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MeSH: TNF-alfa-terapeutické užití

346 záznamů v Medvik Filtry

Kapitola

Cytokiny v terapii

Jílek, Petr, 1954-
Autor Autorita ORCID Katedra biologických a lékařských věd FAF UK, Hradec Králové Výukové a výzkumné centrum UK, Hradec Králové

Imunofarmakologie. 2024 ; () : 15-33, 123-124.

ISBN 978-80-271-3849-4
Medvik
Zdroj

Článek

Dysfunction of peripheral somatic and autonomic nervous system in patients with severe forms of Crohn's disease on biological therapy with TNFα inhibitors-A single center study

PloS one. 2023 ; 18 (11) : e0294441. [pub] 20231115

PLoS One
ISSN 1932-6203
Medvik
Zdroj

OBJECTIVE: Crohn's disease (CD) can be associated with a wide range of extraintestinal manifestations (EIMs), including neurological ones. Published studies differ in their conclusions about the epidemiology and etiopathogenesis of neurological EIMs. The aims of this study were to demonstrate the presence and find risk factors of peripheral (somatic and autonomic) neuropathy patients with severe CD on anti-TNFα biological therapy. MATERIAL AND METHODS: A clinical examination focusing on detection of peripheral sensor-motor nervous dysfunction (including Sudoscan) and examination of autonomic nervous system dysfunction (using Ewing ́s battery tests and spectral analysis) together with laboratory tests and collection of demographic data followed by administration of questionnaires were performed on a total of 30 neurologically asymptomatic outpatients with severe CD on anti-TNFα biological therapy. RESULTS: Peripheral sensor-motor nervous function via clinical neurological examination was pathological in 36.7% and Sudoscan in 33.3% of cases. Statistically significant associations between vibration perception test and age, CD and biological therapy duration, body mass index and Crohn's Disease Activity Index were proved while statistically significant associations between temperature perception test and age and BMI were proved as well. Additionally, a decrease of total protein in a patient ́s serum below the physiological cut-off in the 6 months prior to measurement was associated with a pathological result of a Sudoscan. Cardiovascular autonomic neuropathy based on Ewing ́s battery tests was present in 56.7% of patients, no statistically significant risk factors were found. Our peripheral neuropathy questionnaire correlated with the results of the Sudoscan test and some tests of the clinical examination of peripheral sensor-motor nervous function (discriminatory contact perception test, temperature perception test). CONCLUSIONS: This study demonstrated a relatively high prevalence of peripheral (especially autonomic) neuropathy and verified some risk factors for the development of peripheral somatic neuropathy in asymptomatic patients with severe form of CD on anti-TNFα biological therapy.

MeSH
autonomní nervový systém MeSH
biologická terapie MeSH
Crohnova nemoc * farmakoterapie epidemiologie komplikace MeSH
lidé MeSH
nemoci autonomního nervového systému * MeSH
nemoci periferního nervového systému * MeSH
TNF-alfa terapeutické užití MeSH
Check Tag
lidé MeSH
Publikační typ
časopisecké články MeSH

Článek

Secukinumab v terapii ankylozující spondylitidy - kazuistika
[Secukinumab in ankylosing spondylitis treatment - a case report]

Skácelová, Martina
Autor Autorita III. interní klinika - nefrologická, revmatologická a endokrinologická, LF UP a FN, Olomouc

Farmakoterapeutická revue. 2023 ; 8 (Spec. vyd. 1) : 46-50.

ISSN 2533-6878
Medvik
Zdroj

Klíčová slova
secukinumab,
MeSH
ankylózující spondylitida * farmakoterapie MeSH
dospělí MeSH
injekce subkutánní MeSH
interleukin-17 * antagonisté a inhibitory aplikace a dávkování terapeutické užití MeSH
lidé MeSH
randomizované kontrolované studie jako téma MeSH
TNF-alfa antagonisté a inhibitory škodlivé účinky terapeutické užití MeSH
Check Tag
dospělí MeSH
lidé MeSH
mužské pohlaví MeSH
Publikační typ
kazuistiky MeSH
práce podpořená grantem MeSH

Článek

Pacient s psoriázou a neřešenými bolestmi zad - kazuistika
[Patient with psoriasis and unsolved back pain - case report]

Farmakoterapeutická revue. 2022 ; 7 (3) : 294-296.

