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Rheumatology and CTD
Section 16 Section Editor: G Narsimulu Rheumatology and CTD 206. Refractory Rheumatoid Arthritis 214. Treatment of SLE beyond Steroids Rohini Handa Rathindra Nath Sarkar, Rudrajit Paul 207. Difficulties in Rheumatoid Arthritis 215. Gout Is the Only Enemy That I Do Not Rajan Kumar Wish to Have at My Feet Anjana Pandey, Ajay Maurya, PK Maheshwari 208. Monoarthritis—A Clinical Dilemma to Internists Arup Kumar Kundu, Abhishek Kundu 216. Liver Dysfunction and NAFLD in RA: 209. Oral Targeted Treatments in RA—Update 2021 Is MTX Really a Culprit? Ramakrishna Rao Uppuluri, Sripurna Deepti Challa Kartik Nikhil Balankhe, Rishabh Ramu Nayak, Pulin Kumar Gupta 210. Biosimilars: Bane or Boon for India 217. Sexual Dysfunction in Rheumatic Diseases Durga Prasanna Misra, Pallavi Patro, Vikas Agarwal Vinod Ravindran 211. An Approach to Vasculitis 218. Interpretation of Common Investigations Packiamary Jerome in Rheumatology 212. How to Manage DMARDs Failure in RA? Renu Saigal, Amit Kansal, Vikram Raj Jain N Subramanian 213. IgG4-related Disease Harpreet Singh, Somdatta Giri, Anju Arya MU-206 (Sec-16).indd 1321 29-01-2021 15:25:29 MU-206 (Sec-16).indd 1322 29-01-2021 15:25:30 CHAPTER 206 Refractory Rheumatoid Arthritis Rohini Handa Abstract A sizeable number of patients with rheumatoid arthritis (RA) are unable to attain low disease activity or remission despite treatment. These difficult to treat (D2T) patients are labeled as refractory RA. The troika of D2T RA, as outlined by the European League against Rheumatism, comprises of treatment failure history, presence of active/symptomatic disease, and clinical perception. The approach to refractory RA is evolving. -
JAK-Inhibitors for the Treatment of Rheumatoid Arthritis: a Focus on the Present and an Outlook on the Future
biomolecules Review JAK-Inhibitors for the Treatment of Rheumatoid Arthritis: A Focus on the Present and an Outlook on the Future 1, 2, , 3 1,4 Jacopo Angelini y , Rossella Talotta * y , Rossana Roncato , Giulia Fornasier , Giorgia Barbiero 1, Lisa Dal Cin 1, Serena Brancati 1 and Francesco Scaglione 5 1 Postgraduate School of Clinical Pharmacology and Toxicology, University of Milan, 20133 Milan, Italy; [email protected] (J.A.); [email protected] (G.F.); [email protected] (G.B.); [email protected] (L.D.C.); [email protected] (S.B.) 2 Department of Clinical and Experimental Medicine, Rheumatology Unit, AOU “Gaetano Martino”, University of Messina, 98100 Messina, Italy 3 Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Pordenone, 33081 Aviano, Italy; [email protected] 4 Pharmacy Unit, IRCCS-Burlo Garofolo di Trieste, 34137 Trieste, Italy 5 Head of Clinical Pharmacology and Toxicology Unit, Grande Ospedale Metropolitano Niguarda, Department of Oncology and Onco-Hematology, Director of Postgraduate School of Clinical Pharmacology and Toxicology, University of Milan, 20162 Milan, Italy; [email protected] * Correspondence: [email protected]; Tel.: +39-090-2111; Fax: +39-090-293-5162 Co-first authors. y Received: 16 May 2020; Accepted: 1 July 2020; Published: 5 July 2020 Abstract: Janus kinase inhibitors (JAKi) belong to a new class of oral targeted disease-modifying drugs which have recently revolutionized the therapeutic panorama of rheumatoid arthritis (RA) and other immune-mediated diseases, placing alongside or even replacing conventional and biological drugs. -
Clinical Efficacy of New JAK Inhibitors Under Development. Just More of the Same?
