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Oncologic Emergencies: Immune-Based Cancer Therapies and Complications.

Cancer therapies have undergone several recent advancements. Current cancer treatments include immune-based therapies comprised of checkpoint inhibitors, and adoptive immunotherapy; each treatment has the potential for complications that differ from chemotherapy and radiation. This review evaluates immune-based therapies and their complications for emergency clinicians. Therapy complications include immune-related adverse events (irAE), cytokine release syndrome (CRS), autoimmune toxicity, and chimeric antigen receptor (CAR) T-cell-related encephalopathy syndrome (CRES). Immune-related adverse

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… Prednisone 1–2 milligrams per kilogram per day (mg/kg/day) (or its equivalent) for mild-moderate disease is recommended, but in severe cardiac irAE or in patients who do not respond, methylprednisolone 1 gram intravenous (IV) per day is recommended. 60 – 62 Other immunologic agents such as infliximab … Ipilimumab-induced acute severe colitis treated by infliximab. Melanoma Res. 2013;23:227–230. doi: 10.1097/CMR.0b013e32835fb524. 74. Merrill SP, Reynolds P, Kalra A, et al. Early administration of infliximab for severe ipilimumab-related diarrhea in a critically ill patient. …

Treating children with inflammatory bowel disease: Current and new perspectives.

Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gut characterised by alternating periods of remission and relapse. Whilst the mechanism underlying this disease is yet to be fully understood, old and newer generation treatments can only target selected pathways of this complex inflammatory process. This narrative review aims to provide an update on the most recent advances in treatment of paediatric IBD. A MEDLINE search was conducted using "paediatric inflammatory bowel disease", "paediatric Crohn's disease", "paediatric ulcerative colitis", "treatment", "therapy",

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… Induction and maintenance infliximab therapy for the treatment of moderate-to-severe Crohn’s disease in children. Gastroenterology. 2007;132:863–873; quiz 1165-1166. doi: 10.1053/j.gastro.2006.12.003. 36. … Efficacy of infliximab in pediatric Crohn’s disease: a randomized multicenter open-label trial comparing scheduled to on demand maintenance therapy. Inflamm Bowel Dis. 2009;15:388–394. doi: 10.1002/ibd.20788. 37. …

Targeted Therapy for Idiopathic Inflammatory Myopathy.

BACKGROUND: Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of autoimmune disorders characterized by chronic muscle inflammation and significant extramuscular involvement. A substantial proportion of patients exhibit refractory or relapsing disease despite conventional immunosuppressive therapies, necessitating the development of novel targeted treatments. Recent immunological advances have identified novel therapeutic targets-including B cells, T cells, cytokines and intracellular signalling pathways-paving the way for personalized treatment. Targeted therapies represent pr

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… Compared with the placebo, the addition of infliximab to stable doses of immunosuppressants and glucocorticoids resulted in improved muscle strength [ 46 ]. … Among these patients, those who switched from infliximab to adalimumab experienced further reductions in overall disease activity [ 47 ]. Infliximab has also been shown to be effective against calcinosis in refractory JDM patients [ 48 , 49 ]. …

Customer-centric product presentations for monoclonal antibodies.

Delivering customer-centric product presentations for biotherapeutics, such as monoclonal antibodies (mAbs), represents a long-standing and paramount area of engagement for pharmaceutical scientists. Activities include improving experience with the dosing procedure, reducing drug administration-related expenditures, and ultimately shifting parenteral treatments outside of a controlled healthcare institutional setting. In times of increasingly cost-constrained markets and reinforced with the coronavirus pandemic, this discipline of "Product Optimization" in healthcare has gained momentum and ch

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… Celltrion’s infliximab biosimilar received European Medicines Agency (EMA) approval for a subcutaneous dosing alternative in 2019 and FDA review is anticipated to be completed as a next milestone (Rose 2021 ; Verma et al. 2021 ), while branded infliximab is only available with an intravenous infusion … Here, biosimilar infliximab is being assessed for the feasibility of an oral version in the treatment of IBD. …

Safety and efficacy of BI 695501 versus adalimumab reference product in patients with advanced Crohn's disease (VOLTAIRE-CD): a multicentre, randomised, double-blind, phase 3 trial.

BACKGROUND: BI 695501 is a biosimilar that has demonstrated similar efficacy, safety, and immunogenicity to adalimumab reference product in … em to the BI 695501 group or adalimumab reference product group, stratified by previous exposure to infliximab (yes vs no) and simple endoscopic score for Crohn's disease at screening (<16 vs ≥16). All investigators involved in trial assessments or procedures and all patients were masked to treatment allocation until week 24. Patients received BI 695501 (40 …

Vitiligo as a First Sign of Vogt-Koyanagi-Harada Disease.

