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Bronchiolitis obliterans organizing pneumonia induced by drugs or radiotherapy
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Bucillamine is an anti-inflammatory agent developed in Japan with a structure similar to d-penicillamine. A 74-year-old woman with rheumatoid arthritis for 10 years had been taking bucillamine at 100 mg per day for 3 months and developed unproductive cough and shortness of breath.43 Fine crackles were detected at both lung bases. The chest X-ray showed patchy infiltrates bilaterally predominantly in the lower lungs. The chest CT scan showed ground-glass opacities adjoining bronchovascular bundles and air bronchograms with no honeycombing. The features were suggestive of BOOP. Because of severe hypoxaemia, a transbronchial biopsy and lavage were not performed. However, a drug lymphocyte stimulation test with bucillamine was positive. The bucillamine was discontinued and prednisolone 30 mg daily was given. She gradually improved, and by 2 months she had no cough or shortness of breath and the patchy infiltrates seen on the chest CT scan had nearly resolved.
Treatment of psoriatic arthritis complicated by systemic lupus erythematosus with the IL-17 blocker secukinumab and an analysis of the serum cytokine profile
Published in Modern Rheumatology Case Reports, 2020
Kojiro Sato, Yoshimi Aizaki, Yoshihiro Yoshida, Toshihide Mimura
A 36-year-old male with psoriasis was referred to the outpatient clinic of this department for the treatment of arthritis. He had been diagnosed approximately 5 years previously (200x – 5), with psoriasis vulgaris because of erythematous plaques on the trunk and extremities. He had since been treated with topical preparations, including corticosteroid. Three years later (200x – 2), he noted shoulder and wrist pain and was diagnosed with rheumatoid arthritis. Bucillamine (200 mg) was initiated but was not so effective. He was then diagnosed with PsA and bucillamine was switched to MTX. The laboratory test on that occasion revealed the positivity of antinuclear antibodies (1:320) as well as anti-double-stranded DNA (dsDNA) antibodies (58.0 IU/mL). Lymphocytopenia was also observed (701/μL). SLE comorbidity was suspected, and he was admitted to this hospital for further examination.
What are the main challenges to the pharmacological management of cystinuria?
Published in Expert Opinion on Pharmacotherapy, 2020
Michael E. Rezaee, Andrew D. Rule, Vernon M. Pais
Although few, there are emerging potential pharmacological treatments for cystinuria. L-cystine dimethylester is a molecular imposter of L-cystine that is capable of inhibiting cysteine crystal growth in animal models [12]. However, this molecule has not yet been tested in humans. Further, selenium supplementation was recently shown to decrease cysteine crystal volume in a small cohort of cystinuria patients in the Middle East [13]. However, this finding requires further validation. Bucillamine, a third-generation di-thiol drug, is currently approved for rheumatoid arthritis in Asia. It has a lower side effect profile than tiopronin and D-penicillamine, but has not yet been evaluated in cystinuria [5]. Finally, α-lipoic acid (ALA) is a thiol-containing compound that is available as an over-the-counter supplement, shown to prevent cystine stone formation in animal models [14]. There is currently a Phase 2 clinical trial evaluating the efficacy of 1,200 mg of ALA three times a day in preventing cystine stone formation in cystinuria patients [15].
Predictive factors for structural remission using abatacept: Results from the ABROAD study
Published in Modern Rheumatology, 2019
Kosaku Murakami, Masahiro Sekiguchi, Shintaro Hirata, Takao Fujii, Kiyoshi Matsui, Satoshi Morita, Koichiro Ohmura, Yutaka Kawahito, Norihiro Nishimoto, Tsuneyo Mimori, Hajime Sano
Concomitant use of MTX, glucocorticoid (GC) and csDMARDs was also examined as a predictive factor for St-REM. Median dose of MTX and GC (prednisolone) was 6 mg/week and 3 mg/day in the St-REM group, and 8 mg/week and 2.5 mg/day in the non-St-REM group, both of which did not show significant differences (p= .594 and .470, respectively). At baseline, several other csDMARDs were administrated concomitantly. Salazosulfapyridine was used in 27 patients, and five of these patients decreased the dose. Bucillamine was used in 16 patients, and three of these patients decreased the dose. Mizoribine, actarit and shiosol were used in three, two and one patient, respectively. Tacrolimus were used in 11 patients initially, and five of these patients decreased the dose. Conversely, tacrolimus was newly added for five patients during the observation period, among which four patients achieved St-REM. If these five patients were excluded, the disease duration and baseline mTSS progression remained predictive factors for St-REM according to multivariable logistic regression analysis (data not shown).