- |||||||||| leflunomide / Generic mfg.
Journal: Coated nanostructured lipid carriers targeting the joints - an effective and safe approach for the oral management of rheumatoid arthritis. (Pubmed Central) - Dec 26, 2019 Oral treatment of rheumatoid arthritis (RA) with the immunomodulator, leflunomide (LEF), is associated with systemic side effects namely immunosuppression and hepatotoxicity...Results revealed improved joint healing and reduced hepatotoxicity following treatment with nanoencapsulated LEF compared to LEF suspension, whereby CHS-NLCs ensued the highest C, AUC and lowest TNF-α level. The dual potential of CHS to achieve active targeting to CD44-receptor and hence maximize LEF concentration at the target site in addition to its synergistic effect in joint healing endow promises for a competent oral nanosystem for targeted drug delivery to the joints.
- |||||||||| Actemra IV (tocilizumab) / Roche, JW Pharma, enoxaparin sodium / Generic mfg.
Retrospective data, Journal: Cancellations of elective surgical procedures due to inadequate management of chronic medications. (Pubmed Central) - Dec 23, 2019 Inadequate management of chronic medications (2.4%) is not the most frequent reason for cancellation, although it is one of the easiest to avoid. Based on our results, starting in October 2017, the Pharmacy Department began to offer a pharmaceutical service to patients with doubts about the preoperative management of chronic medications.
- |||||||||| leflunomide / Generic mfg.
Journal, Adverse events: Reversible alopecia areata: a little known side effect of leflunomide. (Pubmed Central) - Dec 23, 2019 Currently, AA is not listed as an adverse effect in the leflunomide product monograph. However, it would appear that based on our case and the three other reported cases, the likelihood of AA being an adverse effect of leflunomide is at least possible to probable.
- |||||||||| Artrolyt (diacerein) - TRB Chemedica, Abiogen, Wockhardt, Neo / Pharma, Kyowa Hakko Kirin, aceclofenac / Generic mfg., leflunomide / Generic mfg.
Journal: Novel spectrophotometric methods for the determination of Leflunomide and Diacerein in binary mixtures. (Pubmed Central) - Dec 20, 2019 The suggested spectrophotometric methods were statistically compared to reference methods showing no significant difference. The suggested spectrophotometric methods are considered to be simple, sensitive and could be easily applied in quality control laboratories instead of LC methods.
- |||||||||| You can take a look at @GavinGiovannoni's off label DMT list: imuran, fumaderm, cladribine, cyclophosphamide, fludarabine, leflunomide, methotrexate, mitoxantrone, rituximab, HSCT. https://t.co/NR89emFz2r (Twitter) - Dec 18, 2019
- |||||||||| Vistide (cidofovir) / Gilead
First Reported Use of Artesunate Adjunctive Therapy for Severe BK Polyoma Virus Hemorrhagic Cystitis (BKPyV-HC) (World Center Marriott - Palms & Cypress Foyers) - Dec 18, 2019 - Abstract #TCTASTCTCIBMTR2020TCT_873; Re-activation risk factors include young age, male sex; high risk donor; HSCT conditioning with CTX, busulfan, TBI; and grade 2-4 GVHD...Cidofovir (CDV), leflunomide, and FQs have in-vitro BKV activity but clinical use is not supported by rigorous trials...In-vitro, ATV is synergistic and/or additive with CDV, GCV and Maribavir...CDV and IVIg therapy may also have contributed to the observed improvement. ART therapy may be an emerging option for BKV-IN and HC and further research is warranted.
- |||||||||| Secukinumab Induced Ulcerative Colitis in a Patient With Psoriatic Arthritis: A Novel Approach to Refractory Cases () - Dec 11, 2019 - Abstract #AIBD2019AIBD_90;
The few cases of psoriatic arthritis and Secukinumab- induced UC were managed successfully with infliximab...This patient had failed prior treatment for her psoriatic arthritis with Etanercept, Leflunomide, Adalimumab and Methotrexate...Later, she was started on Tofacitinib 10mg po bid to treat both psoriatic arthritis and ulcerative colitis to allow prednisone taper...There are no documented case reports treating both these conditions that are refractory to other biologics. In this subset of rare patients, this case illustrates a novel approach of using Tofacitinib in achieving therapeutic response for both psoriatic arthritis and ulcerative colitis.
- |||||||||| leflunomide / generics
Clinical, Journal: Pulmonary Arterial Hypertension in four patients treated by leflunomide. (Pubmed Central) - Dec 6, 2019 A favourable clinical and/or haemodynamic evolution was observed for all patients. The conclusions of the investigations conducted by our pharmacovigilance centre were communicated to the European Medicines Agency, leading to the addition of "pulmonary hypertension" in the paragraph "special warning and precautions of use" of the package leaflet of leflunomide.
- |||||||||| teriflunomide / Generic Mfg.