ISSN 2533-6878
Medvik
Zdroj

Prezentovaná kazuistika popisuje případ pacienta s psoriázou, trpícího dlouhodobými bolestmi zad, které ale nebyly nijak řešeny. Až na základě dovyšetřování na dermatovenerologické klinice vzniklo vážné podezření na možnou přítomnost dosud nerozpoznané ankylozující spondylitidy. Doplněné revmatologické vyšetření toto podezření konfirmovalo. U pacienta byla z revmatologické indikace zahájena biologická terapie, kvůli špatné compliance pacienta ale musela být ukončena. I přes neuspokojivé završení případu tato kazuistika názorně dokumentuje důležitost spolupráce mezi dermatologem a revmatologem.

The presented case report describes a case of a patient with psoriasis who had been suffering from back pain for a long time, but it had not been managed in any way. Only after further investigation at the dermatovenerology a serious suspicion of the possible presence of an unrecognized ankylosing spondylitis arose. Subsequent rheumatological examination confirmed this suspicion. Biological therapy was initiated for rheumatological indication but had to be discontinued because of a patient's poor compliance. Despite the unsatisfactory conclusion of the case, this case report demonstratively illustrates the importance of cooperation between dermatologist and rheumatologist.

MeSH
adherence pacienta MeSH
ankylózující spondylitida diagnostické zobrazování farmakoterapie MeSH
bolesti zad * diagnóza etiologie farmakoterapie MeSH
lidé středního věku MeSH
lidé MeSH
methotrexát terapeutické užití MeSH
psoriáza * farmakoterapie komplikace MeSH
rentgendiagnostika MeSH
TNF-alfa terapeutické užití MeSH
výsledek terapie MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
Publikační typ
kazuistiky MeSH

Článek

The beneficial effect of csDMARDs co-medication on drug persistence of first-line TNF inhibitor in rheumatoid arthritis patients: data from Czech ATTRA registry

Rheumatology international. 2022 ; 42 (5) : 803-814. [pub] 20220326

Rheumatol Int
ISSN 1437-160X
Medvik
Zdroj

The study aimed to compare treatment retention for first-line TNF inhibitor (TNFi) in the ATTRA registry patients receiving either combination with conventional synthetic DMARDs or TNFi as monotherapy. A retrospective multicenter study analyzed data of all adult patients with rheumatoid arthritis (n = 3032) starting TNF inhibitor as the first-line biological therapy in combination with csDMARDs or in monotherapy from January 1st 2012 to December 31st 2020. Kaplan-Meier method was employed to calculate drug retentions. Survival curves of treatment retentions were compared through Log-rank test between the studied subgroups. The hazard ratio for drug discontinuation was assessed through univariate cox regression models. In patients who started the first line TNFi therapy, the median treatment retention was 47.7 (42.2; 53.1) months for combination therapy and 22.7 (14.9; 30.6) months for TNFi monotherapy (p < 0.001). Estimated one-year survival was higher in patients on TNFi combined with csDMARDs as compared with TNFi monotherapy (75.3% vs 65.7%); two-year survival rate was 63.2% vs 49.2%, three-year survival rate was 55.4% vs 42.4% and five-year survival 44.9% vs 26.4% of patients. The estimated survival on the first TNFi was higher in patients taking combination therapy with methotrexate than with other csDMARDs (p = 0.003). Use of csDMARDs co-medication was associated with significantly better first TNFi drug survival compared to monotherapy. The combination of TNFi with MTX is more effective than the combination with leflunomide, which did not demonstrate a significant effect.

MeSH
antirevmatika * škodlivé účinky MeSH
dospělí MeSH
inhibitory TNF terapeutické užití MeSH
kombinovaná farmakoterapie MeSH
lidé MeSH
methotrexát škodlivé účinky MeSH
registrace MeSH
retrospektivní studie MeSH
revmatoidní artritida * chemicky indukované diagnóza farmakoterapie MeSH
TNF-alfa terapeutické užití MeSH
výsledek terapie MeSH
Check Tag
dospělí MeSH
lidé MeSH
Publikační typ
časopisecké články MeSH
multicentrická studie MeSH
Geografické názvy
Česká republika MeSH

Článek

Lékové interakce v revmatologii
[Drug interactions in rheumatology]

Remedia. 2021 ; 31 (1) : 103-108.

ISSN 0862-8947
Medvik
Zdroj

Cílem článku je shrnout závažné lékové interakce nesteroidních antirevmatik, imunosupresiv, antimalarik, glukokortikoidů, biologických a cílených syntetických chorobu modifikujících antirevmatických léků s léky používanými ve vnitřním lékařství.

This report summarizes important interactions of non‑steroidal anti‑inflammatory drugs, immunosupressants, antimalarial drugs, glucocorticosteroids, biological and targeted synthetic disease‑modifying antirheumatic drugs with drugs commonly used in internal medicine.

