scholarly journals Biologic therapies for the treatment of psoriatic arthritis

2021 ◽  
Vol 64 (2) ◽  
pp. 124-129
Author(s):  
Tae-Jong Kim
Keyword(s):  
Psoriatic Arthritis ◽  
Kinase Inhibitors ◽  
Phosphodiesterase Inhibitors ◽  
Janus Kinase ◽  
Interleukin 12 ◽  
Interleukin 17 ◽  
Dramatic Improvement ◽  
Functional Impairments ◽  
Biological Products ◽  
Factor Α

Psoriatic arthritis (PsA) is a chronic inflammatory rheumatic disease commonly associated with plaque psoriasis that, manifests with peripheral arthritis, dactylitis, enthesitis, and axial involvement. PsA can be progressive and harmful, resulting in joint deformities, functional impairments, low quality of life, and increased mortality. It was found that both non-pharmacologic and pharmacologic treatment could improve conditions of PsA. Recently launched biological products have become the main therapeutic agents used for treating PsA unresponsive to conventional disease modifying anti-rheumatic drugs. This paper aims at introducing available biologics for PsA management in Korea. The tumor necrosis factor-α inhibitor was the first approved biological product to show outstanding efficacy for treating PsA. Ustekinumab, designed for blocking interleukin-12/23, has been approved and widely used. Interleukin-17 inhibitors such as secukinumab and ixekizumab have also been introduced to improve the symptoms of PsA. It was found that many patients with PsA experienced a dramatic improvement in their condition after using these biological products. Additionally, new immunological modulators such as phosphodiesterase inhibitors and Janus kinase inhibitors were approved for the treatment of PsA.

scholarly journals New directions of pharmacotherapy of immune - inflammatory rheumatic diseases

2019 ◽  
Vol 91 (8) ◽  
pp. 98-107 ◽  
Author(s):  
E L Nasonov
Keyword(s):  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Kinase Inhibitors ◽  
Systemic Vasculitis ◽  
Janus Kinase ◽  
Inflammatory Rheumatic Diseases ◽  
Dramatic Improvement ◽  
Janus Kinase Inhibitors ◽  
Autoimmune Pathology ◽  
Factor Α

Deciphering immunopathogenesis, expanding the scope of diagnostics and developing new methods for treating human autoimmune diseases are among the priority areas of XXI century medicine. Particularly widely autoimmune pathology is presented in immunoinflammatory rheumatic diseases (IIRD), such as rheumatoid arthritis, systemic lupus erythematosus, systemic scleroderma, systemic vasculitis associated with the synthesis of antineutrophilic cytoplasmic antibodies, Sjogren's syndrome, idiopathic inflammatory myopathies and other other types of others. Deciphering the pathogenesis mechanisms of IIRD created the prerequisites for improving pharmacotherapy, which in the future should lead to a dramatic improvement in the prognosis for these diseases. The review discusses new approaches to IIRD pharmacotherapy associated with the inhibition of tumor necrosis factor-α, interleukin-6 (IL-6), IL-1β, IL-17, IL-23, and the prospects for using Janus kinase inhibitors, depending on the prevailing pathogenesis mechanisms - autoimmunity or autoinflammation.

scholarly journals Biologic therapies for the treatment of ankylosing spondylitis

2021 ◽  
Vol 64 (2) ◽  
pp. 116-123
Author(s):  
Soo Min Ahn ◽  
Yong-Gil Kim
Keyword(s):  
Ankylosing Spondylitis ◽  
Kinase Inhibitors ◽  
Axial Skeleton ◽  
Chronic Inflammatory Disease ◽  
Tnf Inhibitors ◽  
Janus Kinase ◽  
Interleukin 17 ◽  
Biological Products ◽  
Axial Symptoms ◽  
Anti Inflammatory

Ankylosing spondylitis (AS) is a chronic inflammatory disease predominantly affecting the axial skeleton. AS treatment aims to reduce pain and inflammation and maintain functional capacity. Nonsteroidal anti-inflammatory drugs are the first-line treatment for those with active AS. While for peripheral arthritis, sulfasalazine or local glucocorticoid injection can be used, these are not recommended for axial symptoms. Twenty years ago, biological products that target the tumor necrosis factor (TNF) were developed. These have been approved for use in rheumatoid arthritis and AS. Since the introduction of these TNF inhibitors, the control of disease activity in AS has improved markedly. TNF inhibitors, including both anti-TNF-alpha monoclonal antibodies and recombinant TNF soluble receptors, can be considered for patients with persistently active disease despite nonsteroidal anti-inflammatory drug treatment. Recently, interleukin-17 inhibitors have also been approved for use in AS patients with insufficient responses to TNF inhibitors. Ongoing clinical trials are exploring the effect of Janus kinase inhibitors against AS. This review summarizes the current pharmaceutical treatment for AS, focusing on the biological products. Recommendations for AS management are also discussed in this review.