Journal: Kemp Eliminases of the AlleyCat Family Possess High Substrate Promiscuity. (Pubmed Central) - Dec 5, 2019 We have shown that Kemp eliminases of the AlleyCat family facilitate conversion of leflunomide (an immunosupressor pro-drug) to its active form teriflunomide with outstanding rate enhancement (nearly four orders of magnitude) and catalytic proficiency (more than seven orders of magnitude) without any additional optimization. This remarkable activity is achieved by properly positioning the substrate in close proximity to the catalytic glutamate with very high pK.
- |||||||||| methotrexate / Generic Mfg., Azulfidine (sulfasalazine) / Generic Mfg., Otezla (apremilast) / Amgen
Clinical, FDA event, Journal: Use of FDA-Approved Medications: Biologics for Psoriatic Arthritis in Patients at an Urban Outpatient Rheumatology Clinic. (Pubmed Central) - Dec 1, 2019 Although apremilast is allocated as an add-on therapy, 13.4% of patients were on apremilast monotherapy. This quality improvement project reveals that in most instances, biologics are being appropriately initiated as the primary mode of therapy for patients with PsA at our outpatient practice; however, treatment modifications can be made regarding patients who are managed with apremilast alone.
- |||||||||| leflunomide / generics
Clinical, Journal: Leflunomide therapy for refractory cytomegalovirus infections in hematopoietic stem cell transplant recipients. (Pubmed Central) - Nov 28, 2019 Despite current strategies, refractory or recurrent cytomegalovirus infection and disease remain a clinical challenge to treat in the stem cell transplant patient population. Leflunomide used in combination with other concomitant therapies use for refractory cytomegalovirus infection in clinical practice may be a safe and effective option in the allogeneic stem cell transplant patient population.
- |||||||||| leflunomide / Generic mfg.
Enrollment change, Trial withdrawal: Leflunomide in Treating Patients With High-Risk Smoldering Multiple Myeloma (clinicaltrials.gov) - Nov 14, 2019 P2, N=0, Withdrawn, A better understanding of mechanisms of leflunomide-induced hepatotoxicity may be of translational implication for the predictive, preventive and therapeutic purposes. N=58 --> 0 | Not yet recruiting --> Withdrawn
- |||||||||| teriflunomide / Generic mfg., leflunomide / Generic mfg.
AG-636 for the Treatment of Adults with Advanced Lymphoma: Initiation of a Phase 1 Clinical Study (Hall B, Level 2 (Orange County Convention Center)) - Nov 7, 2019 - Abstract #ASH2019ASH_2106; P1 Inhibitors of DHODH are currently in clinical use for the treatment of rheumatoid arthritis (leflunomide) and multiple sclerosis (teriflunomide)...There are no limits on the number of prior lines of therapy and patients may have received prior stem cell transplant or chimeric antigen receptor T-cell therapy...Further expansion may be undertaken if AG-636 shows high activity in specific subtypes of lymphoma, either in the clinic or in preclinical models. The experience in this study with the pharmacokinetics, pharmacodynamics, and safety of AG-636 will inform the optimal starting dose and regimen for evaluation in subsequent studies.
- |||||||||| leflunomide / Generic mfg.
Transcriptional Regulation of Coenzyme Q Biosynthesis By TIF1γ Drives Erythropoiesis (W331, Level 3 (Orange County Convention Center)) - Nov 7, 2019 - Abstract #ASH2019ASH_1503; Among the suppressors, we identified leflunomide, an inhibitor of dihydroorotate dehydrogenase (DHODH), an essential enzyme for de novo pyrimidine synthesis...These results demonstrate a tight coordination of nucleotide and mitochondrial metabolism as a key function of tif1γ-dependent transcription and reveal that TIF1γ activity regulates a metabolic program that drives cell fate decisions in the early blood lineage. Our work highlights the importance of the plasticity achieved by transcription regulatory processes such as transcription elongation for metabolic processes during lineage differentiation and could have therapeutic potential for blood diseases and consequences for erythroid differentiation protocols.
- |||||||||| cyclophosphamide intravenous / Generic Mfg.
Observational data, Retrospective data, Journal: A comparison of the effectiveness of cyclophosphamide, leflunomide, corticosteroids, or conservative management alone in patients with IgA nephropathy: a retrospective observational study. (Pubmed Central) - Nov 2, 2019 The optimal cutoffs of eGFR was 47.085 ml/min/1.73 m predicting renal function recovery in P + CTX therapy. In conclusion, tubular atrophy/interstitial fibrosis and massive proteinuria were poor predictors for complete remission in IgAN, it appears as though patients may have benefited from immunosuppressive treatment but that comparison to a well-matched contemporary control group or, ideally, a randomized controlled clinical trial, would be required to show this.
- |||||||||| leflunomide / Generic mfg.
