The effectiveness of UVB (311 nm emission) therapy and cyclosporine treatment in the patients with poor responsiveness to TNF-a blockers

2016 ◽  
Vol 15 (6) ◽  
pp. 310-314
Author(s):  
Dmitry Nikolaevich Serov ◽  
L. S Kruglova ◽  
E. N Ponich
Keyword(s):  
Adverse Reactions ◽  
Narrow Band ◽  
Combined Treatment ◽  
Severity Index ◽  
Tnf Alpha ◽  
Low Doses ◽  
Combined Approach ◽  
Alpha Blockers

The authors present data concerning the effectiveness of the application of UVB (311 nm emission) therapy and the treatment using low doses of cyclosporine in the patients receiving therapy with TNF-alpha blockers that resulted in the 50% reduction of the Psoriasis Area and Severity Index (PASI 50). The study has demonstrated that the introduction of narrow-band phototherapy into the combined treatment can make it possible to reach the PASI values of 75 and even 100%. Monitoring of the safety of the application of the combined approach has revealed the absence of early adverse reactions within 1 year after the treatment.

Rheumatoide Arthritis – neue Perspektive in der Diagnostik

2005 ◽  
Vol 62 (5) ◽  
pp. 273-279
Author(s):  
von Mühlenen
Keyword(s):  
Rheumatoide Arthritis ◽  
Tnf Alpha ◽  
Alpha Blockers

Seit dem Früheinsatz von Methotrexat und anderen DMARDs und seit wenigen Jahren von TNF-alpha Blockers in der Behandlung der Rheumatoiden Arthritis können wir eine Verlangsamung oder ein Anhalten des Krankheitsprozesses erreichen. Es besteht seitdem die dringende Notwendigkeit von zuverlässigen Hilfsmitteln, welche eine Frühdiagnose erlauben könnten. Zur Hilfe sind in den letzten Jahren die Labordiagnostik, das CCP und in der Bildgebung das MRI und der Ultraschall.

scholarly journals P55 Carcinoid syndrome on etanercept and subsequent treatment with secukinumab in a patient with psoriatic arthritis

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Ali S. F Sheikh ◽  
Sagar G Srivastva ◽  
Fiona Wood
Keyword(s):  
Psoriatic Arthritis ◽  
Carcinoid Syndrome ◽  
Neuroendocrine Tumour ◽  
Early Recognition ◽  
Carcinoid Tumour ◽  
Safety Data ◽  
Biologic Agents ◽  
Tnf Alpha ◽  
First Line ◽  
Alpha Blockers

Abstract Background Psoriatic arthritis requires early recognition and treatment for prevention of disease progression. Conventional disease modifying drugs are first-line agents followed by biologic DMARDs for patients with active disease. TNF-alpha blockers are first line biologic agents in the UK. Th17 inhibitors are used since the elucidation of Th17 pathway. Safety and efficacy profiles of biologic agents inhibiting the Th17 pathway, including secukinumab (IL-17A) and ustekinumab (IL-12/23p40) have been studied. Methods We report a case of carcinoid syndrome in a lady on etanercept for psoriatic arthritis, carcinoid as a potential TNF alpha side effect. We also report safety of Th17 (secukinumab) inhibitors in the patient to date (>1 year). Results A female with a history of acne rosacea, was diagnosed with psoriatic arthritis in 2000 age 32. Initial sulphasalazine failed, then received methotrexate until 2011, when her arthritis flared. She was commenced on etanercept which proved effective. After 4 years of etanercept and methotrexate, her liver profile became deranged. Investigations off treatment included ultrasound abdomen demonstrating a liver mass, which resembled focal nodular hyperplasia on magnetic resonance imaging. Further screening revealed high urinary 5HIAA (527 umol/24h) and raised chromogranin A & B levels (1574 pmol/L and 373 pmol/L respectively). She had no symptoms suggestive of carcinoid, although facial flushing could have been camouflaged by her rosacea. Octreotide scan was positive, CT enterogram showed a distal ileal neuroendocrine tumour with adjacent lymphadenopathy. She underwent right hemihepatectomy and hemicolectomy. Her liver profile deteriorated again on methotrexate, leflunomide was ineffective. In November 2017 she was started on ustekinumab, which was ineffective and was withdrawn after 8 months. There was no alteration in carcinoid blood markers and no CT changes. In July 2018, she was commenced on secukinumab, which has allowed reduction in steroids. The patient is aware of lack of safety data in her circumstances. Regular surveillance has shown no recurrence of carcinoid with serial negative 5HIAA and chromogranin levels. There are no progressive CT changes at 1 year. Conclusion This is a case of carcinoid tumour occurring on TNF-alpha blockers and may represent a rare complication. Screening biomarkers including 5HIAA and chromogranin levels can be useful if disease is suspected. We could not find other similar case reports to guide further management. Within time limited data available - ustekinumab had no effect on the carcinoid. Th17 inhibitors can be safe options for treating psoriatic arthritis and psoriasis with highly sustained efficacy and favourable safety profile seen in large clinical trials. In this case, after > one year of secukinumab treatment - there is no adverse effect on carcinoid syndrome. Disclosures A.S.F. Sheikh None. S.G. Srivastva None. F. Wood None.

Adverse reaction of a combined treatment for unresectable liver cancer

Open Medicine ◽  
2014 ◽  
Vol 9 (2) ◽  
pp. 272-278
Author(s):  
Jianjun Ren ◽  
Tao Jiang ◽  
Rui Peng
Keyword(s):  
Liver Cancer ◽  
Liver Function ◽  
Adverse Reactions ◽  
Combined Treatment ◽  
Haematological Toxicity ◽  
Embolic Agent ◽  
Gelatin Sponge ◽  
Serum Total Bilirubin ◽  
Blood Routine ◽  
Arterial Chemoembolization

AbstractTo investigate the adverse reactions of transcatheter arterial chemoembolization (TACE) combined with trastuzumab in the treatment of unresectable live cancer, 85 unresectable liver cancer patients were treated with 35 mg epirubicin, with lipiodol and gelatin sponge granule as the embolic agent, and trastuzumab (4mg/kg) was administered intravenously. All the adverse reactions were investigated by blood routine examination and the checking of liver, renal and thyroid functions on the postoperative 2nd and 30th day. No patients died of direct medication. The main adverse reactions included haematological toxicity, liver function lesion and postoperative syndromes such as nausea, vomiting, fever and liver area aching. Two days after the treatment, the amount of the serum total bilirubin (TB) and white blood cell (WBC) increased dramatically, while platelet (PLT) changed a little, and creatinine (Cr) and blood urea nitrogen (BUN) did not change at all. Thirty days after the treatment, blood routine, liver and renal functions were examined, demonstrating that the liver function remained unchanged, PLT decreased apparently, WBC was lower, and Cr and BUN changed slightly compared to those before the treatment. The combined treatment is safe for unresectable liver cancer and thus can be used as a routine intervention method.

Modulatory action of combined treatment with antibodies against S100 protein and low doses of this protein on membrane effects of quinine

2006 ◽  
Vol 142 (1) ◽  
pp. 1-4 ◽  
Author(s):  
O. I. Epstein ◽  
M. B. Shtark ◽  
V. V. Andrianov ◽  
Kh. L. Gainutdinov ◽  
T. Kh. Gainutdinova ◽  
...  
Keyword(s):  
Combined Treatment ◽  
S100 Protein ◽  
Low Doses ◽  
Membrane Effects ◽  
Antibodies Against S100 Protein
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