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Emerging Modes of Treatment of IgA Nephropathy.

IgA nephropathy is the most common primary glomerulonephritis with potentially serious outcome leading to end stage renal disease in 30 to 50% of patients within 20 to 30 years. Renal biopsy, which might be associated with risks of complications (bleeding and others), still remains the only reliable diagnostic tool for IgA nephropathy. Therefore, the search for non-invasive diagnostic and prognostic markers for detection of subclinical types of IgA nephropathy, evaluation of disease activity, and assessment of treatment effectiveness, is of utmost importance. In this review, we summarize treat

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… Comparison of the therapeutic effects of leflunomide and mycophenolate mofetil in the treatment of immunoglobulin a nephropathy manifesting with nephrotic syndrome Int. J. Clin. Pharmacol. Ther. 2010 48 509 513 10.5414/CPP48509 20650041 83. Cheng G. Liu D. Margetts P. Liu L. Zhao Z. Liu Z. Tang L. … Valsartan combined with clopidogrel and/or leflunomide for the treatment of progressive immunoglobulin A nephropathy Nephrology 2015 20 77 84 10.1111/nep.12359 25358874 84. Samy E. Wax S. Huard B. Hess H. Schneider P. …

Evaluating clinical heterogeneity in relapsing polychondritis through unsupervised cluster analysis.

BACKGROUND: As a rare autoimmune disease, relapsing polychondritis (RP) exhibits individual variations in clinical manifestations, treatment response and prognosis. To date, no biomarkers have been implemented to clinical practice.This study aimed to apply cluster analysis to identify the clinical phenotype, clarify their prognosis predictor, and monitor treatment decisions to improve the outcomes of patients. METHODS: A total of 135 RP patients hospitalized in two centers from January 2005 to December 2024 were involved in the study.The K-means clustering algorithm was used as the core clust

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… Small numbers of patients(9) did not administer immunosuppressants.The group received the following immuno- suppressants in sequence: methotrexate(38.52%), cyclophosphamide (20.74%), mycophenolate mofetil(20.74%), tripterygium glycosides (8.89%),leflunomide (7.41%), azathioprine(3.70%) and Janus kinase … Abbreviations Albumin Analysis of Variance Azathioprine C-reactive protein to albumin ratio C-reactive protein Cyclophosphamide Erythrocyte sedimentation rate‌ Interquartile Range Janus kinase inhibitor‌ Leflunomide Mycophenolate Mofetil Methotrexate Neutrophil to lymphocyte ratio Principal …

Epidemiology, Risk Factors, and Prophylaxis Use for Pneumocystis jirovecii Pneumonia in the Non-HIV Population: A Retrospective Study in Québec, Canada.

BACKGROUND: Pneumocystis jirovecii pneumonia (PJP) remains a significant threat in immunocompromised cases. Recent data on epidemiology and risk factors for PJP in non-HIV cases are scarce, and guidelines on appropriate prophylaxis are lacking. METHODS: In this multicenter retrospective trial, all non-HIV adult cases admitted to hospitals in Québec City, Canada, between January 2011 and January 2021 with a diagnosis of PJP were assessed for eligibility. RESULTS: An overall 129 cases of PJP were included. More than two-thirds had an underlying hematologic disease or an autoimmune/inflammatory

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… Abbreviations: HCQ, hydroxychloroquine; LEF, leflunomide; mTOR, mammalian target of rapamycin; MTX, methotrexate; PJP, Pneumocystis jirovecii pneumonia; SSZ, sulfasalazine. a Exclusive of corticosteroids. b The first number refers to the number of patients taking the immunosuppressive agent exclusive … Abbreviations: HCQ, hydroxychloroquine; LEF, leflunomide; mTOR, mammalian target of rapamycin; MTX, methotrexate; PJP, Pneumocystis jirovecii pneumonia; SSZ, sulfasalazine. …

Hematology and Immune-Related Disorders

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… If the neutrophil count is less than 0.5 × 10 9 /L, the veterinarian should administer prophylactic antibiotics and reduce the dose by 25%. 85 Other immunosuppressive drugs include cyclophosphamide, cyclosporine, and leflunomide. … Once remission is achieved, the dose can be reduced to once or twice weekly to maintain adequate blood levels. 40 Leflunomide orally at 10 mg per day has been used along with methotrexate to induce remission of refractory rheumatoid arthritis in cats. …

Терапия сотовой связи для руматоидного артрита.

