scholarly journals The Effect of Systemic Methotrexate and Cyclosporine Combination Therapy inPsoriasis Vulgaris Patients in Bandung, Indonesia

2021 ◽  
Vol 33 (3) ◽  
pp. 200
Author(s):  
Oki Suwarsa ◽  
Fatima Aulia Khairani ◽  
Syawalika Ulya Isneny ◽  
Erda Avriyanti ◽  
Hartati Purbo Dharmadji ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Side Effects ◽  
Adverse Effects ◽  
Combination Therapy ◽  
Combination Treatment ◽  
Psoriasis Vulgaris ◽  
Severity Index ◽  
Dermatology Clinic ◽  
Significant Difference ◽  
Pasi Score

Background: Methotrexate (MTX) and cyclosporine have been used as effective systemic mono-therapy for psoriasis. Several factors are considered to switch monotherapy to combination therapy because monotherapy is no longer effective and has higher side effects. Hence,clinicians have avoided systemic therapy combinations due to its toxicity. However, some studies showed that this combination therapy could be usedeffectively for psoriasis patients. Purpose: This study aimed to analyze the efficacy and adverse effects of systemic MTX and cyclosporine combination therapy in Indonesian psoriasis vulgaris patients. Methods: The retrospective study assessed the effectiveness of 3 monthsmono-therapyand combination therapy of systemic MTX and cyclosporine in psoriasisvulgaris patients from 2016–2017 in Dermatology Clinic, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia. Result: Psoriasis area and severity index (PASI) score 90 were achieved in the group MTX (50%) and cyclosporine group (50%), while none in the combination group.However, eight patients (50%) in group MTX and cyclosporine reached the primary endpoint of PASI 50. One patient in cyclosporine group had adverse effects on kidney profiles. Nonetheless, other patients had no biochemical changes. But, there was no significant difference in the change of PASI between each group (p=0.102). Conclusion: We propose that combination therapy of MTX and cyclosporine is relatively safe and efficacious in treating Indonesian psoriasis vulgaris patients. This combination treatment isas effective as MTX or cyclosporinemono-therapy.

scholarly journals A rational pharmacotherapeutic study of comparative safety among topical anti-acne 1% nadifloxacin monotherapy, 0.1% adapalene monotherapy, 0.025% tretinoin monotherapy, 1% nadifloxacin and 0.1% adapalene combination therapy and 1% nadifloxacin and 0.025% tretinoin combination therapy, in mild to moderate acne vulgaris, in tertiary care hospitals

2019 ◽  
Vol 8 (9) ◽  
pp. 1959
Author(s):  
Moumita Hazra
Keyword(s):  
Adverse Effects ◽  
Combination Therapy ◽  
Acne Vulgaris ◽  
Tertiary Care ◽  
Skin Irritation ◽  
Combination Therapies ◽  
Global Alliance ◽  
Topoisomerase Iv ◽  
Significant Difference ◽  
Anti Inflammatory

Background: Topical adapalene and tretinoin, are comedolytic, anti-comedogenic and anti-inflammatory, on RAR (α, β, γ) receptors binding. Adapalene enables quicker follicular penetration, by lesser anti-AP-1 (c-Jun, c-Fos) and no CRBPII mRNA actions, causing chemical stability, lipophilicity and less photo-lability, producing lesser photosensitivity and no skin irritation, unlike tretinoin; wherein reducible by overnight application and combination therapy, slow-release polymers or emollients, respectively. Topical nadifloxacin is bactericidal, anti-inflammatory and comedolytic, with inhibitory effect on DNA gyrase, DNA topoisomerase IV and IL-1α, IL-6, IL-8. The Global Alliance to Improve Outcomes in Acne Guidelines recommend synergistic and additive combination therapies, which enhance therapeutic efficacy and reduce adverse effects. Due to inadequacy of data, this study was conducted, to compare the safety among topical anti-acne monotherapies and combination therapies, and to easily detect any adverse effect producing component in the topical combination therapy.Methods: In this multi-centre, prospective, randomised, open-labelled, comparative study, groups A, B, C, D and E (20 patients each), applied topical 1% nadifloxacin monotherapy, 0.1% adapalene monotherapy, 0.025% tretinoin monotherapy, 1% nadifloxacin and 0.1% adapalene combination therapy and 1% nadifloxacin and 0.025% tretinoin combination therapy, respectively, over their facial mild to moderate acne lesions, once daily overnight; and adverse effects, like erythema, scaling, dryness, prutitus, burning, or stinging, were assessed on 0, 15, 30, 60, 90 days and follow-ups, by Local Irritation Scale.Results: In all 5 groups, no adverse effects were observed, with no statistically significant difference among the observations.Conclusions: The therapies were well tolerated and safe among all 5 groups.

