scholarly journals Persistence and costs with subcutaneous TNF-alpha inhibitors in immune-mediated rheumatic disease stratified by treatment line

2017 ◽  
Vol Volume 11 ◽  
pp. 95-106 ◽  
Author(s):  
A Svedbom ◽  
Johan Dalen ◽  
Christopher Black ◽  
Sumesh Kachroo
Keyword(s):  
Rheumatic Disease ◽  
Tnf Alpha ◽  
Treatment Line ◽  
Immune Mediated

Treatment persistence among patients with immune-mediated rheumatic disease newly treated with subcutaneous TNF-alpha inhibitors and costs associated with non-persistence

2016 ◽  
Vol 36 (7) ◽  
pp. 987-995 ◽  
Author(s):  
Johan Dalén ◽  
Axel Svedbom ◽  
Christopher M. Black ◽  
Ramon Lyu ◽  
Qian Ding ◽  
...  
Keyword(s):  
Rheumatic Disease ◽  
Tnf Alpha ◽  
Treatment Persistence ◽  
Immune Mediated

scholarly journals OP0147 RHEUMATIC? - A DIGITAL DIAGNOSTIC DECISION SUPPORT TOOL FOR INDIVIDUALS SUSPECTING RHEUMATIC DISEASES: A MULTICENTER VALIDATION STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 87.1-88
Author(s):  
R. Knevel ◽  
J. Knitza ◽  
A. Hensvold ◽  
A. Circiumaru ◽  
T. Bruce ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Support ◽  
Rheumatic Disease ◽  
Rheumatic Diseases ◽  
Receiver Operating Curve ◽  
Musculoskeletal Complaints ◽  
Immune Mediated ◽  
Diagnostic Decision ◽  
Ocean Observations ◽  
Receiver Operating

Background:Digital diagnostic decision support tools promise to accelerate diagnosis and increase health care efficiency in rheumatology. Rheumatic? is an online tool developed by specialists in rheumatology and general medicine together with patients and patient organizations for individuals suspecting a rheumatic disease.1,2 The tool can be used by people suspicious for rheumatic diseases resulting in individual advise on eventually seeking further health care.Objectives:We tested Rheumatic? for its ability to differentiate symptoms from immune-mediated diseases from other rheumatic and musculoskeletal complaints and disorders in patients visiting rheumatology clinics.Methods:The performance of Rheumatic? was tested using data from 175 patients from three university rheumatology centers covering two different settings:A.Risk-RA phase setting. Here, we tested whether Rheumatic? could predict the development of arthritis in 50 at risk-individuals with musculoskeletal complaints and anti-citrullinated protein antibody positivity from the KI (Karolinska Institutet)B.Early arthritis setting. Here, we tested whether Rheumatic? could predict the development of an immune-mediated rheumatic disease in i) EUMC (Erlangen) n=52 patients and ii) LUMC (Leiden) n=73 patients.In each setting, we examined the discriminative power of the total score with the Wilcoxon rank test and the area-under-the-receiver-operating-characteristic curve (AUC-ROC).Results:In setting A, the total test score clearly differentiated between individuals developing arthritis or not, median 245 versus 163, P < 0.0001, AUC-ROC = 75.3 (Figure 1). Also within patients with arthritis the Rheumatic? total score was significantly higher in patients developing an immune-mediated arthritic disease versus those who did not: median score EUMC 191 versus 107, P < 0.0001, AUC-ROC = 79.0, and LUMC 262 versus 212, P < 0.0001, AUC-ROC = 53.6.Figure 1.(Area under) the receiver operating curve for the total Rheumatic? scoreConclusion:Rheumatic? is a web-based patient-centered multilingual diagnostic tool capable of differentiating immune-mediated rheumatic conditions from other musculoskeletal problems. A following subject of research is how the tool performs in a population-wide setting.References:[1]Knitza J. et al. Mobile Health in Rheumatology: A Patient Survey Study Exploring Usage, Preferences, Barriers and eHealth Literacy. JMIR mHealth and uHealth. 2020.[2]https://rheumatic.elsa.science/en/Acknowledgements:This project has received funding from EIT Health. EIT Health is supported by the European Institute of Innovation and Technology (EIT), a body of the European Union that receives support from the European Union’s Horizon 2020 Research and Innovation program.This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 777357, RTCure.Disclosure of Interests:Rachel Knevel: None declared, Johannes Knitza: None declared, Aase Hensvold: None declared, Alexandra Circiumaru: None declared, Tor Bruce Employee of: Ocean Observations, Sebastian Evans Employee of: Elsa Science, Tjardo Maarseveen: None declared, Marc Maurits: None declared, Liesbeth Beaart- van de Voorde: None declared, David Simon: None declared, Arnd Kleyer: None declared, Martina Johannesson: None declared, Georg Schett: None declared, Thomas Huizinga: None declared, Sofia Svanteson Employee of: Elsa Science, Alexandra Lindfors Employee of: Ocean Observations, Lars Klareskog: None declared, Anca Catrina: None declared

