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Amat-Samaranch V, Agut-Busquet E, Vilarrasa E, Puig L. New perspectives on the treatment of hidradenitis suppurativa. Ther Adv Chronic Dis 2021; 12:20406223211055920. [PMID: 34840709 PMCID: PMC8613896 DOI: 10.1177/20406223211055920] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/08/2021] [Indexed: 12/25/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by the presence of painful nodules, abscesses, chronically draining fistulas, and scarring in apocrine gland-bearing areas of the body. The exact pathogenesis of HS is not yet well understood, but there is a consensus in considering HS a multifactorial disease with a genetic predisposition, an inflammatory dysregulation, and an influence of environmental modifying factors. Therapeutic approach of HS is challenging due to the wide clinical manifestations of the disease and the complex pathogenesis. This review describes evidence for effectiveness of current and emerging HS therapies. Topical therapy, systemic treatments, biological agents, surgery, and light therapy have been used for HS with variable results. Adalimumab is the only US Food and Drug Administration (FDA) approved biologic agent for moderate-to-severe HS, but new therapeutic options are being studied, targeting different specific cytokines involved in HS pathogenesis. Comparing treatment outcomes between therapies is difficult due to the lack of randomized controlled trials. Treatment strategy should be selected in concordance to disease severity and requires combination of treatments in most cases.
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Affiliation(s)
- Victoria Amat-Samaranch
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Mas Casanovas 90, 08041, Barcelona, Spain
| | - Eugènia Agut-Busquet
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Mas Casanovas 90, 08041, Barcelona, Spain
| | - Eva Vilarrasa
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Mas Casanovas 90, 08041, Barcelona, Spain
| | - Lluís Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Mas Casanovas 90, 08041 Barcelona, Spain
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2
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Mahmmod S, Schultheiss JPD, van Bodegraven AA, Dijkstra G, Gilissen LPL, Hoentjen F, Lutgens MWMD, Mahmmod N, van der Meulen-de Jong AE, Smits LJT, Tan ACITL, Oldenburg B, Fidder HH. Outcome of Reverse Switching From CT-P13 to Originator Infliximab in Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis 2021; 27:1954-1962. [PMID: 33538298 DOI: 10.1093/ibd/izaa364] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients suffering from inflammatory bowel diseases (IBD) and treated with originator infliximab are increasingly being switched to biosimilars. Some patients, however, are "reverse switched" to treatment with the originator. Here we assess the prevalence of reverse switching, including its indication and outcomes. METHODS In this retrospective multicenter cohort study, data on patients with IBD from 9 hospitals in the Netherlands were collected. All adult patients with IBD were included if they previously had been switched from originator infliximab to the biosimilar CT-P13 and had a follow-up time of at least 52 weeks after the initial switch. The reasons for reverse switching were categorized into worsening gastrointestinal symptoms, adverse effects, or loss of response to CT-P13. Drug persistence was analyzed through survival analyses. RESULTS A total of 758 patients with IBD were identified. Reverse switching was observed in 75 patients (9.9%). Patients with reverse switching were predominantly female (70.7%). Gastrointestinal symptoms (25.5%) and dermatological symptoms (21.8%) were the most commonly reported reasons for reverse switching. In 9 patients (12.0%), loss of response to CT-P13 was the reason for reverse switching. Improvement of reported symptoms was seen in 73.3% of patients after reverse switching and 7 out of 9 patients (77.8%) with loss of response regained response. Infliximab persistence was equal between patients who were reverse-switched and those who were maintained on CT-P13. CONCLUSIONS Reverse switching occurred in 9.9% of patients, predominantly for biosimilar-attributed adverse effects. Switching back to originator infliximab seems effective in patients who experience adverse effects, worsening gastrointestinal symptoms, or loss of response after switching from originator infliximab to CT-P13.
