scholarly journals A complex COVID-19 case with rheumatoid arthritis treated with tocilizumab

2020 ◽  
Vol 39 (9) ◽  
pp. 2797-2802 ◽  
Author(s):  
Shaozhe Cai ◽  
Wei Sun ◽  
Ming Li ◽  
Lingli Dong
Keyword(s):  
Rheumatoid Arthritis ◽  
High Throughput Sequencing ◽  
Opportunistic Infections ◽  
Term Treatment ◽  
Close Monitoring ◽  
Long Term Treatment ◽  
History Of ◽  
Antimicrobial Treatments ◽  
Rheumatic Patients

AbstractRecurrences of COVID-19 were observed in a patient with long-term usage of hydroxychloroquine, leflunomide, and glucocorticoids due to her 30-year history of rheumatoid arthritis (RA). Tocilizumab was applied and intended to target both COVID-19 and RA. However, disease of this patient aggravated after usage of tocilizumab. After the discussion of a multiple disciplinary team (MDT) including rheumatologists, antimicrobial treatments were applied to target the potential opportunistic infections (Pneumocystis jirovecii and Aspergillus fumigatus), which were authenticated several days later via high throughput sequencing. As an important cytokine in immune responses, IL-6 can be a double-edged sword: interference in the IL-6-IL-6 receptor signaling may save patients from cytokine release storm (CRS), but can also weaken the anti-infectious immunity, particularly in rheumatic patients, who may have received a long-term treatment with immunosuppressive/modulatory agents. Thus, we suggest careful considerations before and close monitoring in the administration of tocilizumab in rheumatic patients with COVID-19. Besides tocilizumab, several disease-modifying antirheumatic drugs (DMARDs) can also be applied in the treatment of COVID-19. Therefore, we also reviewed and discussed the application of these DMARDs in COVID-19 condition.

Serum concentrations of piroxicam in patients with rheumatoid arthritis on long-term treatment with ampiroxicam.

Ensho ◽  
1991 ◽  
Vol 11 (6) ◽  
pp. 597-605
Author(s):  
Sachiko Sugawara ◽  
Shoichiro Irimajiri ◽  
Torakichi Aoki ◽  
Shuichi Yokoyama ◽  
Sanae Ida ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Term Treatment ◽  
Serum Concentrations ◽  
Long Term Treatment

scholarly journals Effects of denosumab in Japanese rheumatoid arthritis patients treated with conventional anti-rheumatic drugs: 36-month extension of a phase 3 study

2021 ◽  
pp. jrheum.201376
Author(s):  
Yoshiya Tanaka ◽  
Tsutomu Takeuchi ◽  
Satoshi Soen ◽  
Hisashi Yamanaka ◽  
Toshiyuki Yoneda ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Type I Collagen ◽  
Joint Destruction ◽  
Term Treatment ◽  
Drug Discontinuation ◽  
Type I ◽  
Mineral Density ◽  
Phase 3 ◽  
Long Term Treatment

Objective To evaluate safety and efficacy of long-term denosumab 60 mg every 6 (Q6M) or 3 months (Q3M) in rheumatoid arthritis (RA) patients. Methods This 12-month, randomised, double-blind, placebo-controlled, multicentre phase 3 trial with an open-label extension period from 12 to 36 months (DESIRABLE) enrolled Japanese RA patients treated with placebo for 12 months then denosumab Q6M (P/Q6M) or denosumab Q3M (P/Q3M); denosumab Q6M for 36 months (Q6M/Q6M); or denosumab Q3M for 36 months (Q3M/Q3M). Efficacy was assessed by van der Heijde modified total Sharp (mTSS), bone erosion (ES), and joint space narrowing (JSN) scores. Results Long-term treatment better maintained mTSS and ES suppression in the P/Q3M and Q3M/Q3M versus P/Q6M and Q6M/Q6M groups; changes from baseline in total mTSS at 36 months were 2.8 (standard error 0.4), 1.7 (0.3), 3.0 (0.4), and 2.4 (0.3), respectively; corresponding changes in ES were 1.3 (0.2), 0.4 (0.2), 1.4 (0.2), and 1.1 (0.2). No JSN effect was observed. Bone mineral density consistently increased in all groups after denosumab initiation, regardless of concomitant glucocorticoid administration. Serum C-telopeptide of type I collagen decreased rapidly at 1-month post-denosumab administration (both in the initial 12- month [Q3M, Q6M groups] and long-term treatment [P/Q3M, P/Q6M groups] phases). Adverse event incidence leading to study drug discontinuation was similar across treatment groups. Conclusion Denosumab treatment maintained inhibition of progression of joint destruction up to 36 months. Based on effects on ES progression, higher dosing frequency at an earlier treatment stage may be needed to optimise treatment. Denosumab was generally well tolerated.