Химерическая антигенная рецепторная (CAR) клеточная терапия Т произвела революцию в лечении лейкемии, лимфомы и множественных миеломы, реанимировав на поверхности этих клеток антигены CD19 и BCMA. В последнее время появляется все больше свидетельств того, что эти клеточные методы лечения могут также быть направлены против аутоиммунных заболеваний, включая системный волчаньий эритематос, системный склероз, расстройство спектрального спектра нейромиелита, миастения гравис, идиопатический воспалительный миосит, множественный склероз и ревматоидный артрит. На сегодняшний день ten Пациенты с ревмат

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… MTX methotrexate Treatment | Mechanism of Action Conventional DMARDs ▪ MTX (low dose) ▪ Sulfasalazine ▪ Leflunomide ▪ Hydroxychloroquine | Unknown (possibly inhibition of immune cell proliferation) Glucocorticoids | Broad immunosuppression Biological DMARDs ▪ TNFα antagonists - Infliximab (+ MTX) - Etanercept … Over the next 6 years, the patient’s treatment was focused towards their RA via glucocorticoids and csDMARDS (MTX and leflunomide), bDMARDS (rituximab, a co-stimulation modulator, anti-IL-1, an anti-IL-6 receptor and 3 x anti-TNFα), tsDMARDS (4 JAK inhibitors) and an anti-IL-17 A antibody (approved for …

Rituximab and lenalidomide combination treatment for rheumatoid arthritis complicated with myelodysplastic syndrome: A case report.

Rheumatoid arthritis patients might experience several hematologic complications. The development of myelodysplastic syndrome is not clearly associated with RA, even though it has been described in some patients with pre-existing disease. There are only few data available in the literature concerning the therapeutic approach of such patients. Herein, we report a case of RA complicated with progressive MDS, successfully treated with rituximab and lenalidomide combination therapy.

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… Therapy-induced MDS due to methotrexate and leflunomide has been reported in RA patients, 24 however, our patient’s MDS could not be attributed neither to methotrexate nor to adalimumab. …

The role of hypoxic microenvironment in autoimmune diseases.

The hypoxic microenvironment, characterized by significantly reduced oxygen levels within tissues, has emerged as a critical factor in the pathogenesis and progression of various autoimmune diseases (AIDs). Central to this process is the hypoxia-inducible factor-1 (HIF-1), which orchestrates a wide array of cellular responses under low oxygen conditions. This review delves into the multifaceted roles of the hypoxic microenvironment in modulating immune cell function, particularly highlighting its impact on immune activation, metabolic reprogramming, and angiogenesis. Specific focus is given to

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… Additionally, this combination produced outcomes comparable to those achieved with 5 mg/kg leflunomide alone, particularly in terms of reduced inflammation ( 204 ). … While leflunomide has been shown to be effective in treating RA, its use is accompanied by certain limitations and potential adverse effects, including diarrhea, nausea, alopecia, and hepatotoxicity, as reported in previous studies ( 205 , 206 ). …

Viruses

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… globulin 150 mg/kg IV Clinical utility likely limited to HSCT patients with CMV pneumonitis [ 55 ] or hypogammaglobulinemia Fomivirsen 330 µg intravitreally Used for the treatment of CMV retinitis only Maribavir Under study (orphan drug) Novel anti-CMV agent currently undergoing active investigation Leflunomide … 150 mg/kg IV | Clinical utility likely limited to HSCT patients with CMV pneumonitis [ 55 ] or hypogammaglobulinemia Fomivirsen | 330 µg intravitreally | Used for the treatment of CMV retinitis only Maribavir | Under study (orphan drug) | Novel anti-CMV agent currently undergoing active investigation Leflunomide …

Global perspectives on lupus nephritis: a review of clinical trials and therapeutic innovations.