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Affiliation(s)
- Shaden Mahmmod
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Johannes P D Schultheiss
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Ad A van Bodegraven
- Department of Gastroenterology and Hepatology, Zuyderland Medisch Centrum, Sittard, the Netherlands
| | - Gerard Dijkstra
- Department of Gastroenterology and Hepatology, University Medical Centre Groningen, Groningen, the Netherlands
| | - Lennard P L Gilissen
- Department of Gastroenterology and Hepatology, Catharina Ziekenhuis, Eindhoven, the Netherlands
| | - Frank Hoentjen
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Maurice W M D Lutgens
- Department of Gastroenterology and Hepatology, Elisabeth TweeSteden Ziekenhuis, Tilburg, the Netherlands
| | - Nofel Mahmmod
- Department of Gastroenterology and Hepatology, St. Antonius Ziekenhuis, Nieuwegein, the Netherlands
| | | | - Lisa J T Smits
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Adriaan C I T L Tan
- Department of Gastroenterology and Hepatology, Canisius-Wilhelmina Ziekenhuis, Nijmegen, the Netherlands
| | - Bas Oldenburg
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Herma H Fidder
- Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, the Netherlands
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3
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Miguel-Escuder L, Garcia Tirado A, Sainz-de-la-Maza M, Espinosa G, Moll-Udina A, Llorenç V, Parrado-Carrillo A, Adán A. Anti-TNF-alpha-induced lupus in patients with non-infectious uveitis. Eur J Ophthalmol 2021; 33:11206721211054705. [PMID: 34755548 DOI: 10.1177/11206721211054705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Anti-TNF-α-induced lupus (ATIL) is a rare condition considered as a drug-induced lupus (DIL) in patients under anti-TNF-α therapies. Nowadays it is still unclear if ATIL is a classical DIL or represent a distinct syndrome. Some characteristics of DIL have been described specifically associated with patients with lupus-like syndrome receiving anti-TNF-α therapy: the severity of the disease, incidence/prevalence of dsDNA antibodies (anti-dsDNA) and hypocomplementaemia. The objective of this study is to describe the development of ATIL in patients with non-infectious uveitis in a single tertiary center. METHODS Retrospective description of a case series. RESULTS We describe three patients with noninfectious uveitis (NIU) of different etiologies who developed antinuclear antibody (ANA) and anti-dsDNA antibody positivity, arthritis and, in one case, skin lesions under adalimumab treatment. The condition resolved in all of them after adalimumab withdrawal. Corticosteroids were required in one patient, non-steroidal anti-inflammatory drugs in two patients, and hydroxychloroquine in one of them. None required another immunosuppressive drug. A subsequent control of the NIU could continue to be carried out without anti-TNF-α therapy in two patients and in the remaining a switch was made to another anti-TNF-α (golimumab). CONCLUSION The current report describes three cases of ATIL in patients with different types of NIU which share some common features: ANA positivity, articular symptoms, and a temporal relationship between symptoms onset and anti-TNF-α treatment. A review of the literature and comparison with the few previous reported ATIL cases was conducted as well.