Abstract 17062: Reversible Golimumab Induced Cardiomyopathy - First Reported Case Report

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Mian Tanveer Ud Din ◽  
Michael Nestasie ◽  
John Balacko ◽  
Craig Alpert
Keyword(s):  
Lower Extremity ◽  
Troponin T ◽  
Inflammatory Diseases ◽  
Systolic Function ◽  
Left Ventricular ◽  
Tnf Alpha ◽  
Lower Extremity Edema ◽  
Ventricular Systolic Function ◽  
Immune Mediated ◽  
Biventricular Systolic Function

Case Presentation: An 80 year old female with medical history of hypertension, diabetes mellitus, chronic atrial fibrillation presented with four weeks of lower extremity edema and dyspnea. Notably, she had also been taking Golimumab for 6 months for Rheumatoid Arthritis (RA). Vital signs on presentations were: Temp:99 F, HR: 140bpm, BP: 105/64, oxygen saturation of 88% on room air. Physical exam revealed crackles at the mid lower lung fields bilaterally and 2+ lower extremity edema. EKG showed new ST inversions in lead 1, avF and V2. Troponin T was elevated to 0.11 ng/ml and proBNP was 21,246 pg/ml. Chest X Ray showed cardiomegaly with diffuse alveolar opacities. Transthoracic echocardiogram (TTE) revealed severely reduced left ventricular systolic function with LVEF of 25-29%, left ventricular regional wall hypokinesis and mildly reduced right ventricular systolic function. All findings were new compared to her last TTE 3 months prior, which showed preserved biventricular systolic function. Coronary angiography revealed no coronary artery disease. The patient was started on intravenous furosemide, and her home beta blocker and ARB were resumed. The patient’s Golimumab was discontinued given prior reports of TNF alpha inhibitor induced cardiomyopathy. Over the ensuing days, she was aggressively diuresed with improvement in oxygenation and ultimately discharged home. Three months after discontinuation of Golimumab, repeat TTE showed normalization of biventricular systolic function. Discussion: TNF alpha inhibitors have revolutionized the treatment of chronic immune mediated inflammatory diseases. Several TNF alpha inhibitors have been associated with cardiomyopathy, however there remains a paucity of evidence regarding cardiotoxicity with Golimumab. We now present, to our knowledge, the first reported case of reversible heart failure due to Golimumab in an 80 year old woman with RA. Golimumab, like other TNF alpha inhibitors, represents a historic advancement in the treatment of immune mediated inflammatory diseases. However, our case implicates this innovative drug in cardiotoxicity similar to other TNF alpha inhibitors. Further prospective studies are needed to establish a stronger correlation between Golimumab and cardiotoxicity.

scholarly journals Pathological findings in central nervous system demyelination associated with infliximab

2019 ◽  
Vol 26 (9) ◽  
pp. 1124-1129 ◽  
Author(s):  
Alicja Kalinowska-Lyszczarz ◽  
Mahboobeh Fereidan-Esfahani ◽  
Yong Guo ◽  
Claudia F Lucchinetti ◽  
W Oliver Tobin
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Tnf Alpha ◽  
Infliximab Treatment ◽  
Necrosis Factor Alpha ◽  
Immune Mediated ◽  
Central Nervous System Demyelination ◽  
Factor Alpha ◽  
Cns Demyelination ◽  
Necrosis Factor