BACKGROUND AND OBJECTIVES: Lupus nephritis (LN) remains a leading cause of morbidity and mortality in systemic lupus erythematosus (SLE). Although recent years have witnessed the approval of several targeted therapies, achieving long-term, drug-free remission remains challenging. This commentary evaluates the global landscape of interventional LN clinical trials from 2001 to 2026 to identify emerging trends and strategic gaps in drug development. METHODS: We analyzed 200 interventional pharmacological trials retrieved from three major global registries: ClinicalTrials.gov, Chinadrugtrials.org

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… States | III+/- V, IV +/- V, V NCT01407406 (Completed) | Phase I | 2011 | BIIB023 | Australia, Hong Kong (China) | NCT01273389 (Completed) | Phase II | 2011 | CNTO 136 | United States, Belgium, Mexico, Netherlands, Poland, Thailand | III, IV NCT01342016 (Terminated) | Phase III | 2011 | TAC Capsule+Leflunomide … Leflunomide | Pyrimidine Synthesis Inhibitor | Alternative Maintenance Agent. FDA approved for RA. Used off-label for LN maintenance (especially in Asian populations/Chinese guidelines). Mizoribine | IMPDH Inhibitor | Regional Use (Japan/China). Approved in Japan for LN. …

Chest pain without a clue-ultrasound to rescue occult multiple myeloma: A case report.

BackgroundChest pain is one of the most common symptoms with which a patient presents to a doctor. Differentials include, but are not limited to, cardiac pulmonary, gastrointestinal, psychosomatic and musculoskeletal causes. In our case, ultrasound of the chest wall paved the way for the diagnosis of multiple myeloma, which occultly presented with chronic chest pain.Case summaryHere we report a case of 50-year-old man with chronic chest pain without anemia or renal failure who was diagnosed with multiple myeloma, despite negative bence jones protein and M band electrophoresis. An ultrasound of

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… TREATMENT He was started on bortezomib, leflunomide and dexamethasone. OUTCOME AND FOLLOW-UP After a mere two cycles of chemotherapy, he showed drastic improvement in pain wherein his Visual Analogue Score dropped from 7/10 to 2/10. …

Treating rheumatic patients with a malignancy.

Management of patients with inflammatory rheumatic disease and a history of (or even a current) malignant disease poses some particular challenges. As direct evidence of the risk of (recurrent or de novo) malignancy in patients with a history of malignant disease is scarce, such a risk may be estimated indirectly from the principal carcinogenicity of the respective drug to be used or (also indirectly) from cancer reactivation data from the transplant literature. In general, cancer risk is increased in patients receiving combination immunosuppressive treatment, but the risk in patients receivin

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… Other traditional disease-modifying anti-rheumatic drugs Other traditional disease-modifying anti-rheumatic drugs (DMARDs) include sulfasalazine, (hydroxy-)chloroquine, and leflunomide. … For leflunomide, explicit human data are currently not available, but animal studies, such as those in rats, also detected no carcinogenetic potential. Biologics Biologics are a novel substance group with wide use in rheumatic and inflammatory diseases. …

Perioperative use of disease-modifying anti-rheumatic drugs (DMARDs) in people with inflammatory arthritis.

RATIONALE: Disease-modifying anti-rheumatic drugs (DMARDs) are the cornerstone of pharmacologic treatment for inflammatory arthritis (rheuma … ontinued two weeks after the surgery, and in one trial, the discontinuation group stopped csDMARDs (leflunomide) one week prior to surgery and continued one month after the surgery. All trials were at risk of selection, performance, detection and selective outcome reporting biases. We did not find any trials assessing the perioperative use of (any) DMARDs in …

Angiogenesis and Anti-Angiogenic Treatment in Prostate Cancer: Mechanisms of Action and Molecular Targets.

