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Journal of the College of Physicians... Mar 2022The aim of this study was to evaluate the efficacy and safety of prednisone monotherapy for phospholipase A2 receptor (PLA2R)-associated idiopathic membranous...
The aim of this study was to evaluate the efficacy and safety of prednisone monotherapy for phospholipase A2 receptor (PLA2R)-associated idiopathic membranous nephropathy (IMN). This was a retrospective cohort study involving 32 patients enrolled between January 2017 and June 2019 at Beijing Friendship Hospital, Capital Medical University, Beijing, China. Seventeen patients received prednisone monotherapy, and 15 received the Ponticelli regimen. The primary outcome was nephrotic syndrome remission at 12th month. The secondary outcomes were the incidence of adverse events and recurrence over the 12-month follow-up. At 12th month, 16/17 patients (94.1%) in the prednisone monotherapy group and 14/15 patients (93.3%) in the Ponticelli regimen group achieved remission (p = 0.19). The adverse events occurred in 9/17 and 9/15 of the patients receiving prednisone monotherapy and the Ponticelli regimen, respectively (p = 0.74). Four and three patients relapsed in the prednisone monotherapy and Ponticelli regimen groups, respectively (p = 0.99). Initial prednisone monotherapy had similar efficacy and safety compared with the Ponticelli regimen for PLA2R-associated IMN. Key Words: PLA2R-associated idiopathic membranous nephropathy, Ponticelli regimen, Prednisone monotherapy.
Topics: Autoantibodies; Glomerulonephritis, Membranous; Humans; Immunosuppressive Agents; Prednisone; Receptors, Phospholipase A2; Retrospective Studies
PubMed: 35148603
DOI: 10.29271/jcpsp.2022.03.404 -
Neurology Aug 2020To examine whether sustained minimal manifestation status (MMS) with complete withdrawal of prednisone is better achieved in thymectomized patients with myasthenia... (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVE
To examine whether sustained minimal manifestation status (MMS) with complete withdrawal of prednisone is better achieved in thymectomized patients with myasthenia gravis (MG).
METHODS
This study is a post hoc analysis of data from a randomized trial of thymectomy in MG (Thymectomy Trial in Non-Thymomatous Myasthenia Gravis Patients Receiving Prednisone Therapy [MGTX]). MGTX was a multicenter, randomized, rater-blinded 3-year trial that was followed by a voluntary 2-year extension for patients with acetylcholine receptor (AChR) antibody-positive MG without thymoma. Patients were randomized 1:1 to thymectomy plus prednisone vs prednisone alone. Participants were age 18-65 years at enrollment with disease duration less than 5 years. All patients received oral prednisone titrated up to 100 mg on alternate days until they achieved MMS, which prompted a standardized prednisone taper as long as MMS was maintained. The achievement rate of sustained MMS (no symptoms of MG for 6 months) with complete withdrawal of prednisone was compared between the thymectomy plus prednisone and prednisone alone groups.
RESULTS
Patients with MG in the thymectomy plus prednisone group achieved sustained MMS with complete withdrawal of prednisone more frequently (64% vs 38%) and quickly compared to the prednisone alone group (median time 30 months vs no median time achieved, < 0.001) over the 5-year study period. Prednisone-associated adverse symptoms were more frequent in the prednisone alone group and distress level increased with higher doses of prednisone.
CONCLUSIONS
Thymectomy benefits patients with MG by increasing the likelihood of achieving sustained MMS with complete withdrawal of prednisone.
CLINICALTRIALSGOV IDENTIFIER
NCT00294658.
CLASSIFICATION OF EVIDENCE
This study provides Class II evidence that for patients with generalized MG with AChR antibody, those receiving thymectomy plus prednisone are more likely to attain sustained MMS and complete prednisone withdrawal than those on prednisone alone.
Topics: Adolescent; Adult; Animals; Combined Modality Therapy; Female; Humans; Immunosuppressive Agents; Male; Middle Aged; Myasthenia Gravis; Prednisone; Rats; Single-Blind Method; Substance Withdrawal Syndrome; Thymectomy; Thymoma; Thymus Neoplasms; Young Adult
PubMed: 32611638
DOI: 10.1212/WNL.0000000000010031 -
NEJM Evidence Sep 2022Poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors have shown therapeutic success for patients with metastatic castration-resistant prostate cancer (mCRPC)...
Poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors have shown therapeutic success for patients with metastatic castration-resistant prostate cancer (mCRPC) with homologous recombination repair (HRR) deficiency. Preclinical data suggest that PARP inhibitors may have efficacy in a wider population if combined with androgen receptor inhibition. One phase 2 trial for late-stage mCRPC supports this notion, finding that olaparib added to abiraterone/prednisone improved radiographic progression-free survival (PFS) versus abiraterone/prednisone alone in a population that was not biomarker preselected. However, another trial with abiraterone and veliparib did not show benefit..
