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Effect of downregulation of serum MMP-3 levels by traditional Chinese medicine ingredients combined with methotrexate on the progression of bone injury in patients with rheumatoid arthritis: A protocol for a systematic review and meta-analysis.

BACKGROUND: A large number of clinical studies have confirmed that after treatment with traditional Chinese medicine components such as sino … he toxic side effects of methotrexate (MTX), and their combination with other drugs such as MTX and leflunomide (HWA486) has become an important regimen for the treatment of RA in clinical practice. Therefore, we designed this study protocol to evaluate the adjuvant effect of commonly used traditional Chinese medicine components combined with MTX in the treat …

Genetic and epigenetic alteration of the programmed cell death 1 in rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) is an autoimmune disease where both genetics and epigenetics are contributing factors. In order to discover genetic and epigenetic associations with RA and its phenotypes, we analysed RNA expression, DNA variations and DNA methylation of programmed cell death 1 (PDCD1) in a cohort of RA patients and healthy controls. METHODS: RA patients (n = 206) and healthy controls (n = 234) were included for analysis of PDCD1 expression, PDCD1 polymorphisms and PDCD1 methylation. Differences in continuous variables between groups were compared by applying t tests. Ass

Cutaneous sarcoidosis therapy updated.

The widely accepted standard therapy for cutaneous sarcoidosis includes corticosteroids, antimalarials, and methotrexate. However, a better understanding of the basic immunopathogenic properties of sarcoidosis has elucidated a number of steps critical to the persistence and progression of disease that may be vulnerable to treatment by targeted therapy. This article reviews both standard and newer therapeutic options for cutaneous sarcoidosis.

[Ruxolitinib as an effective treatment for panniculitis associated hemophagocytic syndrome: A report of 2 cases and literature review].

Hemophagocytic syndrome (HPS) is a severe disease characterized by excessive release of inflammatory cytokines caused by abnormal activation … nodules on the forehead, neck and bilateral lower legs. The patient was treated with prednisone and leflunomide for improvement. After that, repeated fever and rash occurred again. After admission to our hospital, we found his leukocyte and hemoglobin decreased, ferritin raised, fibrinogen and natural killer (NK) cell activity decreased, and hemophagocytic ce …

Comparing Medical Utilization and Cost Outcomes in Oral Versus Injectable Immunotherapy Users with Chronic Inflammatory Joint and Skin Diseases.

BACKGROUND: Rheumatoid arthritis (RA), psoriatic arthritis (PsA), and psoriasis (PSO) are immune-mediated systemic, chronic inflammatory conditions. Moderate to severe disease is treated with conventional disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, sulfasalazine, or leflunomide. If a patient does not respond to these firstline treatments, then tumor necrosis factor inhibitor (TNFi) or non-TNFi immunotherapy agents are administered via infusion, injection, or taken orally. Although the effectiveness of established infusion, injection, and newer oral therapies are known,…

Treatment of juvenile idiopathic arthritis in the biologic age.

Before the biologic era, treatment of juvenile idiopathic arthritis (JIA) was often highly unsatisfactory, with children forced to endure the ill effects of lifelong disease, including pain and stiffness, disability, and even increased risk of mortality. Thanks in large part to improved understanding of the underlying pathophysiology of the disease, multiple new biologic agents have been developed and applied to these disorders, with remarkable effects. However, much information remains to be learned about applying particular therapies to the distinct categories of JIA, and there is still cons

Guizhi-Shaoyao-Zhimu Decoction regulates the IL-17R-MAPK pathway to alleviate rheumatoid arthritis.

ETHNOPHARMACOLOGICAL RELEVANCE: Guizhi-Shaoyao-Zhimu Decoction (GSZD), derived from Synopsis of the Golden Chamber, has been used for over t … : Sham, CIA, low-dose GSZD (13.24 g crude drug/kg·d), high-dose GSZD (26.48 g crude drug/kg·d), and leflunomide (10 mg/kg). Intragastric administration began 7 days after the secondary immunization and continued for 28 days. Body weight, paw thickness, and arthritis scores were monitored; spleen and thymus indices were calculated. Serum and joint tissues were …

Combination therapy for pain management in inflammatory arthritis (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, other spondyloarthritis).