Vogt-Koyanagi-Harada (VKH) disease is a multisystem disorder characterized by bilateral granulomatous panuveitis resulting in serous retinal … d if the symptoms are persistent or worsening. In case of no improvement, biological agents such as infliximab and adalimumab are included (4).

Anti-TNF agents for paediatric psoriasis.

BACKGROUND: Psoriasis is a chronic skin disease that may develop at any age. Estimates for the United States and Europe suggest that psoriasis accounts for 4% of skin diseases in children. In most cases, the condition is mild and can be treated with creams. However, a small percentage of children have moderate to severe disease that requires drugs, such as ciclosporin or methotrexate, and some will require injections with newer biological agents, such as anti-TNF (tumour necrosis factor) drugs. Anti-TNF drugs (among them etanercept, infliximab, and adalimumab) are designed to reduce inflammati…

Therapy of moderate and severe psoriasis.

OBJECTIVE AND METHODS: This health technology assessment (HTA) report synthesises systematically randomized controlled studies (RCT) on the … n photocarcinogenicity. Three substances from the group of biologicals (Efalizumab, Etanercept, and Infliximab) are now available in Europe and a further substance (Alefacept) is available in the USA for the treatment of moderate to severe psoriasis. All biologicals have been effective in placebo controlled studies. The substances differ in the times until a …

Успешное лечение гуселкумаба у пациента с коморбидом псориазом и амиотропическим латеральным склерозом: тематическое исследование и обзор литературы.

Псориаз имеет генетические последствия и может быть вызван такими факторами, как инфекция, стресс и образ жизни. Хроническая доска psoriasis, наиболее распространенная форма, включает в себя ключевые роли для IL-17 и IL-23 в его патогенезе. Амиотропический боковой склероз (ALS) — нейродегенеративное расстройство, характеризующееся дегенерацией моторных нейронов, что приводит к слабости мышц и атрофии. В настоящее время нет лекарства от БАС, а лечение является симптоматическим и направлено на повышение качества жизни. Сочетание псориаза и БАС является относительно редким. Хотя биологические аге

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… Abbreviations : ADA, adalimumab; ALS, Amyotrophic lateral Sclerosis; AD, Alzheimer’s Disease; CsA, Cyclosporine A; ETA, etanercept; INF, Infliximab; IXE, ixekizumab; MTX, methotrexate; NA, Not available; PSO, Psoriasis; PSA, Psoriatic Arthritis; MS, Multiple Sclerosis; PD, Parkinson’s Disease; PASI, … Cases Reported on Biologic Agents for Psoriasis Complicated by Neurodegenerative Diseases Abbreviations : ADA, adalimumab; ALS, Amyotrophic lateral Sclerosis; AD, Alzheimer’s Disease; CsA, Cyclosporine A; ETA, etanercept; INF, Infliximab; IXE, ixekizumab; MTX, methotrexate; NA, Not available; PSO, Psoriasis …

Immunogenicity to biological drugs in psoriasis and psoriatic arthritis.

Monoclonal antibodies or fusion proteins, defined as biological drugs, have modified the natural history of numerous immune-mediated disorders, allowing the development of therapies aimed at blocking the pathophysiological pathways of the disease, providing greater efficacy and safety than conventional treatment strategies. Virtually all therapeutic proteins elicit an immune response, producing anti-drug antibodies (ADAs) against hypervariable regions of immunoglobulins. Immunogenicity against biological drugs can alter their pharmacokinetic and pharmacodynamic properties, thereby reducing the

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… Infliximab (IFX) was the first anti-TNF-α approved by international regulatory agencies for use in patients with PD. It is an IgG1 chimeric mcAB that is administered intravenously. … Infliximab (IFX) : In a study by Menter et al. in 2007, after 50 weeks of treatment with IFX, between 35-50% of psoriatic patients developed antibodies against the drug ( 43 ). …

Progress in Biological Therapies for Adult-Onset Still's Disease.

Adult-onset Still's disease (AOSD) is a rare multifactorial autoinflammatory disorder of unknown etiology, characterized by an excessive release of cytokines triggered by dysregulated inflammation and articular and systemic manifestations. The clinical spectrum of AOSD ranges from self-limiting forms with mild symptoms to life-threatening cases and presents clinical and biological similarities with the juvenile form (sJIA). Nowadays, the advances in biologic agents no longer limit the treatment to NSAIDs, glucocorticoids, or conventional synthetic DMARDs. The blockade of IL-1 and IL-6 is effec

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… TNF-Alpha Inhibitors Among TNF-α inhibitors, infliximab, etanercept, and adalimumab were the first biologicals used in single case reports or small series in the early 2000s. 59 The first employment of infliximab date to 2001, when it was administered i.v. at a dose of 3–5 mg/kg in three refractory … Infliximab in the treatment of adult Still’s disease refractory to conventional therapy. Clin Exp Rheumatol . 2001;19(3):329–332. 61. Kraetsch HG, Antoni C, Kalden JR, et al. Successful treatment of a small cohort of patients with adult onset of Still’s disease with infliximab: first experiences. …

Precision medicine: The use of tailored therapy in primary immunodeficiencies.