Prostate cancer (PC) is the most common cancer in men and the second leading cause of cancer-related death worldwide. Many therapeutic advances over the last two decades have led to an improvement in the survival of patients with metastatic PC, yet the majority of these patients still succumb to their disease. Antiagiogenic therapies have shown substantial benefits for many types of cancer but only a marginal benefit for PC. Ongoing clinical trials investigate antiangiogenic monotherapies or combination therapies. Despite the important role of angiogenesis in PC, clinical trials in refractory

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… The PDGF receptor inhibitor leflunomide was used in patients with androgen-independent PC in a phase II study of 44 men with metastatic disease. Among them, 22 had already been treated with chemotherapy [ 128 ]. Leflunomide was given intravenously with a 4-day loading dose. … Teriflunomide (Leflunomide) Promotes Cytostatic, Antioxidant, and Apoptotic Effects in Transformed Prostate Epithelial Cells: Evidence Supporting a Role for Teriflunomide in Prostate Cancer Chemoprevention. Neoplasia. 2010;12:464–475. doi: 10.1593/neo.10168. 129. …

Anti-PEG Antibodies and Their Biological Impact on PEGylated Drugs: Challenges and Strategies for Optimization.

Polyethylene glycol (PEG) has been widely utilized in optimizing therapeutics due to its excellent biocompatibility and chemical stability. However, multiple dosing of PEGylated drugs may result in toxicity due to PEG accumulation in tissues, leading to the formation of anti-PEG antibodies (APAs), which can accelerate drug clearance, reduce efficacy, and alongside enhanced side effects, such as allergic reactions. Notably, pre-existing APAs have also been detected in individuals with no prior exposure to PEGylated drugs, raising additional clinical concerns. This review summarizes the mechanis

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… Combination with Immunomodulators Studies have shown that co-administration of immunomodulatory agents, such as methotrexate, mycophenolate mofetil, azathioprine, and leflunomide, significantly enhances the therapeutic response to PEGylated uricase (Pegloticase) [ 61 ]. … The response rates by individual immunomodulators for combination therapy were 87.5% (35 of 40 patients) for Methotrexate, 86.4% (19 of 22) for Mycophenolate mofetil, 63.6% (7 of 11) for Azathioprine, and 66.7% (4 of 6) for Leflunomide. …

Disease-modifying antirheumatic drugs (DMARDs) for rheumatoid arthritis after failure of biologic or targeted synthetic therapy: a systematic review and network meta-analysis.

RATIONALE: After inadequate response to first-line biologic or targeted synthetic (b/ts) disease-modifying antirheumatic drug (DMARD) therap … e interventions included conventional synthetic DMARDs (methotrexate, antimalarials, sulfasalazine, leflunomide, ciclosporin, and azathioprine), biologic DMARDs (adalimumab, certolizumab, etanercept, golimumab, infliximab, abatacept, rituximab, tocilizumab, sarilumab, and anakinra), and targeted synthetic DMARDs (tofacitinib, baricitinib, and upadacitinib). …

Guselkumab, an inhibitor of the IL-23p19 subunit, provides sustained improvement in signs and symptoms of active psoriatic arthritis: 1 year results of a phase III randomised study of patients who were biologic-naïve or TNFα inhibitor-experienced.

OBJECTIVE: Evaluation of the efficacy and safety of guselkumab, a human monoclonal antibody targeting the interleukin-23p19 subunit, in patients with psoriatic arthritis (PsA) through 1 year. METHODS: Adults who met ClASsification criteria for Psoriatic ARthritis, with active disease (≥3 swollen and ≥3 tender joints; C reactive protein ≥0.3 mg/dL) despite standard treatment (31% previously received ≤2 tumour necrosis factor inhibitors (TNFi)), were randomised (1:1:1) to guselkumab 100 mg every 4 weeks (Q4W); guselkumab 100 mg at Week0, Week4, then Q8W; or placebo with cross-over to guselkumab