BACKGROUND: Despite optimal therapy with disease-modifying antirheumatic drugs, many people with inflammatory arthritis (IA) continue to hav … study populations were not taking DMARDs (e.g. methotrexate, sulphasalazine, hydroxychloroquine and leflunomide) and all studies were performed prior to the introduction of biologic therapies (e.g. etanercept, infliximab and adalimumab). All trials were at high risk of bias, heterogeneity precluded meta-analysis, and we were only able to report a general desc …

[Cheng's Juanbi Decoction Inhibits Rheumatoid Arthritis Pathology by Blocking the WTAP-Wnt7b-Wnt/β-Catenin Signaling Axis].

OBJECTIVE: Cheng's Juanbi Decoction (CSJBD) is a classic traditional Chinese medicine formula for treating rheumatoid arthritis (RA), exhibi … roup, the model + CSJBD-M (16.2 g/kg) group, the model + CSJBD-H (32.4 g/kg) group, and the model + leflunomide (LEF) (0.05 mg/10 g) group, with 10 mice in each group. CSJBD was administered twice daily via gastric gavage, while LEF was administered once daily via gastric gavage, for a duration of 28 days. We also conducted in vitro experiments. RA FLSs were …

Drug-associated pulmonary arterial hypertension.

INTRODUCTION: While pulmonary arterial hypertension remains an uncommon diagnosis, various therapeutic agents are recognized as important as … icating these agents; nonetheless, trastuzumab emtansine, rituximab, bevacizumab, cyclosporine, and leflunomide have all been implicated in case reports. Opioids and substances of abuse: Buprenorphine and cocaine have been identified as potential causes of pulmonary arterial hypertension. The mechanism by which this occurs is unclear. Tramadol has been demons …

Endometriosis: in search of optimal treatment.

Endometriosis is an enigmatic, debilitating disease which affects as many as 15% of all women of reproductive age and is characterized by pelvic pain and infertility. Current treatment regimes used to manage the disease do so by inducing a hypoestrogenic state. While the absence of circulating estrogen levels lead to a regression of the disease, this hypoestrogenism also induces many unpleasant and unwanted side-effects. As such, these and other shortcomings of current drug therapies emphasize their limitations and the necessity for the development of novel endometriosis treatments. In this re

Evaluation of early response to SU101 target-based therapy in patients with recurrent supratentorial malignant gliomas using FDG PET and Gd-DTPA MRI.

Changes in [18F]-2-fluoro-2-deoxyglucose (FDG) uptake and gadopentetate dimeglumine (Gd-DTPA) enhancement before and after the first course of treatment with a cytostatic agent SU101 (N-[(4-trifluoromethyl)-phenyl]-5-methylisoxazole-4-carboxamide, SUGEN) were assessed using positron emission tomography (PET) and magnetic resonance imaging (MRI) in a pilot study of 8 patients with recurrent supratentorial malignant gliomas. The localization and the volume of Gd-DTPA enhancement and FDG hypermetabolism were analyzed. PET and MRI studies were performed one week before and 7.6+/-3.7 weeks after ad

Risk and severity of herpes zoster in patients with rheumatoid arthritis receiving different immunosuppressive medications: a case-control study in Asia.

OBJECTIVE: Increasing evidence indicates that the risk of herpes zoster (HZ) is elevated in rheumatoid arthritis (RA). Little is known about the epidemiology of HZ in patients with RA in Asia. The aim of this study was to determine the risk factors and outcomes of HZ among patients with RA. DESIGN: A case-control study. SETTING: A medical centre in Asia. PARTICIPANTS: A total of 9025 newly diagnosed and eligible patients with RA (International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 714.0) during the period 2001-2014. Among them, 275 (3.05%) were n

Immunotherapies in rheumatologic disorders.

