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Pulmonary – Treatable traits
Published in Vibeke Backer, Peter G. Gibson, Ian D. Pavord, The Asthmas, 2023
Vibeke Backer, Peter G. Gibson, Ian D. Pavord
Treatment options for ABPA or SAFS are limited and the chronic relapsing nature of this disease further complicates management. Corticosteroids, which suppress the hypersensitivity reaction, and anti-fungal drugs (i.e. itraconazole 200 mg twice daily for 4 months) are regarded as first- and second-line agents. Biological therapy might have a role but has not been evaluated extensively. Omalizumab has been used but most patients have blood IgE levels that are above the current prescription dosing range imposed for clinical use. There could be a role for other biological therapies targeting type-2 cytokines but this needs to be studied.
The locomotor system
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
Recent advances in the treatment of inflammatory conditions with biological agents has resulted in an increase in susceptibility to infection. Patients being treated with biological therapy may present with the symptoms of an underlying infection. These symptoms may be subtle, and are often systemic.
Melanoma-associated emergencies
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Vidya Kharkar, M. R. L. Sujata
Patients with disease that has metastasized to the brain have poor prognosis and generally ineffective treatment options. Recently, ipilimumab and vemurafenib are promising treatment options for patients with melanoma and central nervous system involvement. Radical metastasectomy for pulmonary metastases should be performed early for patients who have solitary or a minimal number of pulmonary metastases without extrathoracic involvement. Inhalative IL-2 therapy in combination with DTIC is an effective and nontoxic treatment of lung metastasis of malignant melanoma. Hepatic resection for metastatic melanoma of liver significantly improves survival over medical treatment alone. The metastatic disease is stabilized with systemic therapy prior to surgery. Treatment of bone metastases of malignant melanoma can be curative or palliative. The options include surgery, chemotherapy, radiotherapy, biological therapy, and combination therapy (chemotherapy combined with biological agents). Combination therapy, as an initial treatment, gives a higher response rate and long-term remissions [77].
Safety of current systemic therapies for nail psoriasis
Published in Expert Opinion on Drug Safety, 2023
Jonathan K. Hwang, Shari R. Lipner
Biologic treatments, including TNFai, IL-17i, and IL-23i agents all carry increased infection risk, notably URI or nasopharyngitis [66]. Review of long-term data has demonstrated that infliximab is associated with the highest risk of serious infections, although still overall rare [57]. Amongst biologic agents, IL-23i drugs are associated with the lowest rates of safety events in both the short- (12–16 weeks) and long-term (48–56 weeks) [66]. Nevertheless, given the potential for novel infection or viral reactivation, screening for tuberculosis, hepatitis B/C, and HIV is currently recommended for all biologic agents, along with annual monitoring for latent tuberculosis [73]. IL-17i and IL-23i agents are favored over TNFai agents for patients with high risk for tuberculosis infection or with history of latent tuberculosis [57]. IL-17i agents should be avoided when preventing Candida infections is a priority [34]. Patients with a history of moderate-to-severe heart failure should avoid TNFai, while those with concurrent IBD should avoid IL-17i agents [57]. For malignancy risk, there is a lack of concrete data demonstrating increased risk with biologic agents, but some expert guidelines have suggested that patients with a history of or concurrent malignancy, especially NMSCs, should avoid TNFai agents [34,100]. Overall, further studies assessing these risks are necessary for future guidelines on what conditions are truly contraindications to biological therapy use. Until then, physicians must take necessary precautionary measures when prescribing these drugs for nail psoriasis treatment.
An evaluative in vitro investigation of the delivery of cytarabine with RGD decorated solid lipid nanoparticles
Published in Journal of Microencapsulation, 2021
Shelly Roselyn Van Eyssen, Doga Kavaz
Globally, breast cancer is the secondary cause of mortality in women and is projected to exceed the mortality rate of the primary cause of death, heart disease, in the future (Kavaz et al. 2018, Aldawsari and Singh 2020). In 2018, WHO stated that breast cancer was 24.4% of the total number of cancer cases in Turkey. According to (Yassemi et al. 2020) 10.05 million women are projected to die of breast cancer in 2020. The aggressive nature of breast cancer makes it taxing to provide effective treatment. Conventional treatment of breast cancer is dependent on the stage of breast cancer. Local treatments, which are the most common, comprise surgery or radiation. The more effective type of treatment is a systemic treatment which involves the therapeutic agent reaching the bloodstream, for example, chemotherapy, hormone therapy, biological therapy and more notably, targeted therapy (Nounou et al.2015).
Comparative analysis of the etanercept efficacy in children with juvenile idiopathic arthritis under the age of 4 years and children of older age groups using the propensity score matching method
Published in Modern Rheumatology, 2019
Ekaterina Alexeeva, Tatyana Dvoryakovskaya, Rina Denisova, Tatyana Sleptsova, Kseniya Isaeva, Alexandra Chomahidze, Anna Fetisova, Anna Mamutova, Alina Alshevskaya, Victor Gladkikh, Andrey Moskalev
The use of biological therapy has achieved significant success in the treatment of this severe pathological condition. One of the biological therapy options is the use of medications able to inhibit the pro-inflammatory cytokine tumor necrosis factor (TNF). Anti-TNF agent etanercept (ETA) is such a biological agent that has been successfully used to treat JIA for more than 15 years. A high efficacy of ETA has been confirmed by studies in large cohort studies [1–4]. But, the question regarding the ‘ideal patients’ for ETA, as well as for other biologics, still remains open. Predictors associated with the efficacy of ETA treatment are studied to select the optimal personalized therapy [5–10]. At present, the association between certain baseline characteristics and the rate of response to therapy is identified retrospectively by comparing groups of patients showing different responses to therapy, without allowing initial heterogeneity of groups in terms of diagnosis and disease duration or severity.