Trial initiation date: Leflunomide in Treating Patients With High-Risk Smoldering Multiple Myeloma (clinicaltrials.gov) - Oct 30, 2019 P2, N=58, Not yet recruiting, In conclusion, tubular atrophy/interstitial fibrosis and massive proteinuria were poor predictors for complete remission in IgAN, it appears as though patients may have benefited from immunosuppressive treatment but that comparison to a well-matched contemporary control group or, ideally, a randomized controlled clinical trial, would be required to show this. Initiation date: Sep 2019 --> Dec 2019
- |||||||||| Remicade (infliximab) / Mitsubishi Tanabe, J&J, Enbrel (etanercept) / Takeda, Pfizer, Amgen, Humira (adalimumab) / Eisai, AbbVie
Retrospective data, Journal, HEOR, Monotherapy: Comparative effectiveness of first-line biological monotherapy use in rheumatoid arthritis: a retrospective analysis of the RECord-linkage On Rheumatic Diseases study on health care administrative databases. (Pubmed Central) - Oct 29, 2019 Concomitant methotrexate, leflunomide and csDMARDs combination associate with longer survival on bDMARD. Our data confirm the effectiveness of the current practices in the choice of etanercept as first-line anti-TNF monotherapy and strengthen the currently recommended use of bDMARDs in combination with csDMARDs.
- |||||||||| Xeljanz (tofacitinib) / Pfizer
Journal: 2017 recommendations of the Brazilian Society of Rheumatology for the pharmacological treatment of rheumatoid arthritis. (Pubmed Central) - Oct 27, 2019 General principles: RA treatment should (1) preferably consist of a multidisciplinary approach coordinated by a rheumatologist, (2) include counseling on lifestyle habits, strict control of comorbidities, and updates of the vaccination record, (3) be based on decisions shared by the patient and the physician after clarification about the disease and the available therapeutic options; (4) the goal is sustained clinical remission or, when this is not feasible, low disease activity. Recommendations: (1) the first line of treatment should be a csDMARD, started as soon as the diagnosis of RA is established; (2) methotrexate (MTX) is the first-choice csDMARD; (3) the combination of two or more csDMARDs, including MTX, may be used as the first line of treatment; (4) after failure of first-line therapy with MTX, the therapeutic strategies include combining MTX with another csDMARD (leflunomide), with two csDMARDs (hydroxychloroquine and sulfasalazine), or switching MTX for another csDMARD (leflunomide or sulfasalazine) alone; (5) after failure of two schemes with csDMARDs, a bDMARD may be preferably used or, alternatively a tsDMARD, preferably combined, in both cases, with a csDMARD; (6) the different bDMARDs in combination with MTX have similar efficacy, and therefore, the therapeutic choice should take into account the peculiarities of each drug in terms of safety and cost; (7) the combination of a bDMARD and MTX is preferred over the use of a bDMARD alone; (8) in case of failure of an initial treatment scheme with a bDMARD, a scheme with another bDMARD can be used; in cases of failure with a TNFi, a second bDMARD of the same class or with another mechanism of action is effective and safe; (9) tofacitinib can be used to treat RA after failure of bDMARD; (10) corticosteroids, preferably at low doses for the shortest possible time, should be considered during periods of disease activity, and the risk-benefit ratio should also be considered; (11) reducing or spacing out bDMARD doses is possible in patients in sustained remission.
- |||||||||| tacrolimus / Generic Mfg., Vistide (cidofovir) / Gilead
Is Cidofovir an Option for Refractory BK Nephropathy? () - Oct 23, 2019 - Abstract #KIDNEYWEEK2019KIDNEY_WEEK_5878; The initial treatment for BK viremia includes lowering immunosuppression followed by IVIG as well as Leflunomide. In patients who are refractory to initial treatment, cidofovir can be a treatment option.
- |||||||||| tacrolimus / Generic Mfg.
Transplant Renal Artery Stenosis in a Child with BK Nephropathy () - Oct 23, 2019 - Abstract #KIDNEYWEEK2019KIDNEY_WEEK_5858; Thymoglobulin, tacrolimus and mycophenolate were started...After immunosuppression reduction and leflunomide initiation, her BK load decreased to 1200 copies/mL after 4 months...Discussion Although ureteral and urethral stenosis are known to occur with BK infection, TRAS is an interesting association. Timely recognition and management of both is important to prevent uncontrolled hypertension and allograft dysfunction.
- |||||||||| Remicade (infliximab) / Mitsubishi Tanabe, J&J, Humira (adalimumab) / Eisai, AbbVie
IgA Nephropathy in Patients with Psoriatic Arthritis: A Case Series and Systematic Review of the Literature (Exhibit Hall, Walter E. Washington Convention Center) - Oct 14, 2019 - Abstract #KIDNEYWEEK2019KIDNEY_WEEK_1739; She was treated with prednisone and recovered kidney function after 20 days...She was treated with steroids and cyclophosphamide, with improvement to eGFR 22 mL/min...There is heterogeneity in these patients’ presentations, treatments, and outcomes. Conclusion Further study is warranted to determine whether there is a pathophysiological link between IgAN and PsA.
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