of glucocorticoid (GC) on the fracture healing process in a closed femur fracture mice model. Materials and methods: Forty 12-week-old female CD-1 mice were randomly allocated into four groups: healthy control and mice with prednisone exposure (oral gavage), 6 mg/kg/day (GC-L), 9 mg/kg/day (GC-M) and 12 mg/kg/day (GC-H). Three weeks after the initiation of prednisone dosing, closed femur fractures were created on prednisone-exposed mice and the healthy control...
2018: Clinical Interventions in Aging
Steven Lehrer, Peter H Rheinstein
Background: Studies of Alzheimer's disease suggest that neuroinflammation or deranged brain wound healing may be a cause of some cases. But a placebo controlled study showed no effect at all on Alzheimer's disease of low dose oral prednisone after one year. Introducing the steroid directly into the hippocampus and rhinencephalon via the nose, as happens in hay fever subjects, could be more effective. Objective: In the present study, we analyzed FDA MedWatch data for intranasal fluticasone propionate (Flonase) to determine the frequency of Alzheimer's disease as an adverse event reported after use of the medication...
2018: JAD reports
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