Combination therapy with acipimox enhances the effect of growth hormone treatment on linear body growth in the normal and small-for-gestational-age rat

2006 ◽  
Vol 291 (6) ◽  
pp. E1212-E1219 ◽  
Author(s):  
M. H. Vickers ◽  
P. L. Hofman ◽  
P. D. Gluckman ◽  
P. E. Lobie ◽  
W. S. Cutfield
Keyword(s):  
Growth Hormone ◽  
Side Effects ◽  
Combination Therapy ◽  
Gestational Age ◽  
Combination Treatment ◽  
Small For Gestational Age ◽  
Body Growth ◽  
Maternal Undernutrition ◽  
Fasting Plasma ◽  
Linear Body

Growth hormone (GH) therapy is often associated with adverse side effects, including impaired insulin sensitivity. GH treatment of children with idiopathic short stature does not lead to an optimized final adult height. It has been demonstrated that FFA reduction induced by pharmacological antilipolysis can stimulate GH secretion per se in both normal subjects and those with GH deficiency. However, to date, no investigation has been undertaken to establish efficacy of combination treatment with GH and FFA regulators on linear body growth. Using a model of maternal undernutrition in the rat to induce growth-restricted offspring, we investigated the hypothesis that combination treatment with GH and FFA regulators can enhance linear body growth above that of GH alone. At postnatal day 28, male offspring of normally nourished mothers (controls) and offspring born with low birth weight [small for gestational age (SGA)] were treated with saline, GH, or GH (5 mg·kg−1·day−1) in combination with acipimox (GH + acipimox, 20 mg·kg−1·day−1) or fenofibrate (GH + fenofibrate, 30 mg·kg−1·day−1) for 40 days. GH plus acipimox treatment significantly enhanced linear body growth in the control and SGA animals above that of GH, as quantified by tibial and total body length. Treatment with GH significantly increased fasting plasma insulin, insulin-to-glucose ratio, and plasma volumes in control and SGA animals but was not significantly different between saline and GH-plus-acipimox-treated animals. GH-induced lipolysis was blocked by GH plus acipimox treatment in both control and SGA animals, concomitant with a significant reduction in fasting plasma FFA and insulin concentrations. This is the first study to show that GH plus acipimox combination therapy, via pharmacological blocking of lipolysis during GH exposure, can significantly enhance the efficacy of GH in linear growth promotion and ameliorate unwanted metabolic side effects.

scholarly journals Does Hemoperfusion Increase Survival in Acute Paraquat Poisoning? A Retrospective Multicenter Study

Toxics ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 84
Author(s):  
Ying-Tse Yeh ◽  
Chun-Kuei Chen ◽  
Chih-Chuan Lin ◽  
Chia-Ming Chang ◽  
Kai-Ping Lan ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Retrospective Study ◽  
Confidence Interval ◽  
Cox Regression ◽  
Severity Index ◽  
Cox Regression Analysis ◽  
Medical Centers ◽  
Paraquat Poisoning ◽  
Significant Difference ◽  
Retrospective Multicenter Study