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Affiliation(s)
| | | | | | - Gerard Espinosa
- Department of Autoimmune Diseases, 16493Hospital Clinic, Barcelona, Spain
| | - Aina Moll-Udina
- Clínic Institute of Ophthalmology, 16493Hospital Clinic, Barcelona, Spain
| | - Víctor Llorenç
- Clínic Institute of Ophthalmology, 16493Hospital Clinic, Barcelona, Spain
| | | | - Alfredo Adán
- Clínic Institute of Ophthalmology, 16493Hospital Clinic, Barcelona, Spain
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4
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Macfarlane GJ, Pathan E, Jones GT, Dean LE. Predicting response to anti-TNFα therapy among patients with axial spondyloarthritis (axSpA): results from BSRBR-AS. Rheumatology (Oxford) 2020; 59:2481-2490. [PMID: 31990352 PMCID: PMC7449799 DOI: 10.1093/rheumatology/kez657] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 12/06/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES While many axSpA patients, eligible to receive anti-TNFα therapy, derive benefit when prescribed them, some patients do not. The current study aims to identify modifiable targets to improve outcome as well as non-modifiable targets that identify groups less likely to derive benefit. METHODS The BSRBR-AS is a prospective cohort study of axSpA patients who, at recruitment, were naïve to biologic therapy. Those in the 'biologic' sub-cohort commenced their first anti-TNFα therapy at recruitment or during follow-up. Prior to commencement, information was collected on socio-economic, clinical and patient-reported factors. Outcome was assessed according to ASAS20, ASAS40, ASDAS reduction and achieving a moderate/inactive ASDAS disease state. RESULTS 335 participants commenced their first anti-TNFα therapy and were followed up at a median of 14 (inter-quartile range 12-17) weeks. Response varied between 33% and 52% according to criteria used. Adverse socio-economic factors, fewer years in education predicted lower likelihood of response across outcome measures as did not working full-time. Co-morbidities and poor mental health were clinical and patient-reported factors, respectively, associated with lack of response. The models, particularly those using ASDAS, were good at predicting those who did not respond (negative predictive value (NPV) 77%). CONCLUSION Some factors predicting non-response (such as mental health) are modifiable but many (such as social/economic factors) are not modifiable in clinic. They do, however, identify patients who are unlikely to benefit from biologic therapy alone. Priority should focus on how these patients receive the benefits that many derive from such therapies.
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Affiliation(s)
- Gary J Macfarlane
- Epidemiology Group, School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Ejaz Pathan
- Spondylitis Program, Department of Rheumatology, Toronto Western Hospital, Toronto, Canada
| | - Gareth T Jones
- Epidemiology Group, School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Linda E Dean
- Epidemiology Group, School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK
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5
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Xue L, van Bilsen K, Schreurs MWJ, van Velthoven MEJ, Missotten TO, Thiadens AAHJ, Kuijpers RWAM, van Biezen P, Dalm VASH, van Laar JAM, Hermans MAW, Dik WA, van Daele PLA, van Hagen PM. Are Patients at Risk for Recurrent Disease Activity After Switching From Remicade ® to Remsima ®? An Observational Study. Front Med (Lausanne) 2020; 7:418. [PMID: 32850911 PMCID: PMC7424016 DOI: 10.3389/fmed.2020.00418] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/30/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Since the late ‘90s, infliximab (Remicade®) is being used successfully to treat patients with several non-infectious immune mediated inflammatory diseases (IMIDs). In recent years, infliximab biosimilars, including Remsima® were introduced in clinical practice. Aim: To investigate the interchangeability of Remicade® (originator infliximab) and its biosimilar Remsima® in patients with rare immune-mediated inflammatory diseases (IMIDs). Methods: This two-phased prospective open label observational study was designed to monitor the transition from Remicade® to Remsima® in patients with rare IMIDs. All included patients were followed during the first 2 years. The primary endpoint was the demonstration of non-difference in quality of life and therapeutic efficacy, as measured by parameters including a safety monitoring program, physicians perception of disease activity (PPDA) and patient self-reported outcomes (PSROs). Secondary outcomes included routine blood analysis, pre-infusion serum drug concentration values and anti-drug antibody formation. Results: Forty eight patients treated with Remicade® were switched to Remsima® in June-July 2016 and subsequently monitored during the first 2 years. The group consisted of patients with sarcoidosis (n = 17), Behçet's disease (n = 12), non-infectious uveitis (n = 11), and other diagnoses (n = 8). There were no significant differences in PPDA, PSROs, clinical and laboratory assessments and pre-infusion serum drug concentrations between the groups. De novo anti-drug antibodies were observed in two patients. Seven patients with sarcoidosis and five with another diagnosis developed a significant disease relapse (n = 7) or adverse events (n = 5) within 2 years; 10 of these patients discontinued Remsima® treatment, one withdrew from the study and one received additional corticosteroid therapy. Conclusions: We observed no significant differences in PSROs, PPDA and laboratory parameters after treatment was switched from Remicade® to Remsima®. However, disease relapse or serious events were observed in 12 out of 48 patients when treatment was switched from Remicade® to Remsima®. The choice to switch anti-TNF alpha biologics in patients with rare IMIDs, particularly in sarcoidosis, requires well-considered decision-making and accurate monitoring due to a possibly higher incidence of disease worsening.