scholarly journals Long term dual antiplatelet therapy after myocardial infarction: retrospective analysis in an outpatient population

2021 ◽  
Author(s):  
Gennaro Ratti ◽  
Antonio Maglione ◽  
Emilia Biglietto ◽  
Cinzia Monda ◽  
Ciro Elettrico ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Term Treatment ◽  
Multivessel Disease ◽  
Coronary Syndrome ◽  
Anticoagulant Drugs ◽  
Long Term Treatment ◽  
Risk Condition ◽  
History Of

Long term treatment with ticagrelor 60 mg and low-dose aspirin are indicated after acute coronary syndrome (ACS). We retrospectively reviewed aggregate data of 187 patients (155 M and 38 F) (mean age 63.8±9 years) in follow up after ACS with at least one high risk condition (Multivessel disease, diabetes, GFR<60 mL/min, history of prior myocardial infarction, age >65 years) treated with ticagrelor 60 mg twice daily (after 90 mg twice daily for 12 months). The results were compared with findings (characteristics of the patients at baseline, outcomes, bleeding) of PEGASUS-TIMI 54 trial and Eu Label. The highrisk groups were represented as follows: multivessel disease 105 pts (82%), diabetes 63 pts (33%), GFR< 60 mL/min 27 pts (14%), history of prior MI 33 pts (17%), >65 year aged 85 pts (45%). Treatment was withdrawn in 7 patients: 3 cases showed atrial fibrillation and were placed on oral anticoagulant drugs, one developed intracranial bleeding, in three patients a temporary withdrawal was due to surgery (1 colon polyposis and 2 cases of bladder papilloma). Chest pain without myocardial infarction occurred in 16 patients (revascularization was required in 9 patients). Dyspnea was present in 15 patients, but was not a cause for discontinuation of therapy. Long term treatment with ticagrelor 60 mg twice daily plus aspirin 100 mg/day showed a favourable benefit/risk profile after ACS.  In this study all patients had been given ticagrelor 90 mg twice daily for 12 months and the 60 mg twice daily dosage was started immediately thereafter, unlike PEGASUS-TIMI 54 trial in which it was prescribed within a period ranging from 1 day to 1 year after discontinuation of the 90 mg dose. This makes our results more consistent with current clinical practice. However, a careful outpatient follow-up and constant counseling are mandatory to check out compliance to therapy and adverse side effects.

Long term treatment of rheumatoid arthritis with rituximab

2009 ◽  
Vol 8 (7) ◽  
pp. 591-594 ◽  
Author(s):  
Roberto Caporali ◽  
Marta Caprioli ◽  
Francesca Bobbio-Pallavicini ◽  
Serena Bugatti ◽  
Carlomaurizio Montecucco
Keyword(s):  
Rheumatoid Arthritis ◽  
Term Treatment ◽  
Long Term Treatment

scholarly journals Slower Elimination of Tofacitinib in Acute Renal Failure Rat Models: Contribution of Hepatic Metabolism and Renal Excretion

Pharmaceutics ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 714
Author(s):  
Sung Hun Bae ◽  
Sun-Young Chang ◽  
So Hee Kim
Keyword(s):  
Rheumatoid Arthritis ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Hepatic Metabolism ◽  
Term Treatment ◽  
Concentration Time ◽  
Long Term Treatment ◽  
Total Body ◽  
Body Clearance