The efficacy of hemoperfusion (HP) in patients with acute paraquat poisoning (PQ) remains controversial. We conducted a multi-center retrospective study to include acute PQ-poisoned patients admitted to two tertiary medical centers between 2005 and 2015. We used the Severity Index of Paraquat Poisoning (SIPP) to stratify the severity of PQ-poisoned patients. The indication to start HP was a positive result for the semiquantitative urine PQ test and presentation to the hospital was within 24 h. Early HP was defined as the first session of HP performed within five hours of PQ ingestion. A total of 213 patients (100 HP group, 113 non-HP group) were eligible for the study. The overall 60-day mortality of poisoned patients was 75.6% (161/213). Multivariate Cox regression analysis showed no statistically significant difference in 60-day survival between HP and non-HP groups (95% confidence interval (CI): 0.84–1.63, p = 0.363). Further subgroup analysis in the HP group showed early HP (95% CI: 0.54–1.69, p = 0.880), and multiple secessions of HP (95% CI: 0.56–1.07, p = 0.124) were not significantly related to better survival. Among acute PQ-poisoned patients, this study found that HP was not associated with increased 60-day survival. Furthermore, neither early HP nor multiple secessions of HP were associated with survival.

scholarly journals Combination therapy with beraprost sodium and aspirin for acute ischemic stroke: a single-center retrospective study

2019 ◽  
Vol 47 (7) ◽  
pp. 3014-3024 ◽  
Author(s):  
De Cai ◽  
Xiao-Pu Chen ◽  
Dun-Can Wei ◽  
Qian Zhang ◽  
Si-Qia Chen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Retrospective Study ◽  
Combination Therapy ◽  
Adverse Events ◽  
Acute Ischemic Stroke ◽  
Blood Coagulation ◽  
Control Group ◽  
Single Center ◽  
Beraprost Sodium ◽  
Significant Difference

Objectives To evaluate the effectiveness and safety of the combination of beraprost sodium (BPS) and aspirin in patients with acute ischemic stroke (AIS). Methods There were 384 patients with AIS enrolled in this single-center, retrospective study. The BPS group comprised patients who received combination therapy with BPS and aspirin, and the control group comprised those who received only aspirin. Primary measurements were glomerular filtration rate (GFR), cystatin-c (Cys-C), National Institute of Health Stroke Scale (NIHSS) score, modified activities of daily living index (MBI), modified Rankin scale (mRS), and blood coagulation indexes. Recurrence and adverse events were recorded. Results There were no significant differences in patient characteristics at baseline between the two groups. GFR and Cys-C levels increased in the BPS group compared with the control group. After treatment, the NIHSS and mRS score were significantly lower in the BPS group compared with the control group, whereas the MBI scores were significantly higher in the BPS group compared with the control group. There was no significant difference in blood coagulation between the two groups. There were no serious adverse events in either group. Conclusions Combination therapy with BPS and aspirin may be a safe and effective treatment for AIS.

scholarly journals Short Practical Regimen of Acupuncture for Melasma: A Prospective Cohort Study in a Tertiary Hospital in Thailand