Over the past several decades, rheumatology has directed its focus to understanding and countering the immune dysregulation underlying autoimmune diseases with rheumatologic manifestations. Older therapies, effective though poorly understood, are being scrutinized anew and are yielding the immune-modulating mechanisms behind their efficacy. New therapies, the "biologics," are drugs tailored to address specific immune defects and imbalances. This article discusses the current standard and biologic immunotherapies of the rheumatic diseases, correlating our current understanding of their mechanis

My treatment approach to rheumatoid arthritis.

The past decade has brought important advances in the understanding of rheumatoid arthritis and its management and treatment. New classification criteria for rheumatoid arthritis, better definitions of treatment outcome and remission, and the introduction of biologic response-modifying drugs designed to inhibit the inflammatory process have greatly altered the approach to managing this disease. More aggressive management of rheumatoid arthritis early after diagnosis and throughout the course of the disease has resulted in improvement in patient functioning and quality of life, reduction in com

Biologics and Non-Biologics Immunosuppressive Treatments for IgA Nephropathy in Both Adults and Children.

Immunoglobulin A nephropathy represents the most prevalent cause of glomerulonephritis worldwide and may lead to renal failure in a relevant number of cases in both paediatric and adult subjects. Although their pathogenesis is still largely unclear, evidence of immune abnormalities provides the background for the use of immunosuppressive drugs, such as corticosteroids, calcineurin inhibitors, and antiproliferative and alkylating agents. Unfortunately, these treatments fail to achieve a sustained remission in a significant percentage of affected patients and are burdened by significant toxiciti

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… Leflunomide Leflunomide reduces the proliferation of T and B cells through the inhibition of di-hydroorotate dehydrogenase, a key enzyme in pyrimidine synthesis. Additionally, it inhibits the activity of tyrosine kinases and NF-kB in T cells [ 48 ]. … The combined treatment with leflunomide + CS is more effective than CS alone in reducing proteinuria and preserving renal function. …

The Calcium Conundrum: Hypercalcemia of Unknown Etiology.

Hypercalcemia is a common clinical finding with a wide variety of clinical presentations and etiologies. The differential is broad and includes hyperparathyroidism, malignancy, medication adverse effects, endocrinopathies, and a variety of granulomatous diseases. We present the case of an 84-year-old woman with severe parathyroid hormone-independent hypercalcemia and elevated 1,25-OH Vitamin D. Non-necrotizing granulomas were identified on bone marrow biopsy. After an exhaustive workup for granulomatous disease, the patient was felt to have sarcoidosis isolated to the bone marrow and started o

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… After carefully weighing the adverse effects against the above context, leflunomide was ultimately selected as our patient’s steroid-sparing agent. … a=4175 21044457 20 Leflunomide for chronic sarcoidosis Sarcoidosis Vasc Diffuse Lung Dis Baughman RP Lower EE 43 48 21 2004 15127974 10.1007/s11083-004-5178-y 21 Effectiveness and safety of leflunomide for pulmonary and extrapulmonary sarcoidosis Eur Respir J Sahoo DH Bandyopadhyay D Xu M 1145 1150 …

Perinatal use and discontinuation of disease-modifying anti-rheumatic drugs and biologics in women with rheumatoid arthritis: a cohort study.

OBJECTIVES: To characterize the utilization and discontinuation of medications before, during and after pregnancy among women with RA. METHODS: We used population-based administrative data to identify women with RA who had a singleton pregnancy ending in delivery between 1 January 2002 and 31 December 2012. We assessed the utilization of RA medications, namely, conventional synthetic DMARDs, biologics, glucocorticosteroids and NSAIDs, across six windows spanning 24 and 12 months before the start of pregnancy, each trimester of pregnancy and 12 months post-pregnancy. We defined medication disc