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… Central randomisation and study blinding procedures were previously reported. 14 Patients could continue stable baseline use of methotrexate (≤25 mg/week), sulfasalazine (≤3 g/day), hydroxychloroquine (≤400 mg/day) or leflunomide (≤20 mg/day); oral corticosteroids (≤10 mg/day prednisone or equivalent … Eight of 16 (50%) guselkumab-treated patients with SAEs were receiving methotrexate, two (12%) received leflunomide and six (38%) did not use any non-biologic DMARD. All SAEs were singular events. …

Medical Management of the Kidney Transplant Recipient : Infections and Malignant Neoplasms

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… Although no approved antiviral drug is available, adjunctive therapy with leflunomide, cidofovir, quinolones, or intravenous immune globulin (IVIG) may be beneficial, especially in patients with progressive allograft dysfunction. … Quinolones are preferred by some centers because of low cost and ease of administration; leflunomide is used by others because of its potential simultaneous antiviral and immunosuppressive properties. …

Multiple myeloma presenting with amyloid arthropathy as the first manifestation: Two case reports.

BACKGROUND: Multiple myeloma (MM) can be accompanied by amyloidosis, which occurs in a small number of patients and is characterized by deposition of light chains in the joints, leading to multiple myeloma-associated amyloid arthropathy (MAA). As a rare complication of MM, clinical manifestations of MAA are often similar to those of rheumatoid arthritis, and the two are easily confused. CASE SUMMARY: In recent years, our center treated two patients of MM with amyloid arthropathy as the first manifestation, both of whom presented with polyarthritis. After treatment for MM, both patients achiev

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… According to imaging examinations (see below), the patient was diagnosed with seronegative RA and treated with methylprednisolone, leflunomide, technetium methylene bisphosphate, and triamcinolone acetonide injected into the joint cavities of both knees and shoulders. …

Иммуномодуляторы и иммунопрессанты для релапсирующего многократного склероза: сетевой метаанализ.

ЦЕЛЬ: Существуют различные терапевтические стратегии для лечения лиц с повторно излучающимся множественным склерозом (РРМС), включая иммуномодуляторы, иммунодепрессанты и биологические агенты. Хотя и каждый one Из этих методов снижается частота рецидивов и замедляется накопление инвалидности по сравнению с отсутствием лечения, и их относительные преимущества остаются неясными. Это обновленный вариант обзора Кокрана, опубликованного 2015.ЦЕЛИ: Сопоставление эффективности и безопасности интерферона с помощью сетевого метаанализа beta-1bИнтерферон beta-1a, глатирамерный ацетат, натализумб, митокс

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BACKGROUND: Different therapeutic strategies are available for the treatment of people with relapsing-remitting multiple sclerosis (RRMS), i … s, cladribine, cyclophosphamide, diroximel fumarate, fludarabine, interferon beta 1-a and beta 1-b, leflunomide, methotrexate, minocycline, mycophenolate mofetil, ofatumumab, ozanimod, ponesimod, rituximab, siponimod and steroids for the treatment of people with RRMS. SEARCH METHODS: CENTRAL, MEDLINE, Embase, and two trials registers were searched on 21 Sept …

Shift in Epidemiology of Cryptococcal Infections in Ottawa with High Mortality in Non-HIV Immunocompromised Patients.

Cryptococcus neoformans is a fungus that can cause life-threatening infections. While human immunodeficiency virus (HIV)-positive status historically had the highest risk for cryptococcal infection and was associated with high mortality rates, there have been changes in HIV treatment and the epidemiology of other acquired immunodeficiencies, such as hematological malignancies. We conducted a retrospective case series analysis of patients who had cryptococcal infections documented at the Ottawa Hospital from 2005 to 2017. The Ottawa Hospital is a tertiary care hospital and provides complex care

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… Resolved | 84 months 64 | M | Kidney transplantation | Prednisone, tacrolimus and mycophenolate | CSF | Fluconazole | Resolved | 172 months 53 | M | Sarcoidosis | Prednisone | BAL | Fluconazole | Resolved | 99 months 72 | F | Sjogren’s syndrome and rheumatoid arthritis | Prednisone, methotrexate, and leflunomide …