2021 ◽  
Vol 9 ◽  
Author(s):  
Thanan Supasiri ◽  
Nuntida Salakshna ◽  
Krit Pongpirul
Keyword(s):  
Side Effects ◽  
Adverse Events ◽  
Severity Index ◽  
Tertiary Hospital ◽  
Optimal Number ◽  
Significant Difference ◽  
Patient Reported ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Acupuncture shows benefits for patients with melasma, although no optimal number of sessions have been determined.Methods: The prospective observational study was conducted in melasma patients who were treated with acupuncture procedures two times a week and were evaluated after the 5th and the 10th sessions of acupuncture, with a 1-week follow-up after the last session. Participants Groups A and B received five and 10 acupuncture sessions, respectively. Melasma was assessed by using the melanin index (MI), melasma area and severity index (MASI), patient-reported improvement scores, and acupuncture-related adverse events.Results: Out of 113 participants, 67 received five sessions of acupuncture treatment while 39 received 10 sessions. At 1 week after five sessions of acupuncture in Group A, the mean MI decreased by 28.7 (95% CI −38.5 to −18.8, p < 0.001), whereas the median MASI decreased by 3.4 (95% CI −6.9 to −1.2, p < 0.001) points. At 1 week after ten sessions of acupuncture in Group B, the mean MI decreased by 31.3 (95% CI −45 to −17.6, p < 0.001), whereas the median MASI decreased by 5.4 (95%CI −9.9 to −3, p < 0.001) points. The first five sessions of acupuncture had a higher incremental effect than the last five sessions, although there was no statistically significant difference. Twenty-nine participants reported minor side effects. Group B had a risk ratio (RR) of having adverse events 1.8 times (95% CI 1.0–3.4, p = 0.05) compared with Group A.Conclusion: Short acupuncture regimens of 5–10 sessions in melasma seem to be effective and practical with minor side effects.

scholarly journals PREVALENCE OF MTHFR GENE 677C>T POLYMORPHISM IN THE PATIENTS WITH PSORIASIS VULGARIS

2021 ◽  
Vol 27 (2) ◽  
pp. 3707-3711
Author(s):  
Borislav Dimitrov ◽  
◽  
Dimitar Gospodinov ◽  
Veronika Gincheva ◽  
Regina Komsa-Penkova ◽  
...  
Keyword(s):  
Psoriasis Vulgaris ◽  
Mthfr C677t ◽  
Mthfr Gene ◽  
Mthfr Polymorphism ◽  
Significant Difference ◽  
Pcr Rflp ◽  
Pasi Score ◽  
Bulgarian Population ◽  
Relationship Of ◽  
The Relationship

The study aimed to investigate the relationship between carriage of 677C>T polymorphism in the gene of methylene tetrahydrofolate reductase (MTHFR) and plaque psoriasis in patients in Bulgaria. We examined the prevalence of MTHFR C677T genotype in patients with psoriasis, as well as the relationship of the polymorphism with disease severity. Our study covered63 patients with psoriasis and 98psoriasis-free control subjects from northern Bulgaria. MTHFR677C>T genotype was verified by the PCR-RFLP method. There was no significant difference between carriage of TT genotype among the patients and controls: 12.7% versus 10.8 %in controls, OR 1.203, (CI 95% 0465-3.175), p>0.05 respectively. There was a higher PASI score in patients, carriers of TT genotype of MTHFR polymorphism 677C>T than in non-carriers, 28.18versus 24.87 respectively, but not significant. Conclusion: Carriage of TT genotype of MTHFR polymorphism 677C>T was not associated with Psoriasis Vulgaris in the northern Bulgarian population when compared to healthy controls.

scholarly journals Outcome for Advanced or Metastatic Soft Tissue Sarcoma of Nonextremities Treated with Doxorubicin-Based Chemotherapy: A Retrospective Study from a Single Cancer Institution

Sarcoma ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Shoko Marshall ◽  
Kenji Nakano ◽  
Yoshiya Sugiura ◽  
Shinichiro Taira ◽  
Makiko Ono ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Retrospective Study ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Combination Therapy ◽  
Response Rate ◽  
Overall Response ◽  
Institutional Review ◽  
Significant Difference ◽  
Bulky Mass