Topics: Male; Humans; Prostatic Neoplasms, Castration-Resistant; Prednisone; Phthalazines; Piperazines
PubMed: 38319811
DOI: 10.1056/EVIDe2200154 -
Heart (British Cardiac Society) May 2021
Topics: Anti-Inflammatory Agents; Blood Sedimentation; C-Reactive Protein; Colchicine; Echocardiography, Doppler; Heart Ventricles; Humans; Magnetic Resonance Imaging, Cine; Pericarditis, Constrictive; Prednisone; Ventricular Function, Left
PubMed: 33568431
DOI: 10.1136/heartjnl-2020-318723 -
Clinical Journal of Oncology Nursing Sep 2023A combination of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is a first-line combination chemotherapy regimen for diffuse large B-cell...
A combination of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is a first-line combination chemotherapy regimen for diffuse large B-cell lymphoma that has many nursing implications. Understand.
Topics: Humans; Alchemy; Prednisone; Rituximab; Vincristine; Cyclophosphamide; Doxorubicin
PubMed: 37729458
DOI: 10.1188/23.CJON.553-564 -
Patient reported side-effects of prednisone and methotrexate in a real-world sarcoidosis population.Chronic Respiratory Disease 2021Currently prednisone is the first-line pharmacological treatment option for pulmonary sarcoidosis. Methotrexate is used as second-line therapy and seems to have fewer...
Currently prednisone is the first-line pharmacological treatment option for pulmonary sarcoidosis. Methotrexate is used as second-line therapy and seems to have fewer side-effects. No prospective comparative studies of first-line treatment with methotrexate exist. In this study, we evaluated patient reported presence and bothersomeness of side-effects of prednisone and methotrexate in a sarcoidosis population to guide the design of a larger prospective study. During a yearly patient information meeting 67 patients completed a questionnaire on medication use; 11 patients never used prednisone or methotrexate and were excluded from further analysis. Of the remaining 56 patients, 89% used prednisone and 70% methotrexate (present or former). Significantly more side-effects were reported for prednisone than for methotrexate, 78% versus 49% ( = 0.006). In conclusion, methotrexate seems to have fewer and less bothersome side-effects than prednisone. These findings need to be confirmed in a prospective study.
Topics: Humans; Immunosuppressive Agents; Methotrexate; Patient Reported Outcome Measures; Prednisone; Prospective Studies; Sarcoidosis
PubMed: 34569301
DOI: 10.1177/14799731211031935 -
Modern Rheumatology Case Reports Jan 2022The case of a 75-year-old woman diagnosed with polymyalgia rheumatica (PMR), treated with low doses of prednisone, and with clinical and analytical remission is...
The case of a 75-year-old woman diagnosed with polymyalgia rheumatica (PMR), treated with low doses of prednisone, and with clinical and analytical remission is reported. Two years later, she presented with a clinical picture of giant cell arteritis (GCA), including headache, diplopia, jaw pain, feeling of swelling in both temples, and elevation of acute phase reactants. Symptoms spontaneously subsided 2 weeks later, while analytical parameters improved without any treatment. A high-resolution colour Doppler ultrasound showed thickening of the intima-media complex with 'halo' sign in the right temporal artery. A biopsy of the right temporal artery was performed, although it was not successful, as no artery could be found, and the procedure became more complicated with an eyebrow ptosis due to a lesion in the frontal branch of the facial nerve. GCA diagnosis was based on the clinical, laboratory, and ultrasound findings. The patient was treated with prednisone and methotrexate, without clinical or analytical relapse. Comments are presented on the described cases of GCA with spontaneous remission, and the most appropriate treatments in these cases are discussed. Other peculiarities of the case, such as the progression to GCA more than 2 years after the onset of PMR, and the complications from the temporal artery biopsy are also mentioned.
Topics: Aged; Female; Giant Cell Arteritis; Humans; Polymyalgia Rheumatica; Prednisone; Remission, Spontaneous; Temporal Arteries
PubMed: 34491342
DOI: 10.1093/mrcr/rxab001 -
Basic & Clinical Pharmacology &... Jun 2023This study explores the role of steroid administration in identifying distressed or even mentally disordered cancer patients (so-called case finding). Charts of 12 298...
This study explores the role of steroid administration in identifying distressed or even mentally disordered cancer patients (so-called case finding). Charts of 12 298 cancer patients (4499 treated with prednisone equivalents) were analysed descriptively. A subset of 10 945 was further explored via latent class analysis (LCA). LCA avoids confounding by indication because it subgroups patients without prior preconceptions based on homogeneous expression of traits (i.e. the variables examined). LCA identified four subgroups: two subgroups with high dosages of prednisone equivalent (≥80 mg/day on average over all treatment days) and two with low dosages. The two subgroups with high average dosages had an increased likelihood of psychotropic drug administration, but only one was more likely to require 1:1 observation. In one subgroup, low dosages of prednisone equivlents correlated with a slightly increased probability for a psychiatric assessment and psychotropic drug administration. The subgroup least likely to receive steroid treatment was also the least likely to receive a psychiatric assessment and psychotropic drug administration. Descriptive statistics on age, sex, cumulative inpatient treatment, type of cancer, stage of cancer at first diagnosis, mental disorders, severe mental disorders and psychotropic drug administration (antidepressants, antipsychotics, benzodiazepines, anticonvulsants/mood stabilizers, opioids) are provided for patients receiving no, less and more than 80 mg of prednisone equivalent.