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Affiliation(s)
- Laixi Xue
- Internal Medicine, Erasmus University Rotterdam, Rotterdam, Netherlands.,Academic Center for Rare Immunological Diseases, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - K van Bilsen
- Department of Internal Medicine, Division of Clinical Immunology, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Internal Medicine, Spaarne Gasthuis Hospital, Haarlem, Netherlands
| | - M W J Schreurs
- Academic Center for Rare Immunological Diseases, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Immunology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - M E J van Velthoven
- Academic Center for Rare Immunological Diseases, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,The Rotterdam Eye Hospital, Rotterdam, Netherlands
| | - T O Missotten
- Academic Center for Rare Immunological Diseases, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,The Rotterdam Eye Hospital, Rotterdam, Netherlands
| | - A A H J Thiadens
- Department of Ophthalmology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - R W A M Kuijpers
- Department of Ophthalmology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands.,Department of Ophthalmology, Albert Schweitzer Hospital, Dordrecht, Netherlands.,Department of Ophthalmology, University Hospital, Vrije Universiteit Brussel, Brussels, Belgium
| | - P van Biezen
- Academic Center for Rare Immunological Diseases, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Clinical Immunology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - V A S H Dalm
- Academic Center for Rare Immunological Diseases, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Clinical Immunology, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Immunology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - J A M van Laar
- Academic Center for Rare Immunological Diseases, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Clinical Immunology, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Immunology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - M A W Hermans
- Academic Center for Rare Immunological Diseases, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Clinical Immunology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - W A Dik
- Academic Center for Rare Immunological Diseases, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Clinical Immunology, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Immunology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - P L A van Daele
- Academic Center for Rare Immunological Diseases, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Clinical Immunology, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Immunology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - P M van Hagen
- Academic Center for Rare Immunological Diseases, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Internal Medicine, Division of Clinical Immunology, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Immunology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
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6
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Force BK, Vogel TP, Nguyen DM, Heck KA, Sebastian S, Takashima M, Yoshor D, Samson SL. A Remarkable Response of Granulomatous Hypophysitis to Infliximab in a Patient With a Background of Crohn's Disease-A Case Report. Front Endocrinol (Lausanne) 2020; 11:350. [PMID: 32547497 PMCID: PMC7272571 DOI: 10.3389/fendo.2020.00350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/04/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Hypophysitis is primary or idiopathic or secondary to another disease process. The histologic subtypes of hypophysitis are lymphocytic, granulomatous, xanthomatous, xanthogranulomatous, or IgG4-related. Granulomatous hypophysitis is the second most common form and is characterized by multinucleated giant cells with granulomas and histiocytes. It can be idiopathic or secondary to another process such as infection, sarcoidosis, vasculitis, dendritic cell disorders, Crohn's disease (CD) or a reaction to rupture of a Rathke's cyst or pituitary adenoma. We present a case of granulomatous hypophysitis in a patient with CD who had resistance to corticosteroids but a dramatic response to immunosuppressive therapy with anti-tumor necrosis factor (TNF)-α therapy. Case description: A 43-year-old woman with a 9-year history of ileal and colonic CD presented to the Pituitary Center with headaches, visual disturbance, fatigue, nausea, and secondary amenorrhea. She was not on active therapy for her CD at the time of presentation and had no gastrointestinal symptoms. Hormonal evaluation revealed hyperprolactinemia, secondary hypothyroidism and adrenal insufficiency. MRI revealed a 12 × 12 × 19 mm sellar lesion abutting the optic chiasm, reported as a macroadenoma. The patient underwent endoscopic transsphenoidal biopsy of the pituitary mass. Pathology revealed granulomatous hypophysitis. Evaluation for secondary causes of hypophysitis, apart from CD, was negative. Despite a course of high dose prednisone, her symptoms and MRI findings worsened and she developed symptoms consistent with diabetes insipidus. Using a personalized medicine approach, she was started on anti-(TNF)-α therapy with infliximab combined with azathioprine, which are indicated for treatment of CD. Her headaches and polyuria resolved and her menstrual cycles resumed. MRI at 3 months and more than 1.5 years after initiation of anti-TNF-α therapy revealed durable resolution of the pituitary mass. Conclusion: To our knowledge, this is the first report of successful use of anti-TNF-α therapy for a patient with granulomatous hypophysitis, in this case associated with a previous diagnosis of CD. Although glucocorticoids are used frequently as first-line therapy for primary hypophysitis, granulomatous hypophysitis can be corticosteroid resistant and other immunosuppressive approaches may need to be considered within the context of the patient.