Background. Doxorubicin is the key drug for treatment of advanced soft tissue sarcoma (STS). The appropriate dosage of doxorubicin, regarding monotherapy or the role of combination therapy, is unclear. Methods. We retrospectively reviewed patients with advanced or metastatic STS of nonextremities who were treated with doxorubicin-based chemotherapies in our institution. Time to treatment failure (TTF), overall survival (OS), overall response, and prognostic factors for OS were evaluated. Results. Seventy-five patients were enrolled. The median TTF was 4.7 months, and the median OS was 20.1 months. The overall response rate was 20%. Doses of doxorubicin monotherapy did not show significant difference either in TTF or in OS. There were no significant differences in OS between combination therapy and monotherapy, but the TTF with combination therapy was better than monotherapy. The overall response for combination therapy indicated a better response rate. Less number of involved organs, no bulky mass, and a normal CRP level were independent favorable prognostic factors for OS. Conclusions. Combination therapy showed better response and TTF than monotherapy but did not show better OS. Possible prognostic factors for OS were indicated. This retrospective study was approved by the institutional review board. This trial is registered with UMIN000028787.

scholarly journals PSORIASIS VULGARIS PADA BAYI

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Shienty Gaspersz ◽  
Herry E. J. Pandaleke
Keyword(s):  
Vitamin D3 ◽  
Psoriasis Vulgaris ◽  
Age Of Onset ◽  
Severity Index ◽  
Psoriasis Area Severity Index ◽  
Normal Limits ◽  
Severity Index Score ◽  
Pasi Score ◽  
Erythematous Plaques ◽  
Topical Emollient

Abstract: Psoriasis may begin at any age but most often after puberty and only about 2% occurs in less than 2 years of age. The age of onset plays an important role because early onset psoriasis accompanied by a psoriasis family history is more severe and has a tendency to relapse. The treatment for mild psoriasis is topical and phototherapy. The first-line treatment is topical emollient, glucocorticoids, and vitamin D3 analog. We reported a case of a 3-month-old female infant presenting erythematous plaques with scales on scalp, face, neck, chest, tummy, armpit, back, buttock, and groin accompanied with irritability that had occured for a week. The Psoriasis Area Severity Index score (PASI) was 7% and laboratory examinations were within normal limits. Treatment with topical desonide 0.05% for 1 week did not result in any improvement. The treatment was changed to topical mometason furoat 0.1%. After 7 weeks of therapy, the plaques became flattened and less pigmented, and the PASI score decreased to 0.9%.Keywords: psoriasis vulgaris, infant  Abstrak: Usia awitan psoriasis bervariasi dari bayi hingga usia lanjut, namun sebagian besar timbul setelah pubertas dan hanya sekitar 2% terjadi pada usia kurang dari 2 tahun. Usia awitan perlu diketahui karena semakin dini usia awitan disertai adanya riwayat keluarga dengan psoriasis, perjalanan penyakit akan makin berat dan makin sering kambuh. Pilihan pengobatan pada psoriasis ringan (< 10%) ialah pengobatan topikal dan fototerapi. Pengobatan topikal lini pertama ialah emolien, glukokortikoid, dan analog vitamin D3. Kami melaporkan seorang bayi perempuan berusia 3 bulan yang datang dengan plak eritematosa, berbatas tegas, ukuran bervariasi, dengan skuama pada kepala, wajah, leher, dada, perut, ketiak, punggung, bokong, dan selangkangan, disertai rewel sejak 1 minggu lalu. Perhitungan Psoriasis Area Severity Index (PASI) 7%. Pemeriksan laboratorium masih dalam batas normal. Pasien diterapi dengan krim desonide 0,05%, namun setelah 1 minggu tidak terdapat perbaikan yang memuaskan, sehingga diganti dengan krim mometason furoat 0,1%. Setelah 7 minggu menggunakan mometason furoat, bercak merah yang awalnya meninggi menjadi hipopigmentasi dan mendatar serta perhitungan PASI menjadi 0,9%.Kata kunci: psoriasis vulgaris, bayi

scholarly journals Investigation of the Frequency of Adverse Effects in Patients Treated with Favipiravir as SARS-CoV-2 Treatment

