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Reumatologia Clinica 2017Biological therapy has changed the course of inflammatory rheumatic diseases. The safety is well documented in national and international studies. Neurological... (Review)
Review
Biological therapy has changed the course of inflammatory rheumatic diseases. The safety is well documented in national and international studies. Neurological manifestations are uncommon and it is difficult to establish a clear causal relationship. The neurological signs and symptoms that may appear are multiple and sometimes mimic demyelinating neurological diseases and/or neurodegenerative diseases. Knowledge and disclosure of these cases is essential for a comprehensive management of biological therapy in our patients.
Topics: Antibodies, Monoclonal; Antirheumatic Agents; Biological Therapy; Humans; Nervous System Diseases; Rheumatic Diseases; Tumor Necrosis Factor-alpha
PubMed: 27373584
DOI: 10.1016/j.reuma.2016.04.012 -
Frontiers in Immunology 2020Monogenic autoinflammatory diseases are rare conditions caused by genetic abnormalities affecting the innate immunity. Previous therapeutic strategies had been mainly... (Review)
Review
Monogenic autoinflammatory diseases are rare conditions caused by genetic abnormalities affecting the innate immunity. Previous therapeutic strategies had been mainly based on results from retrospective studies and physicians' experience. However, during the last years, the significant improvement in their genetic and pathogenic knowledge has been accompanied by a remarkable progress in their management. The relatively recent identification of the inflammasome as the crucial pathogenic mechanism causing an aberrant production of interleukin 1β (IL-1β) in the most frequent monogenic autoinflammatory diseases led to the introduction of anti-IL-1 agents and other biologic drugs as part of the previously limited therapeutic armamentarium available. Advances in the treatment of autoinflammatory diseases have been favored by the use of new biologic agents and the performance of a notable number of randomized clinical trials exploring the efficacy and safety of these agents. Clinical trials have contributed to increase the level of evidence and provided more robust therapeutic recommendations. This review analyzes the treatment of the most frequent monogenic autoinflammatory diseases, namely, familial Mediterranean fever, tumor necrosis factor receptor-associated periodic fever syndrome, hyperimmunoglobulin D syndrome/mevalonate kinase deficiency, and cryopyrin-associated periodic syndromes, together with periodic fever with aphthous stomatitis, pharyngitis, and cervical adenitis syndrome, which is the most common polygenic autoinflammatory disease in children, also occurring in adult patients. Finally, based on the available expert consensus recommendations and the highest level of evidence of the published studies, a practical evidence-based guideline for the treatment of these autoinflammatory diseases is proposed.
Topics: Animals; Autoimmune Diseases; Biological Therapy; Colchicine; Dapsone; Evidence-Based Medicine; Fever; Humans; Immunotherapy; Lymphadenitis; Pharyngitis; Randomized Controlled Trials as Topic; Stomatitis, Aphthous; Syndrome; Thalidomide
PubMed: 32655539
DOI: 10.3389/fimmu.2020.00865 -
The Lancet. Gastroenterology &... Jan 2020Treatment strategies for inflammatory bowel disease (IBD) focus on the induction and long-term maintenance of deep remission to avoid complications of active disease and... (Review)
Review
Treatment strategies for inflammatory bowel disease (IBD) focus on the induction and long-term maintenance of deep remission to avoid complications of active disease and improve long-term outcomes. Medical therapies for IBD, notably the increasingly widespread use of biological therapy, are often effective at controlling disease, but these drugs are associated with substantial adverse events, which together with other factors-including increasing treatment costs and patient preferences-leads to concerns regarding indefinite use of medical therapy. Consequently, the need to consider the safety and feasibility of drug de-escalation once IBD remission has been achieved is clear. Here, we review the current evidence surrounding de-escalation of immunomodulator and biological therapy in Crohn's disease and ulcerative colitis. We discuss strategies for de-escalation, including the selection of patients who are appropriate for treatment de-escalation and the use of proactive drug monitoring, and review the evidence on subsequent optimal follow-up. We conclude by proposing an algorithm to guide de-escalation decisions, and highlight future perspectives, including the potential effect of emerging medication and personalised medicine for these diseases.
Topics: Biological Therapy; Drug Monitoring; Humans; Immunologic Factors; Inflammatory Bowel Diseases; Remission Induction
PubMed: 31818473
DOI: 10.1016/S2468-1253(19)30186-4 -
Cell Host & Microbe Aug 2021The spectrum of gut microbiome composition is readily but controversially distilled into a handful of community types. In this issue of Cell Host & Microbe, Lee et al....
The spectrum of gut microbiome composition is readily but controversially distilled into a handful of community types. In this issue of Cell Host & Microbe, Lee et al. (2021) find that matching pre-existing community types (and associated molecular biomarkers) to the class of immune biologic therapy in inflammatory bowel disease may double the treatment response.
Topics: Biological Therapy; Biomarkers; Gastrointestinal Microbiome; Humans; Inflammatory Bowel Diseases
PubMed: 34384525
DOI: 10.1016/j.chom.2021.07.012 -
Oral Surgery, Oral Medicine, Oral... Nov 2015In recent years, a new class of drugs has revolutionized the treatment of autoimmune, allergic, infectious, and many more diseases. This new class of drugs is made of 3... (Review)
Review
In recent years, a new class of drugs has revolutionized the treatment of autoimmune, allergic, infectious, and many more diseases. This new class of drugs is made of 3 groups-cytokines, monoclonal antibodies, and fusion proteins-that may target special damaged cells but not all the cells. These drugs may have side effects such as infection, hypersensitivity, hematologic disorders, cancer, hepatotoxicity, and neurologic disorders. However, there is not enough evidence or long-term studies of the mechanism of action and side effects of these drugs. Patients receiving biological therapies may need special consideration in dentistry. This paper is a review of the classification, mechanism of action, and side effects of these drugs and dental consideration for patients receiving biological therapies.