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Affiliation(s)
- Bahar K. Force
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
- Baylor St. Luke's Pituitary Center, Houston, TX, United States
| | - Tiphanie P. Vogel
- Division of Rheumatology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Dang M. Nguyen
- Greater Houston Gastroenterology, Houston, TX, United States
| | - Kent A. Heck
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, United States
| | - Sherly Sebastian
- Baylor St. Luke's Pituitary Center, Houston, TX, United States
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Mas Takashima
- Houston Methodist Hospital, Department of Otolaryngology, Houston, TX, United States
| | - Daniel Yoshor
- Baylor St. Luke's Pituitary Center, Houston, TX, United States
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Susan L. Samson
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
- Baylor St. Luke's Pituitary Center, Houston, TX, United States
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
- *Correspondence: Susan L. Samson
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7
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Duricova D, Dvorakova E, Hradsky O, Mitrova K, Durilova M, Kozeluhova J, Kohout P, Zarubova K, Bronsky J, Hradska N, Bronska E, Adamcova M, Machkova N, Hruba V, Bortlik M, Lukas M, Malickova K, Lukas M. Safety of Anti-TNF-Alpha Therapy During Pregnancy on Long-term Outcome of Exposed Children: A Controlled, Multicenter Observation. Inflamm Bowel Dis 2019; 25:789-796. [PMID: 30239799 DOI: 10.1093/ibd/izy294] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Evidence of the impact of in utero exposure to anti-tumor necrosis factor (TNF)-alpha on long-term childhood development is limited. The aim was to assess the impact of in utero exposure to anti-TNF-alpha due to mothers' inflammatory bowel disease (IBD) on long-term postnatal development of exposed children. METHODS We included consecutive children (≥12 months of age) born to mothers with IBD (2007-2016) treated with anti-TNF-alpha during pregnancy in 3 centers in the Czech Republic. A control group was comprised of unexposed children of non-IBD mothers undergoing mandatory check-ups at general pediatricians' offices. Data on perinatal period, psychomotor development, vaccination, infections, antibiotics, and allergy were collected by treating pediatricians using a predefined questionnaire. RESULTS Seventy-two exposed and 69 unexposed children were included (median age, 35 and 50 months, respectively). Exposed children had growth and psychomotor development similar to controls. There was no significant difference in infectious complications within the first year of life (23.9% vs 17.4%; P = 0.36) or during the whole follow-up between exposed infants and controls (P = 0.32). Concomitant immunosuppressants during pregnancy and anti-TNF-alpha levels in cord blood were not associated with elevated infection rate within the first year of life (P > 0.05). Over 95% of exposed children had adequate serologic response to vaccination, except for haemophilus and mumps vaccines. Clinically manifested allergy was similar between the groups (P = 0.98). CONCLUSIONS Anti-TNF-alpha exposure in utero does not seem to have a negative impact on postnatal development of children with regard to infectious complications, allergy, growth, or psychomotor development when compared with unexposed children of non-IBD women.