Primary immunodeficiencies (PID) are rare, complex diseases that can be characterised by a spectrum of phenotypes, from increased susceptibility to infections to autoimmunity, allergy, auto-inflammatory diseases and predisposition to malignancy. With the introduction of genetic testing in these patients and wider use of next-Generation sequencing techniques, a higher number of pathogenic genetic variants and conditions have been identified, allowing the development of new, targeted treatments in PID. The concept of precision medicine, that aims to tailor the medical interventions to each patie

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… Infliximab was recognised as a therapeutic agent for patients with CVID with granulomatous disease, a condition that can increase morbidity and mortality in these patients ( 161 ). … Adalimumab as similar indications as infliximab with the advantage in the type of administration (subcutaneous) in comparison to infliximab (intravenous) with doses that can vary depending on the patient weight and disease ( 141 ). …

Extraintestinal Cancers in Inflammatory Bowel Disease: A Literature Review.

BackgroundInflammatory bowel disease (IBD) is a group of chronic multifactorial inflammatory disorders including two major entities: Crohn's disease (CD) and ulcerative colitis (UC). Preliminary evidence suggests that patients with IBD may be at increased risk of developing intestinal and extraintestinal cancers (EICs). Actually, little is known about the association between IBD and EICs, and there is ever-growing concern regarding the safety of immunomodulators and biological therapy, which may represent a risk factor for carcinogenesis.AimsThe aim of this review is to summarize the evidence

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… Regarding overall cancer risk in IBD patients, a systematic review and meta-analysis published in 2016 analyzed as a secondary outcome the malignancy risk associated with biological therapies (adalimumab (ADA), certolizumab, golimumab, infliximab (IFX), natalizumab, or vedolizumab (VDZ)) in IBD and included …

Role of Ceramide from Glycosphingolipids and Its Metabolites in Immunological and Inflammatory Responses in Humans.

Glycosphingolipids (GSLs) are composed of hydrophobic ceramide and hydrophilic sugar chains. GSLs cluster to form membrane microdomains (lipid rafts) on plasma membranes, along with several kinds of transducer molecules, including Src family kinases and small G proteins. However, GSL-mediated biological functions remain unclear. Lactosylceramide (LacCer, CDw17) is highly expressed on the plasma membranes of human phagocytes and mediates several immunological and inflammatory reactions, including phagocytosis, chemotaxis, and superoxide generation. LacCer forms membrane microdomains with the Sr

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… Infliximab, a chimeric IgG1 κ monoclonal antibody against human TNF- α , inhibits the TNF- α -mediated production of IL-8 by keratinocytes [ 69 ]. PaCDase-induced phosphorylation of NF- κ B p65 was markedly suppressed by infliximab [ 55 ]. … The effects of infliximab have also been evaluated in other inflammatory dermatoses and in systemic diseases involving the skin, pityriasis rubra pilaris, pyoderma gangrenosum, and cutaneous sarcoidosis [ 73 ]. …

Biological Therapies or Apremilast in the Treatment of Psoriasis in Patients with a History of Hematologic Malignancy: Results from a Retrospective Study in 21 Patients.

BackgroundFew studies addressing the safety and efficacy of biological therapy (BT) or apremilast (APR) in patients with psoriasis with a history of hematologic malignancy (HM) exist.AimTo describe the tolerance and efficacy of BT and APR in moderate-to-severe psoriasis in patients with a history of in-remission or evolving HM.MethodologyA retrospective, multicenter chart review of the tolerance and efficacy of BT or APR in patients with moderate-to-severe psoriasis and a clinical history of in-remission or evolving HM.ResultsTwenty-one patients with severe psoriasis and a history of HM were i

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… BT in psoriasis comprise anti-TNFα (adalimumab, etanercept, infliximab, certolizumab pegol) and anti-interleukins including ustekinumab (anti-IL-12/23), secukinumab and ixekizumab (anti- IL-17), brodalumab (anti-receptor of IL-17), guselkumab and risankizumab (anti-IL-23). 1 , 2 BT are well tolerated … Cancer risk with tumor necrosis factor alpha (TNF) inhibitors: meta-analysis of randomized controlled trials of adalimumab, etanercept, and infliximab using patient level data . Pharmacoepidemiol Drug Saf . 2011 ; 20 ( 2 ): 119 – 130 . doi: 10.1002/pds.2046 21254282 20. …

Pretreatment multi-biomarker disease activity score and radiographic progression in early RA: results from the SWEFOT trial.