2021 ◽  
pp. 1-4
Author(s):  
Ebru Dogan ◽  
Sevil Alkan-Çeviker ◽  
Servan Vurucu ◽  
Alper Sener ◽  
Buse Yüksel ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Demographic Data ◽  
Antiviral Agents ◽  
Good Alternative ◽  
Long Term Effects ◽  
Cardiac Side Effects ◽  
Significant Difference ◽  
Gastrointestinal Side Effects ◽  
Treatment Agent

Objective: For 2019 and 2020, SARS-CoV-2 has been a sensational virus. Unfortunately, a treatment agent specific for SARS-CoV-2 has not been developed yet. Favipiravir is one of the antiviral agents used experimentally in the treatment of SARS-CoV-2. This study aimed to determine the frequency of side effects seen in patients hospitalized in our hospital and received favipiravir at any stage of their treatment. Methods: Our study is a retrospective observational study. Definite and probable COVID-19 cases hospitalized in our hospital between March 23, 2020, May 31, 2020, were determined, and those receiving favipiravir as initial or secondary therapy were included in the study. The demographic data, laboratory tests, observed side effects of the patients were recorded and analyzed statistically. Results: A total of 134 patients, 37.3% using favipiravir at the beginning and 62.7% as secondary, were included in the study. The mean age of the patients was 66.8±15.7 years. 38.1% (n=51) of the group were female. Side effects were detected in 17 (13%) patients in the whole group. Hepatotoxicity (4.5%), increased serum uric acid (4.5%), nephrotoxicity (1.5%), gastrointestinal side effects (1.5%), cardiac side effects (0.7%) were detected. There was no statistically significant difference in terms of adverse events between the patients who received favipiravir initially or later on disease course. Conclusions: Although some results support the short-term safety of favipiravir, more studies are needed for its long-term effects. Studies on hyperuricemia, QTc prolongation, use in pregnancy, use during lactation and use in children are insufficient. Therefore, although Favipiravir appears to be a good alternative in the treatment of COVID-19, it should be used carefully because the data on its safety is still insufficient. Key Words: Favipiravir, adverse effects, COVID-19, SARS-CoV-2

scholarly journals Clinical experience of combination therapy of infliximab and total glucosides of paeony for severe psoriasis with liver disorder history

2019 ◽  
Vol 3 (2) ◽  
pp. 62
Author(s):  
Yu Hu ◽  
Lin Lin ◽  
Pangen Cui ◽  
Xu Yao ◽  
Chao Luan ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Combined Therapy ◽  
Severity Index ◽  
Liver Disorder ◽  
Severe Psoriasis ◽  
Total Glucosides Of Paeony ◽  
Pasi Score ◽  
History Of ◽  
The Mean

Severe psoriasis patients are reported to have a higher risk of liver abnormalities. Treatment option for severe psoriasis patients with liver disorder history remains a great challenge. Hepatic toxicity and long-term safety are the major concerns. Hence it is necessary to look for safer and more effective treatment for those patients. This retrospective review evaluated the safety and efficacy of combination therapy of infliximab and total glucosides of paeony (TGP) in treating 13 severe psoriasis patients with liver disorder history. Patients with severe psoriasis, comprising eight men and five women with a mean age of 37.3 ± 12.3, were observed. The patients experienced a mean course of psoriasis of 11.2 ± 7.1 years. The mean psoriasis area and severity index (PASI) score was 29.3 ± 12.9. All patients have the history of liver disorder. In our study, these patients were treated with infliximab at a dose of 5 mg/kg and TGP at a dose of 1.8 g/day. No liver test abnormalities were seen during combination therapy. After treatment, 61.5% patients showed PASI 50 response at week 2, and 81.8% patients have PASI 75 response at week 6. The mean time for achieving PASI 75 and PASI 90 improvement was 4.2 weeks and 9.6 weeks, respectively. Our observation demonstrates that combined therapy of infliximab and TGP is effective and safe in the treatment of severe psoriasis, especially for patients with liver disorder history.

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