Topics: Humans; Prednisone; Psychotropic Drugs; Antipsychotic Agents; Mental Disorders; Anticonvulsants; Neoplasms
PubMed: 36878670
DOI: 10.1111/bcpt.13853 -
American Journal of Reproductive... Jun 2023To retrospectively investigate whether the oral administration of prednisone acetate with doxycycline increases the cure rate of chronic endometritis (CE) and improves...
OBJECTIVE
To retrospectively investigate whether the oral administration of prednisone acetate with doxycycline increases the cure rate of chronic endometritis (CE) and improves in vitro fertilization (IVF) outcomes in patients with repeated implantation failure (RIF) with CE.
METHODS
In total, 352 patients with RIF were investigated, 128 of whom were diagnosed with CE by hysteroscopy and endometrial immunohistochemical analysis. The patients with CE were divided into CD138-positive high-power field (HPF) counts of 1-2 and ≥3. Forty-five patients were orally administered prednisone acetate tablet 5 mg daily and doxycycline 100 mg twice daily for 14 consecutive days (group A), and 55 patients were administered doxycycline 100 mg orally twice daily for 14 days (group B) and underwent repeated endometrial sampling and histological assessment. Twenty-eight patients (group C) did not receive any treatment. The cure rate of CE and final reproductive outcomes of the frozen-thawed embryo transfer cycle were compared.
RESULTS
The total cure rate, cure rate of patients with CE(CD138+ HPF counts: 1-2), and cure rate of patients with CE(CD138+ HPF counts: ≥3) showed no significant difference between groups A and B. Logistics regression analysis indicated that the implantation rate, human chorionic gonadotropin (hCG)-positive rate, clinical pregnancy rate, clinical pregnancy rate with fetal heartbeat on day 30 (D30), and ongoing pregnancy rate was significantly higher in group A than in group C. For CE-cured patients after the treatment, the implantation rate, hCG-positive rate, clinical pregnancy rate, clinical pregnancy rate with fetal heartbeat on D30, and ongoing pregnancy rate were significantly higher in group A than in group B.
CONCLUSION
CE is closely related to RIF occurrence, and the combined oral administration of prednisone acetate and doxycycline can be a treatment option for patients with RIF with CE and improves reproductive outcomes, although it does not improve the CE cure rate compared with doxycycline treatment alone.
Topics: Pregnancy; Female; Humans; Endometritis; Doxycycline; Prednisone; Retrospective Studies; Embryo Implantation; Chronic Disease; Fertilization in Vitro; Chorionic Gonadotropin
PubMed: 37165806
DOI: 10.1111/aji.13713 -
European Neurology 2023Rituximab is a monoclonal chimeric antibody against CD20+ B cells. We aimed to assess the long-term efficacy and safety of CD20+ B cell-guided treatment with low-dose...
INTRODUCTION
Rituximab is a monoclonal chimeric antibody against CD20+ B cells. We aimed to assess the long-term efficacy and safety of CD20+ B cell-guided treatment with low-dose rituximab in refractory myasthenia gravis patients.
METHODS
Patients with refractory myasthenia gravis treated with rituximab for more than 2 years were included. Rituximab was administered when CD20+ B cells were greater than 1%. We analysed the efficacy of rituximab, treatment interval, side effects, prognosis, and treatment course.
RESULTS
A total of 22 patients were included. All patients received 2-12 doses of rituximab, and the median follow-up time was 48.5 months. The scores of the Myasthenia Gravis Activities of Daily Living and Myasthenia Gravis Composite were significantly lower than those at baseline (p < 0.05). MGFA-PIS was significantly improved in 21 (95.45%) patients and 14 (63.64%) patients have reached MGFA-PIS minimal manifestations. The average daily dose of prednisone and pyridostigmine bromide and the proportion of immunosuppressants were significantly lower (p < 0.05). Seven patients suffered from 14 worsenings. Eight patients terminated rituximab due to good efficacy. Most patients tolerated rituximab well, although 1 patient had opportunistic infection and hypogammaglobulinemia, 1 patient had an intracranial mass.
CONCLUSION
Long-term CD20+ B-cell-guided low-dose rituximab showed good efficacy and tolerance in patients with refractory myasthenia gravis.
Topics: Humans; Rituximab; Immunologic Factors; Activities of Daily Living; Myasthenia Gravis; Prednisone
PubMed: 37778340
DOI: 10.1159/000534336