A comprehensive review of rituximab therapy in rheumatoid arthritis patients

AbstractRituximab (RTX) is an approved treatment for rheumatoid arthritis (RA) patients that do not respond adequately to disease-modifying antirheumatic drugs. However, different new concerns, such as efficacy, optimum dose, safety issues, prediction of response to RTX, and pregnancy outcomes have attracted a lot of attention. The PubMed database was systematically reviewed for the last published articles, new findings, and controversial issues regarding RTX therapy in RA using “Rheumatoid arthritis” AND “rituximab” keywords, last updated on June 18, 2019. From 1812 initial recorders, 162 studies met the criteria. Regarding the optimum dose, low-dose RTX therapy (2 × 500 mg) seems as effective as standard dose (2 × 1000 mg), safer, and more cost-effectiv e. The most common reported safety challenges included de novo infections, false negative serologic tests of viral infections, reactivation of chronic infections, interfering with vaccination outcome, and development of de novo psoriasis. Other less reported side effects are infusion reactions, nerv ous system disorders, and gastrointestinal disorders. Lower exposure to other biologics, presence of some serological markers (e.g., anti-RF, anti-CCP, IL-33, ESR), specific variations inFCGR3A,FCGR2A,TGF β1,IL6,IRF5,BAFF genes, and also EBV-positivity could be used to predict response to RTX. Although there is no evidence of the teratogenic effect of RTX, ...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research

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Publication date: Available online 19 October 2019Source: Autoimmunity ReviewsAuthor(s): Andrea Rubbert-Roth, Melinda Zsuzsanna Szabó, Melinda Kedves, György Nagy, Fabiola Atzeni, Piercarlo Sarzi-PuttiniAbstractThe five TNF inhibitors currently approved for the treatment of RA are characterised by differences in their molecular structures, half-lives, administration routes, dosing intervals, immunogenicity, and use in women who wish to become pregnant. TNF inhibitors still represent the first biologic after conventional synthetic DMARD (csDMARD) in the majority of patients according to registry data. This was p...
Source: Autoimmunity Reviews - Category: Allergy & Immunology Source Type: research
The end of another quarter means a new list of FDA-approved drugs for primary care. Which ones should you know about? Click through to find out.  
Source: ConsultantLive - Category: Internal Medicine Authors: Tags: Obesity Opioid Related Disorders Osteoporosis Pregnancy and Birth Psoriasis Rheumatoid Arthritis T2 Diabetes Source Type: news
Discussion MDSCs violently emerge in pathological conditions in an attempt to limit potentially harmful immune and inflammatory responses. Mechanisms supporting their expansion and survival are deeply investigated in cancer, in the perspective to reactivate specific antitumor responses and prevent their contribution to disease evolution. These findings will likely contribute to improve the targeting of MDSCs in anticancer immunotherapies, either alone or in combination with immune checkpoint inhibitors. New evidence indicates that the expansion of myeloid cell differentiation in pathology is subject to fine-tuning, as its...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Maunil K. Desai1 and Roberta Diaz Brinton2,3* 1School of Pharmacy, University of Southern California, Los Angeles, CA, United States 2Center for Innovation in Brain Science, University of Arizona, Tucson, AZ, United States 3Departments of Pharmacology and Neurology, College of Medicine, University of Arizona, Tucson, AZ, United States Women have a higher incidence and prevalence of autoimmune diseases than men, and 85% or more patients of multiple autoimmune diseases are female. Women undergo sweeping endocrinological changes at least twice during their lifetime, puberty and menopause, with many women undergoin...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Authors: De Simone C, Caldarola G, Moretta G, Piscitelli L, Ricceri F, Prignano F Abstract Psoriasis affects 2-4% of the world's population, with no difference between men and women and 70% of patients experiencing disease onset before the age of 40, which coincides with the reproductive years. Few data are available from literature on impact of psoriasis on fertility, course and outcome of pregnancy and risk associated with treatments. Recent studies on other immune-mediated inflammatory diseases, among which psoriasis is also included, indicate that rheumatoid arthritis and inflammatory bowel diseases can impact ...
Source: Giornale Italiano di Dermatologia e Venereologia - Category: Dermatology Tags: G Ital Dermatol Venereol Source Type: research
ConclusionThere was a preference for etanercept among pregnancies with AS/JIA/PsA/PsO/RA, despite the availability of other TNFis. Decline in TNFi use after the first trimester may be related to the desire to reduce TNFis transplacental transfer and to minimize infection risk to the fetus or baby associated with live vaccine immunizations after birth.
Source: Pharmacoepidemiology and Drug Safety - Category: Drugs & Pharmacology Authors: Tags: ORIGINAL REPORT Source Type: research
Authors: Kalati M, Kashanian M, Jahdi F, Naseri M, Haghani H, Sheikhansari N Abstract The purpose of the present study was to evaluate the effects of evening primrose oil (EvPO) on the duration of pregnancy and labour. The study was performed as a triple blind placebo controlled randomised clinical trial on nulliparous low-risk women with a certain gestational age of 40 weeks of pregnancy and a Bishop score of less than 4. In the case group (EvPO group), EvPO capsules were administered, 1000 mg, twice daily, for 7 days, and in the control group, placebo was administered similarly. The women of ...
Source: Journal of Obstetrics and Gynaecology - Category: OBGYN Tags: J Obstet Gynaecol Source Type: research
Discussion Fats and fatty acids are essential for good human health. Saturated fats have hydrogen pairs linked to each carbon on the carbon backbone. They are solid or semi-solid at room temperature. Common examples are butter, lard, or hardened vegetable shortening. They are linked to higher cholesterol and triglycerides and only a small amount of them are recommended to be consumed in the diet. Unsaturated fats have one or more hydrogen atoms missing from the carbon backbone. They are liquid at room temperature. Monounsaturated fatty acids have one hydrogen pair that is missing from the carbon backbone. They are liq...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Conclusions: We conclude transvaginal estriol potentially offers a suitable physiologic delivery and cost-effective alternative to currently available estrogen regimens in selected patients. Additional studies on mode of delivery, safety, and efficacy merit further investigation.
Source: Menopause - Category: OBGYN Tags: Review Article Source Type: research
Conclusions The pregnancy outcomes reported in this small number of RA/psoriasis patients appear similar to those observed in the general population and in patients treated with biologic therapies for inflammatory diseases. However, definitive conclusions cannot be drawn, and pregnancy outcomes in patients receiving tofacitinib will continue to be monitored.
Source: Drug Safety - Category: Drugs & Pharmacology Source Type: research
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