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Affiliation(s)
- Dana Duricova
- IBD Clinical and Research Center, ISCARE IVF, a.s., Prague, Czech Republic
| | - Eva Dvorakova
- IBD Clinical and Research Center, ISCARE IVF, a.s., Prague, Czech Republic
| | - Ondrej Hradsky
- Department of Pediatrics, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Katarina Mitrova
- IBD Clinical and Research Center, ISCARE IVF, a.s., Prague, Czech Republic.,Department of Pediatrics, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Marianna Durilova
- Department of Pediatric Surgery, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Jana Kozeluhova
- Department of Internal Medicine, University Hospital Plzeň, Plzeň, Czech Republic
| | - Pavel Kohout
- Department of Internal Medicine, Thomayer University Hospital, Prague, Czech Republic
| | - Kristyna Zarubova
- Department of Pediatrics, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Jiri Bronsky
- Department of Pediatrics, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | | | | | | | - Nadezda Machkova
- IBD Clinical and Research Center, ISCARE IVF, a.s., Prague, Czech Republic
| | - Veronika Hruba
- IBD Clinical and Research Center, ISCARE IVF, a.s., Prague, Czech Republic
| | - Martin Bortlik
- IBD Clinical and Research Center, ISCARE IVF, a.s., Prague, Czech Republic.,Department of Internal Medicine, First Faculty of Medicine, Charles University and Military University Hospital, Prague, Czech Republic.,Institute of Pharmacology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Martin Lukas
- IBD Clinical and Research Center, ISCARE IVF, a.s., Prague, Czech Republic
| | - Karin Malickova
- IBD Clinical and Research Center, ISCARE IVF, a.s., Prague, Czech Republic
| | - Milan Lukas
- IBD Clinical and Research Center, ISCARE IVF, a.s., Prague, Czech Republic
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8
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Germain V, Scherlinger M, Barnetche T, Schaeverbeke T. Long-term follow-up after switching from originator infliximab to its biosimilar CT-P13: the weight of nocebo effect. Ann Rheum Dis 2018; 79:e11. [PMID: 30352888 DOI: 10.1136/annrheumdis-2018-214374] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/01/2018] [Accepted: 10/06/2018] [Indexed: 11/04/2022]
Affiliation(s)
- Vincent Germain
- Department of Rheumatology, Centre Hospitalier Universitaire de Bordeaux, Service de Rhumatologie, Bordeaux, France.,Department of Rheumatology, Université de Bordeaux, Bordeaux, France
| | - Marc Scherlinger
- Department of Rheumatology, Centre Hospitalier Universitaire de Bordeaux, Service de Rhumatologie, Bordeaux, France.,Department of Rheumatology, Université de Bordeaux, Bordeaux, France.,Department of Rheumatology, CNRS-UMR 5164 Immuno ConcEpT, Bordeaux, France
| | - Thomas Barnetche
- Department of Rheumatology, Centre Hospitalier Universitaire de Bordeaux, Service de Rhumatologie, Bordeaux, France
| | - Thierry Schaeverbeke
- Department of Rheumatology, Centre Hospitalier Universitaire de Bordeaux, Service de Rhumatologie, Bordeaux, France .,Department of Rheumatology, Université de Bordeaux, Bordeaux, France
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9
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Pugliese D, Felice C, Landi R, Papa A, Guidi L, Armuzzi A. Benefit-risk assessment of golimumab in the treatment of refractory ulcerative colitis. Drug Healthc Patient Saf 2016; 8:1-7. [PMID: 26893582 PMCID: PMC4745853 DOI: 10.2147/dhps.s62649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Significant advances in the management of patients with ulcerative colitis (UC) have been made since the introduction of anti-tumor necrosis factor (TNF)-alpha agents, especially for those who fail or do not tolerate conventional therapies. Two drugs, infliximab first, then adalimumab afterward, showed effectiveness in inducing and maintaining long-term remission both in pivotal trials as well as in clinical practice. However, approximately 25% of patients with UC, who fail or do not tolerate all available therapies, require a colectomy for refractory disease. The therapeutic scenario of UC has been recently upgraded by the introduction of golimumab, the latest anti TNF-alpha agent to be approved. Golimumab is a totally humanized monoclonal antibody, administered by a subcutaneous injection every 4 weeks. Treatment with golimumab has shown to be effective to induce sustained clinical benefit in tough-to-treat patients with UC, including steroid and/or immunosuppressive refractory and steroid-dependent patients. In this review, we summarize all available efficacy and safety data of golimumab in UC, analyzing the potential therapeutic position for the treatment of refractory patients with UC.