Optimizing Immunization Strategies in Patients with IBD

2020 ◽  
Vol 27 (1) ◽  
pp. 123-133 ◽  
Author(s):  
Freddy Caldera ◽  
Dana Ley ◽  
Mary S Hayney ◽  
Francis A Farraye
Keyword(s):  
Kinase Inhibitors ◽  
Mucosal Healing ◽  
Common Adverse Event ◽  
Janus Kinase ◽  
Interleukin 12 ◽  
Vaccine Preventable Diseases ◽  
Immunization Strategies ◽  
The Us ◽  
Inflammatory Bowel ◽  
Adult Immunization

Abstract Recent advances in the treatment of inflammatory bowel disease (IBD) include the use of immune modifiers and monoclonal antibodies, such as tumor necrosis factor (TNF) alpha inhibitors, anti-integrin agents, janus kinase inhibitors, and interleukin-12/23 inhibitors. These agents achieve higher rates of clinical remission and mucosal healing than conventional therapy. However, these therapies increase the risk of infections, including some vaccine-preventable diseases. Infections are one of the most common adverse event of immunosuppressive therapy. Thus, providers should optimize immunization strategies to reduce the risk of vaccine-preventable infections in patients with IBD. There are several newly licensed vaccines recommended for adults by the US Advisory Committee on Immunization Practices. This review will focus on how gastroenterology providers can implement the adult immunization schedule approved by ACIP for patients with IBD.

scholarly journals EXPERIENCE OF THE LONG-TERM USE OF ANTICYTOKINE THERAPY IN PSORIASIS

2017 ◽  
Vol 20 (3) ◽  
pp. 163-166
Author(s):  
Violetta A. Kovtunova ◽  
V. V Dumchenko ◽  
E. G Bakhmutova ◽  
T. A Tkachenko ◽  
E. Yu Yanchevskaya ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Therapeutic Response ◽  
Biological Therapy ◽  
Combined Therapy ◽  
Severe Form ◽  
Genetic Characteristics ◽  
Biological Products ◽  
Factor Α ◽  
And Control

Increasing the effectiveness of treatment and restoring the quality of life in patients with moderate to severe and severe forms of psoriasis is one of the most important trends in modern dermatology. The appearance of biological products in the late XXth century opened new opportunities in the treatment and control of the course of the disease in patients suffering from moderate and severe forms of psoriasis. Conducting maintenance system treatment with biological products reduces the severity of course of dermatosis, and in some cases prevents the occurrence of disease relapses. Despite the increasing popularity of anti-cytokine drugs, there are difficulties in the treatment of choice of the therapy in some cases. Among the main reasons for the lack of response to ongoing biological therapy are the genetic characteristics of the patient and the immunogenicity of the drugs. Failures in the use of biological therapy can also result a low concentration of the drug before the next administered dose. It has been proven that the combined use of methotrexate and infliximab inhibits the development of anti-drug antibodies that are associated with the development of a low therapeutic response. The article describes the clinical observation of a patient suffering for 20 years from a severe form of psoriasis and psoriatic arthritis. The experience of long-term (about 10 years) prescription of the biological preparation infliximab with sufficient clinical response without additional use of methotrexate is shown. The results of successful combined therapy of psoriatic erythroderma and psoriatic arthritis with infliximab and acitretin in order to reduce the immunogenicity of the tumor necrosis factor α blocker and avoid the ”escape” effect are described. The data of restoration of a good therapeutic response to systemic biological therapy with infliximab after administration of acitretin are presented.

scholarly journals Removal of Procalcitonin and Selected Cytokines during Continuous Veno-Venous Hemodialysis Using High Cutoff Hemofilters in Patients with Sepsis and Acute Kidney Injury

2018 ◽  
Vol 46 (2) ◽  
pp. 153-159 ◽  
Author(s):  
Grzegorz Kade ◽  
Sławomir Literacki ◽  
Agnieszka Rzeszotarska ◽  
Stanisław Niemczyk ◽  
Arkadiusz Lubas
Keyword(s):  
Septic Shock ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Interleukin 12 ◽  
Interleukin 17 ◽  
Reactive Protein ◽  
Before And After ◽  
Factor Α ◽  
The Impact ◽  
Necrosis Factor