Tofacitinib is a Jak inhibitor developed as a treatment for rheumatoid arthritis. Tofacitinib is metabolized mainly through hepatic CYP3A1/2, followed by CYP2C11. Rheumatoid arthritis tends to increase renal toxicity due to drugs used for long-term treatment. In this study, pharmacokinetic changes of tofacitinib were evaluated in rats with gentamicin (G-ARF) and cisplatin-induced acute renal failure (C-ARF). The time-averaged total body clearance (CL) of tofacitinib in G-ARF and C-ARF rats after 1-min intravenous infusion of 10 mg/kg was significantly decreased by 37.7 and 62.3%, respectively, compared to in control rats. This seems to be because the time-averaged renal clearance (CLR) was significantly lower by 69.5 and 98.6%, respectively, due to decreased creatinine clearance (CLCR). In addition, the time-averaged nonrenal clearance (CLNR) was also significantly lower by 33.2 and 57.4%, respectively, due to reduction in the hepatic CYP3A1/2 and CYP2C11 subfamily in G-ARF and C-ARF rats. After oral administration of tofacitinib (20 mg/kg) to G-ARF and C-ARF rats, both CLR and CLNR were also significantly decreased. In conclusion, an increase in area under plasma concentration-time curves from time zero to time infinity (AUC) of tofacitinib in G-ARF and C-ARF rats was due to the significantly slower elimination of tofacitinib contributed by slower hepatic metabolism and urinary excretion of the drug.

scholarly journals Acne Conglobata Associated with Hidradenitis Suppurativa, Disorders of Follicular Occlusion (Case Report)

2015 ◽  
Vol 15 (2) ◽  
pp. 30-34
Author(s):  
K. Pecova
Keyword(s):  
Hidradenitis Suppurativa ◽  
Severe Form ◽  
Term Treatment ◽  
Acne Conglobata ◽  
Long Term Treatment ◽  
Associated Symptoms ◽  
History Of ◽  
Inflammatory Bowel ◽  
Prepubertal Age

Abstract The author is presenting the case of a 23-year-old female patient with a severe form of acne conglobata, with the first symptoms of the disease occurring as far back as the prepubertal age. In the past year the disease has combined with hidradenitis suppurativa (to be referred to henceforth as “HS”), Hurley stage I, in the axillae and both sides of the inguinal region, with a family history of acne conglobata (both her mother and brother were affected). Further examinations ruled out inflammatory bowel disease because of a lack of further associated symptoms, except for sideropenic anaemia (lesser form) and lower serum values of vitamin D. Up until now the disease has been resistant to treatment, including the long-term treatment of methylprednisolone in combination with isotretinoid as well as dapsone and antibiotics.

scholarly journals 89. Influence of Immunogenicity on the Efficacy of Long-Term Treatment of Rheumatoid Arthritis with Adalimumab: A UK-Based Prospective Study

Rheumatology ◽  
2014 ◽  
Vol 53 (suppl_1) ◽  
pp. i89-i90
Author(s):  
Meghna Jani ◽  
Hector Chinoy ◽  
Richard B. Warren ◽  
Christopher E. M. Griffiths ◽  
Ann W. Morgan ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Prospective Study ◽  
Term Treatment ◽  
Long Term Treatment

The Frequency of Coronary Heart Disease and Myocardial Infarction in Patients with Rheumatoid Arthritis

1975 ◽  
Author(s):  
S. Czaplicki ◽  
J. Gietka ◽  
K. Sulek
Keyword(s):  
Rheumatoid Arthritis ◽  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Normal Population ◽  
Term Treatment ◽  
Coronary Risk Factors ◽  
Long Term Treatment ◽  
Adhesion Of Platelets

The frequency of coronary heart disease and myocardial infarction in 500 persons with rheumatoidearthritis (116 men and 384 women) receiving salicylates during long period time were examined. Coronary heart disease in 2 cases (1 man and 1 woman) and myocardial infarction in 1 man were found.On the basis of the age and duration observations the authors discovered that the coefficient morbidity was statistically significant lower than in the same population but without rheumatoid arthritis. The coronary risk factors as hypertenia arterialis, hyper-cholestrolemia and diabetes was less frequent than in normal population too. The cigarettes smoking and obesity were found equally frequent.The authors suggested that long term treatment with acetylsalicylic acid effects inhibition adhesion of platelets and in this way protects before arterial thrombosis and may be artherosclerosis.

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