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Affiliation(s)
- Daniela Pugliese
- Inflammatory Bowel Disease Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy
| | - Carla Felice
- Inflammatory Bowel Disease Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy
| | - Rosario Landi
- Inflammatory Bowel Disease Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy
| | - Alfredo Papa
- Inflammatory Bowel Disease Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy
| | - Luisa Guidi
- Inflammatory Bowel Disease Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy
| | - Alessandro Armuzzi
- Inflammatory Bowel Disease Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy
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10
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Gökmen F, Akbal A, Reşorlu H, Gökmen E, Güven M, Aras AB, Erbağ G, Kömürcü E, Akbal E, Coşar M. Neutrophil-Lymphocyte Ratio Connected to Treatment Options and Inflammation Markers of Ankylosing Spondylitis. J Clin Lab Anal 2014; 29:294-8. [PMID: 24849656 DOI: 10.1002/jcla.21768] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 04/02/2014] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND In recent years, white blood cells (WBCs) and their subtypes have been studied in relation to inflammation. The aim of our study was to assess the relationship between neutrophil-lymphocyte ratio (NLR) and ankylosing spondylitis (AS). MATERIALS AND METHODS We enrolled a total of 177 patients, 96 AS and 81 healthy controls. Complete blood count, WBC, neutrophil and lymphocyte levels were measured, and the NLR was calculated. In the assessment of AS, we used the erythrocyte sedimentation rate, C-reactive protein (CRP), the Bath Ankylosing Spondylitis Disease Activity Index, and the Bath Ankylosing Spondylitis Functional Index. RESULTS In the present study, 96 AS and 81 healthy individuals were enrolled. The mean age was 43.8 ± 12.9 and 46.5 ± 11.2 years, respectively. Mean disease duration of AS patients was 6.9 ± 5.6 years (median = 5, min-max = 1-25). The patients with AS had a higher NLR than the control individuals (mean NLR, 2.24 ± 1.23 and 1.73 ± 0.70, respectively, P < 0.001). A statistically significant positive correlation was observed between NLR and CRP (r = 0.322, P = 0.01). The patients receiving antitumor necrosis factor α therapy had a lower NLR than the patients receiving nonsteroidal anti-inflammatory drug therapy (mean NLR, 1.71 ± 0.62 and 2.41 ± 1.33, respectively, P = 0.02). CONCLUSION NLR may be seen as a useful marker for demonstrating inflammation together with acute phase reactants such as CRP and in evaluating the effectiveness of anti-TNF-α therapy.
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Affiliation(s)
- Ferhat Gökmen
- Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Ayla Akbal
- Canakkale Onsekiz Mart University, Canakkale, Turkey
| | | | | | - Mustafa Güven
- Canakkale Onsekiz Mart University, Canakkale, Turkey
| | | | - Gökhan Erbağ
- Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Erkam Kömürcü
- Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Erdem Akbal
- Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Murat Coşar
- Canakkale Onsekiz Mart University, Canakkale, Turkey
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11
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Abstract
Vasculitis syndromes are relative rare conditions but can cause significant mortality and morbidity if not treated adequately. Recent advances in immunosuppressant therapy have radically changed the course of these diseases. However, the standard therapy is not always well tolerated by patients, and some cases are refractory to treatment. New therapeutic possibilities have emerged with the use of so-called "biologics," a new class of genetically engineered drugs used for inflammatory rheumatic diseases, including rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. In the present review, summarized are the most recent data on the efficacy and safety of biologics in the treatment of vasculitis syndromes that cannot be treated with standard therapy.
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Affiliation(s)
- Marino Paroli
- Division of Clinical Immunology and Rheumatology, Department of Biotechnology and Medical-Surgical Sciences, Sapienza University of Rome, Italy
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