Introduction: The purpose of this study was to evaluate the impact of continuous veno-venous hemodialysis (CVVHD) using high cutoff (HCO) hemofilters on the removal of procalcitonin (PCT), and other inflammatory markers in the treatment of patients during septic shock with acute kidney injury (AKI). Materials and Methods: Thirty-six patients with septic shock and AKI were included in the study. Before and after the 24-h HCO-CVVHD, PCT, native C-reactive protein (CRP) and cytokines (interleukin-1β, interleukin-6, interleukin-12, interleukin-17, tumor necrosis factor-α) in serum and effluent were assessed. Results: After the HCO-CVVHD serum concentrations of PCT, CRP and selected cytokines were significantly lower. The decrease in PCT was bigger than in CRP (p = 0.007). The change in PCT concentration was significantly influenced by PCT and IL-17 clearances (R2 = 0.525; p < 0.001). Conclusion: In contrast to the native CRP, monitoring of PCT during HCO-CVVHD is less useful because it reflects the clearance of this marker and anti-inflammatory effectiveness of the method.

scholarly journals The Era of Janus Kinase Inhibitors for Inflammatory Bowel Disease Treatment

2021 ◽  
Vol 22 (21) ◽  
pp. 11322
Author(s):  
Jin-Woo Kim ◽  
Su-Young Kim
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Kinase Inhibitors ◽  
Significant Proportion ◽  
Janus Kinase ◽  
Response To Treatment ◽  
Interleukin 12 ◽  
Disease Treatment ◽  
Janus Kinase Inhibitors ◽  
Inflammatory Bowel

For a significant proportion of patients with inflammatory bowel disease (IBD), primary non-response and secondary loss of response to treatment remain significant issues. Anti-tumor necrosis factor therapies have been licensed for use in IBD. Other disease-related pathways have been targeted as well, including the interleukin 12/23 axis and lymphocyte tracking. However, the need for parenteral administration and the associated costs of dispensing and monitoring all biologics remain a burden on healthcare systems and patients. Janus kinase inhibitors are small-molecule drugs that can be administered orally and are relatively inexpensive, thus offering an additional option for treating IBD. They have been shown to be effective in patients with ulcerative colitis (UC), but they are less effective in those with Crohn’s disease (CD). Nonetheless, given the immune-system-based mechanism of these drugs, their safety profile remains a cause for concern. This article provides an overview of Janus kinase (JAK) inhibitors and new trends in the treatment of IBD.

scholarly journals Advantages and disadvantages of targeted therapy in patients with rheumatoid arthritis

2021 ◽  
Vol 64 (2) ◽  
pp. 90-93
Author(s):  
Yoon-Kyoung Sung
Keyword(s):  
Rheumatoid Arthritis ◽  
Targeted Therapies ◽  
Kinase Inhibitors ◽  
Medical Personnel ◽  
Janus Kinase ◽  
High Price ◽  
Targeted Therapeutics ◽  
Biological Products ◽  
Advantages And Disadvantages

With the recent understanding of the pathogenesis of rheumatoid arthritis at the cellular and molecular levels, as well as the rapid progress of biotechnology, targeted therapies have been developed and used since 2000. Starting with the development of biological products, which were early targeted therapeutics, small molecule inhibitors have recently been developed that target Janus kinase, a signaling molecule for intracellular inflammatory cytokines. The use of targeted therapies has dramatically improved the treatment outcomes and prognosis of rheumatoid arthritis. However, there is still concern around long-term safety of drugs and the rise in the economic burden on individuals and society due to the high price of biological products and Janus kinase inhibitors. To use those targeted therapeutics efficiently to ensure that suitable patients can fully benefit, both a multidisciplinary approach and the collaboration of experts are required. From the patient’s perspective, it is necessary to develop a system of patient’ education and to support shared decision-making between patients and physician. From the perspective of medical personnel, it is necessary to ensure the autonomy of experts. In addition, from a socio-economic viewpoint, it is necessary to adjust drug prices and review biosimilar utilization plans to reduce medical costs. The expanding use of these drugs among rheumatoid arthritis patients will eventually lead to greater social benefits by reducing disability among patients, facilitating their economic activity, and improving their quality of life. However, it is time to discuss their appropriate selection and safe long-term use with well-trained experts.

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