Článek

The Impact of Anti-Tumor Necrosis Factor Alpha Therapy on Postoperative Complications in Pediatric Crohn's Disease

European journal of pediatric surgery. 2020 ; 30 (1) : 27-32. [pub] 20191010

Eur J Pediatr Surg
ISSN 1439-359X
Medvik
Zdroj

INTRODUCTION: The incidence of Crohn's disease (CD) within the pediatric population is increasing worldwide. Despite a growing number of these patients receiving anti-tumor necrosis factor α therapy (anti-TNF-α), one-third of them still require surgery. There is limited data as to whether anti-TNF-α influences postoperative complications. We evaluated postoperative complications in patients who were or were not exposed to anti-TNF-α therapy in our institutional cohort. MATERIALS AND METHODS: A retrospective review of CD patients who underwent abdominal surgery between September 2013 and September 2018 was performed. The patients were divided into two groups based on whether they were treated with anti-TNF-α within 90 days before surgery. Thirty-day postoperative complications were assessed using Clavien-Dindo classification (D-C); this examination included surgical site infections (SSIs), stoma complications, intra-abdominal septic complications, non-SSIs, bleeding, ileus, readmission rate, and return to the operating room. Mann-Whitney U-test, Fisher's exact test, and multivariate logistic regression analyses were used for statistical analysis. RESULTS: Sixty-five patients (41 males) with a median age of 16 years (range: 7-19) at the time of operation were identified. The most common surgery was ileocecal resection in 49 (75%) patients. Forty-three (66.2%) patients were treated with anti-TNF-α preoperatively. Seven patients (11%) experienced postoperative complications. There was no statistically significant difference in postoperative complication in patients who did or did not receive anti-TNF-α before surgery (D-C minor 2.3% vs. 4.6%, p = 1; D-C major 7% vs. 9.1%, p = 1). CONCLUSION: The use of anti-TNF-α in pediatric CD patients within the 90 days prior to their abdominal surgery was not associated with an increased risk of 30-day postoperative complications.

MeSH
Crohnova nemoc farmakoterapie chirurgie MeSH
dítě MeSH
lidé MeSH
mladiství MeSH
pooperační komplikace * MeSH
reoperace MeSH
retrospektivní studie MeSH
rizikové faktory MeSH
TNF-alfa škodlivé účinky terapeutické užití MeSH
znovupřijetí pacienta MeSH
Check Tag
dítě MeSH
lidé MeSH
mladiství MeSH
mužské pohlaví MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH

Článek

Lze ovlivnit strukturální progresi u pacientů s axiální spondyloartritidou?
[Is it possible to modify structural progression in patients with axial spondyloarthritis?]

Gregová, Monika
Autor Autorita ORCID Revmatologický ústav a Revmatologická klinika 1. LF UK, Praha

Česká revmatologie. 2019 ; 27 (2) : 50-56.

ISSN 1210-7905
Medvik
Zdroj

Spondyloartritidy jsou chronická progresivní zánětlivá onemocnění s širokou a pestrou škálou projevů. Přesná patofyziologie těchto onemocnění není doposud známa, klíčovou roli hrají zánětlivé cytokiny, jako je tumor nekrotizující faktor alfa (TNF-α) nebo interleukin 17 (IL-17). V terapii nemocných s dominantním axiálním postižením jsou vedle nefarmakologických postupů užívána nesteroidní antiflogistika (NSA) a biologické a biosimilární chorobu modifikující léky. Léčba cílená na prozánětlivě působící cytokiny je velice efektivní v ovlivnění projevů a aktivity onemocnění. Otázkou však zůstává, zda jsme v současné době schopni zastavit nebo zpomalit strukturální progresi onemocnění. Tento článek si klade za cíl zhodnotit současné možnosti léčby nemocných s axiální spondyloartritidou (axSpA) zejména v kontextu ovlivnění dlouhodobé radiografické progrese.

Spondyloarthritides are chronic progressive inflammatory diseases with multiple and variable clinical symptoms. Exact pathophysiology of the diseases is currently unknown, but apparently key players are inflammatory cytokines such as tumour necrosis factor alpha (TNF-α) and interleukin 17 (IL-17). In treatment of patients with dominant axial involvement are besides traditional non-pharmacological procedures used nonsteroidal anti-inflammatory drugs (NSAID) and biological and biosimilar disease modifying drugs. Treatment targeted against main inflammatory cytokines is highly efficacious for disease symptoms and activity. Nevertheless, the question of whether we are currently able to slow or stop disease structural progression remains unanswered. This article focuses on current treatment options for axial spondyloarthritis (axSpA) in context of long-term radiographic progression.