OBJECTIVES: Prediction of radiographic progression (RP) in early rheumatoid arthritis (eRA) would be very useful for optimal choice among available therapies. We evaluated a multi-biomarker disease activity (MBDA) score, based on 12 serum biomarkers as a baseline predictor for 1-year RP in eRA. METHODS: Baseline disease activity score based on erythrocyte sedimentation rate (DAS28-ESR), disease activity score based on C-reactive protein (DAS28-CRP), CRP, MBDA scores and DAS28-ESR at 3 months were analysed for 235 patients with eRA from the Swedish Farmacotherapy (SWEFOT) clinical trial. RP wa

Ten tips for an onco-nephrology clinic.

An increasing number of cancer patients are benefiting from long term cancer-directed therapy with an ever-expanding arsenal of novel agents from monoclonal antibodies to small molecules and cellular therapies in addition to the mainstay cytotoxic chemotherapy. All these therapies are accompanied by a unique array of adverse events, which include kidney toxicity. In this context, the need for onco-nephrology expertise continues to grow. Oncologists and hematologists collaborate closely with onco-nephrologists to determine: (i) treatment options for special populations based on accurate assessm

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… **Infliximab is the preferred steroid-sparing agent to trial initially, in the authors’ opinions. … Contraindications to Infliximab use are listed in Box 1 . …

Home infusion services in Saudi Arabia: Where are we standing?

Diseases management has reached the highest level of complexity and cost in history, worldwide, and in Saudi Arabia in particular, which led to prolonged, unnecessary hospital stays. There have been many recent innovative measures to reduce these issues. One is to provide home infusion services. Hence, this narrative review emphasizes the expected benefits and challenges of such services and the applicability of their implementation in Saudi Arabia. A literature search was conducted via PubMed database, involving all published studies from inception until March 24th, 2023. Many studies showed

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… The study found that the mean patients' satisfaction with home-infused infliximab was 9.2 compared to 8.2 for hospital-treated patients ( Condino, Fidanza, & Hoffenberg, 2005 ). … A home infliximab infusion program. J. Pediatr. Gastroenterol. Nutr. 2005;40(1):67–69. doi: 10.1097/00005176-200501000-00012. Creating a PRISMA flow diagram: PRISMA 2020. Retrieved from https://guides.lib.unc.edu/prisma . Docherty T., Schneider J.J., Cooper J. …

Exploring the top 30 drugs associated with drug-induced constipation based on the FDA adverse event reporting system.

ObjectiveThis project aims to identify the top 30 drugs most commonly associated with constipation and their signal values within the FDA Adverse Event Reporting System database.MethodsWe extracted adverse drug events (ADEs) related to constipation from the FAERS database spanning from January 1, 2004, to September 30, 2023. We compiled the 30 most frequently reported drugs based on the frequency of constipation events. We employed signal detection methodologies to ascertain whether these drugs elicited significant signals, including reporting odds ratio, proportional reporting ratio, multi-it

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… We categorized the 30 drugs ( Table 2 ; Figure 3B ) and found that antineoplastic and immunomodulating agents (lenalidomide, adalimumab, niraparib, palbociclib, pomalidomide, enzalutamide, cabozantinib, nintedanib, etanercept, capecitabine, vedolizumab, infliximab, and bevacizumab) were the most common … We categorized 30 medications, among which antineoplastic and immunomodulating agents (including lenalidomide, adalimumab, niraparib, palbociclib, pomalidomide, enzalutamide, cabozantinib, nintedanib, etanercept, capecitabine, vedolizumab, infliximab, and bevacizumab) emerged as the most prevalent class …

Role of T cells and cytokines in the pathogenesis of rheumatoid arthritis.

Rheumatoid arthritis (RA) is a long-term autoimmune disease. It causes persistent joint inflammation, aberrant tissue growth, and progressive joint deterioration. T cells have a key role in the onset of RA. They identify and trigger other immune cells, and produce inflammatory signals such as interleukin-6 (IL-6), interleukin-17 (IL-17), and tumor necrosis factor-α (TNF-α). Prolonged inflammation and tissue damage are caused by an imbalance between regulatory T cells (Tregs) and pro-inflammatory T helper 17 (Th17) cells. Additionally, the condition is exacerbated by uncontrolled cytokine netwo

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… However, TNF inhibitors such as adalimumab, etanercept, and infliximab generally achieve superior clinical outcomes. … Infliximab Infliximab is a chimeric monoclonal antibody (mouse variable region, human IgG1) that binds both soluble and membrane-bound TNF-α with high affinity, preventing receptor activation and downstream inflammatory signalling. …