Background: Tumor necrosis factor alpha (TNF-alpha) inhibitors, such as infliximab, are commonly used to treat rheumatoid arthritis (RA) and other immune-mediated disorders. Objective: To determine whether infliximab-associated central nervous system (CNS) demyelination can be differentiated from multiple sclerosis (MS). Methods: We present a case of pathologically proven CNS demyelination in a patient treated with infliximab and describe clinical–radiographic–neuropathological findings. Putative mechanisms of TNF-alpha inhibitor-associated CNS demyelination are described. Results and conclusion: Infliximab treatment is associated with CNS inflammatory demyelinating activity, which is histopathologically indistinguishable from MS.

Second-line treatment persistence and costs among patients with immune-mediated rheumatic diseases treated with subcutaneous TNF-alpha inhibitors

2017 ◽  
Vol 37 (12) ◽  
pp. 2049-2058 ◽  
Author(s):  
Johan Dalén ◽  
Axel Svedbom ◽  
Christopher M. Black ◽  
Sumesh Kachroo
Keyword(s):  
Rheumatic Diseases ◽  
Tnf Alpha ◽  
Line Treatment ◽  
Second Line ◽  
Treatment Persistence ◽  
Immune Mediated

Anti-TNF alpha-induced immune-mediated skin adverse reactions resolved by switching to ustekinumab

2019 ◽  
Vol 73 (6) ◽  
pp. 496-500 ◽  
Author(s):  
Karolína Vorčáková ◽  
Marta Horáková ◽  
Juraj Péč
Keyword(s):  
Adverse Reactions ◽  
Tnf Alpha ◽  
Immune Mediated

scholarly journals Comparative Assessment of the New PDE7 Inhibitor – GRMS-55 and Lisofylline in Animal Models of Immune-Related Disorders: A PK/PD Modeling Approach

2020 ◽  
Vol 37 (2) ◽  
Author(s):  
Artur Świerczek ◽  
Krzysztof Pociecha ◽  
Marietta Ślusarczyk ◽  
Grażyna Chłoń-Rzepa ◽  
Sebastian Baś ◽  
...  
Keyword(s):  
Animal Models ◽  
Tnf Alpha ◽  
Collagen Induced Arthritis ◽  
Future Studies ◽  
Immune Mediated ◽  
Pde Inhibitors ◽  
Anti Inflammatory ◽  
New Compounds

Abstract Purpose This study aimed to assess the activity of two phosphodiesterase (PDE) inhibitors, namely GRMS-55 and racemic lisofylline ((±)-LSF)) in vitro and in animal models of immune-mediated disorders. Methods Inhibition of human recombinant (hr)PDEs and TNF-alpha release from LPS-stimulated whole rat blood by the studied compounds were assessed in vitro. LPS-induced endotoxemia, concanavalin A (ConA)-induced hepatitis, and collagen-induced arthritis (CIA) animal models were used for in vivo evaluation. The potency of the investigated compounds was evaluated using PK/PD and PK/PD/disease progression modeling. Results GRMS-55 is a potent hrPDE7A and hrPDE1B inhibitor, while (±)-LSF most strongly inhibits hrPDE3A and hrPDE4B. GRMS-55 decreased TNF-alpha levels in vivo and CIA progression with IC50 of 1.06 and 0.26 mg/L, while (±)-LSF with IC50 of 5.80 and 1.06 mg/L, respectively. Moreover, GRMS-55 significantly ameliorated symptoms of ConA-induced hepatitis. Conclusions PDE4B but not PDE4D inhibition appears to be mainly engaged in anti-inflammatory activity of the studied compounds. GRMS-55 and (±)-LSF seem to be promising candidates for future studies on the treatment of immune-related diseases. The developed PK/PD models may be used to assess the anti-inflammatory and anti-arthritic potency of new compounds for the treatment of rheumatoid arthritis and other inflammatory disorders.

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