Topics: Antibodies, Monoclonal; Biological Therapy; Cytokines; Dental Care for Chronically Ill; Humans
PubMed: 26372436
DOI: 10.1016/j.oooo.2015.07.032 -
Rheumatology (Oxford, England) Sep 2021Adult-onset Still's disease (AOSD) is a rare, but characteristic non-familial, multi-genic systemic auto-inflammatory disorder, characterized by high spiking fever,... (Review)
Review
Adult-onset Still's disease (AOSD) is a rare, but characteristic non-familial, multi-genic systemic auto-inflammatory disorder, characterized by high spiking fever, salmon-like evanescent skin rash, polyarthritis, sore throat, hyperferritinemia and leucocytosis. The hallmark of AOSD is a cytokine storm triggered by dysregulation of inflammation. Nowadays, with advances in anti-cytokine biologic agents, the treatment of AOSD is no longer limited to NSAIDs, glucocorticoids or conventional synthetic DMARDs. In this review, we focussed on the roles of these cytokines in the pathogenesis of AOSD and summarized the current and emerging biological therapy.
Topics: Biological Therapy; Cytokine Release Syndrome; Humans; Still's Disease, Adult-Onset
PubMed: 34117886
DOI: 10.1093/rheumatology/keab485 -
Clinical and Experimental Medicine May 2024Malignant tumors pose a grave threat to the quality of human life. The prevalence of malignant tumors in China is steadily rising. Presently, clinical interventions... (Review)
Review
Malignant tumors pose a grave threat to the quality of human life. The prevalence of malignant tumors in China is steadily rising. Presently, clinical interventions encompass surgery, radiotherapy, and pharmaceutical therapy in isolation or combination. Nonetheless, these modalities fail to completely eradicate malignant tumor cells, frequently leading to metastasis and recurrence. Conversely, tumor biotherapy has emerged as an encouraging fourth approach in preventing and managing malignant tumors owing to its safety, efficacy, and minimal adverse effects. Currently, a range of tumor biotherapy techniques are employed, including gene therapy, tumor vaccines, monoclonal antibody therapy, cancer stem cell therapy, cytokine therapy, and adoptive cellular immunotherapy. This study aims to comprehensively review the latest developments in biological treatments for malignant tumors.
Topics: Humans; Neoplasms; Biological Therapy; Cancer Vaccines; Genetic Therapy; Immunotherapy; China
PubMed: 38801637
DOI: 10.1007/s10238-024-01376-2 -
Folia Biologica 2012
Review
Topics: Animals; Antineoplastic Agents; Biological Therapy; Humans; Molecular Targeted Therapy; Neoplasms
PubMed: 22464818
DOI: No ID Found -
The British Journal of Dermatology Nov 2021The management of moderate-to-severe psoriasis has been transformed by the introduction of biological therapies. These medicines, particularly those targeting... (Review)
Review
The management of moderate-to-severe psoriasis has been transformed by the introduction of biological therapies. These medicines, particularly those targeting interleukin (IL)-17 and IL-23p19, can offer clear or nearly clear skin for the majority of patients with psoriasis, with good long-term drug survival. However, as currently used, none of these therapies is curative and disconcertingly there is a small but increasing number of patients with severe psoriasis who have failed all currently available therapeutic modalities. A similar scenario has occurred in other immune-mediated inflammatory diseases (IMIDs) where treatment options are limited in severely affected patients. In these cases, cell therapy, including haematopoietic stem cell transplantation (HSCT) and mesenchymal stromal cells (MSC), has been utilized. This review discusses the various forms of cell therapy currently available, their utility in the management of IMIDs and emerging evidence for efficacy in severe psoriasis that is unresponsive to biological therapy. Balancing the risks and benefits of treatment vs. the underlying disease is key; cell therapy carries significant risks, costs, regulation and other complexities, which must be justified by outcomes. Although HSCT has anecdotally been reported to benefit severe psoriasis, sometimes with apparent cure, this has mainly been in the setting of other coincidental 'routine' indications. In psoriasis, cell therapies, such as MSC and regulatory T cells, with a lower risk of complications are likely to be more appropriate. Well-designed controlled trials coupled with mechanistic studies are warranted if advanced cell therapies are to be developed and delivered as a realistic option for severe psoriasis.
Topics: Biological Therapy; Hematopoietic Stem Cell Transplantation; Humans; Psoriasis
PubMed: 34036569
DOI: 10.1111/bjd.20517 -
The Israel Medical Association Journal... 2016Long-term extension studies and observational drug registers have revealed an increased risk of serious infections in patients treated with anti-tumor necrosis factor... (Review)
Review
Long-term extension studies and observational drug registers have revealed an increased risk of serious infections in patients treated with anti-tumor necrosis factor agents, particularly infliximab, etanercept and adalimumab. The same may be true for the newer biological drugs rituximab, tocilizumab and abatacept, although this has yet to be confirmed by long-term observational studies. We review the risk of tuberculosis, herpes zoster and other opportunistic infections, and the recommendations for screening for tuberculosis and hepatitis B and C infections in patients with rheumatoid arthritis, with the aim of informing patients and encouraging greater awareness among physicians.
Topics: Antirheumatic Agents; Biological Therapy; Certolizumab Pegol; Drug Therapy, Combination; Humans; Infections; Infliximab; Interleukin-6; Rheumatic Diseases; Severity of Illness Index; Tumor Necrosis Factor-alpha
PubMed: 27228636
DOI: No ID Found