RHEUMATOLOGY Rheumatology 2019;58:i27i33 doi:10.1093/rheumatology/key256 Clinical efficacy of new JAK inhibitors under development. Just more of the same? Rene Westhovens1 Abstract Janus kinase inhibition is promising in the treatment of RA, with already two oral drugs marketed. New compounds are under investigation that are more selective for Janus kinase 1 or Janus kinase 3. Phase II results for filgotinib, upadacitinib, peficitinib and decernotinib are reviewed showing almost consistently a fast dose-dependent clinical improvement similar to already approved drugs tofacitinib and baricitinib. I will reflect on the most frequently reported dose-dependent adverse events and laboratory changes. Some are similar for all drugs of this class, some are more specific for a certain drug, but all may influence future treatment effectiveness in daily practice. This implies the need for a critical evaluation of phase III trials, and eventually trials specifically powered for conclusions on the safety profile and registries once these drugs become marketed. These innovative drugs also need head-to-head trials versus biologics or in-class as well as specific strategy studies to determine their optimal future use. Key words: Janus kinase inhibitor, RA, filgotinib, upadacitinib, peficitinib, decernotinib Rheumatology key messages . Efficacy but also some adverse events of most new Janus kinase inhibitors are dose dependent. Target selectivity of new Janus kinase inhibitors is an interplay between selectivity, dosing, drugdrug interaction, pharmacokinetics and pharmacodynamics. These new Janus kinase inhibitors might alter treatment paradigms by a rapid dose-dependent action, eventually also in monotherapy. Introduction regarding functionality, quality of life and even aspects of participation in daily life. -
Pathological Mechanisms and Modern Pharmacologic Therapies
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by espace@Curtin Bone Research www.nature.com/boneres REVIEW ARTICLE OPEN Rheumatoid arthritis: pathological mechanisms and modern pharmacologic therapies Qiang Guo1,2, Yuxiang Wang1, Dan Xu2,3, Johannes Nossent3,4, Nathan J. Pavlos2 and Jiake Xu2 Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that primarily affects the lining of the synovial joints and is associated with progressive disability, premature death, and socioeconomic burdens. A better understanding of how the pathological mechanisms drive the deterioration of RA progress in individuals is urgently required in order to develop therapies that will effectively treat patients at each stage of the disease progress. Here we dissect the etiology and pathology at specific stages: (i) triggering, (ii) maturation, (iii) targeting, and (iv) fulminant stage, concomitant with hyperplastic synovium, cartilage damage, bone erosion, and systemic consequences. Modern pharmacologic therapies (including conventional, biological, and novel potential small molecule disease-modifying anti-rheumatic drugs) remain the mainstay of RA treatment and there has been significant progress toward achieving disease remission without joint deformity. Despite this, a significant proportion of RA patients do not effectively respond to the current therapies and thus new drugs are urgently required. This review discusses recent advances of our understanding of RA pathogenesis, disease modifying drugs, and provides perspectives on next generation therapeutics for RA. Bone Research (2018) 6:15 ; https://doi.org/10.1038/s41413-018-0016-9 INTRODUCTION manifestations such as keratitis, pulmonary granulomas (rheuma- Rheumatoid arthritis (RA) is a chronic systemic autoimmune toid nodules), pericarditis/pleuritis, small vessel vasculitis, and disease that arises more frequently in females than males, being other non-specific extra-articular symptoms will develop. -
Promising Therapeutic Targets for Treatment of Rheumatoid Arthritis
REVIEW published: 09 July 2021 doi: 10.3389/fimmu.2021.686155 Promising Therapeutic Targets for Treatment of Rheumatoid Arthritis † † Jie Huang 1 , Xuekun Fu 1 , Xinxin Chen 1, Zheng Li 1, Yuhong Huang 1 and Chao Liang 1,2* 1 Department of Biology, Southern University of Science and Technology, Shenzhen, China, 2 Institute of Integrated Bioinfomedicine and Translational Science (IBTS), School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China Rheumatoid arthritis (RA) is a systemic poly-articular chronic autoimmune joint disease that mainly damages the hands and feet, which affects 0.5% to 1.0% of the population worldwide. With the sustained development of disease-modifying antirheumatic drugs (DMARDs), significant success has been achieved for preventing and relieving disease activity in RA patients. Unfortunately, some patients still show limited response to DMARDs, which puts forward new requirements for special targets and novel therapies. Understanding the pathogenetic roles of the various molecules in RA could facilitate discovery of potential therapeutic targets and approaches. In this review, both Edited by: existing and emerging targets, including the proteins, small molecular metabolites, and Trine N. Jorgensen, epigenetic regulators related to RA, are discussed, with a focus on the mechanisms that Case Western Reserve University, result in inflammation and the development of new drugs for blocking the various United States modulators in RA. Reviewed by: Åsa Andersson, Keywords: rheumatoid arthritis, targets, proteins, small molecular metabolites, epigenetic regulators Halmstad University, Sweden Abdurrahman Tufan, Gazi University, Turkey *Correspondence: INTRODUCTION Chao Liang [email protected] Rheumatoid arthritis (RA) is classified as a systemic poly-articular chronic autoimmune joint † disease that primarily affects hands and feet. -
A Closer Look at JAK/STAT Signaling Pathway Emira Bousoik Chapman University
Chapman University Chapman University Digital Commons Pharmacy Faculty Articles and Research School of Pharmacy 7-31-2018 “Do We Know Jack” About JAK? A Closer Look at JAK/STAT Signaling Pathway Emira Bousoik Chapman University Hamidreza Montazeri Aliabadi Chapman University, [email protected] Follow this and additional works at: https://digitalcommons.chapman.edu/pharmacy_articles Part of the Amino Acids, Peptides, and Proteins Commons, Cancer Biology Commons, Cell Anatomy Commons, Cell Biology Commons, Enzymes and Coenzymes Commons, Oncology Commons, and the Other Pharmacy and Pharmaceutical Sciences Commons Recommended Citation Bousoik E, Montazeri Aliabadi H. “Do we know jack” about JAK? A closer look at JAK/STAT signaling pathway. Front. Oncol. 2018;8:287. doi: 10.3389/fonc.2018.00287 This Article is brought to you for free and open access by the School of Pharmacy at Chapman University Digital Commons. It has been accepted for inclusion in Pharmacy Faculty Articles and Research by an authorized administrator of Chapman University Digital Commons. For more information, please contact [email protected]. “Do We Know Jack” About JAK? A Closer Look at JAK/STAT Signaling Pathway Comments This article was originally published in Frontiers in Oncology, volume 8, in 2018. DOI: 10.3389/ fonc.2018.00287 Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 License. Copyright The uthora s This article is available at Chapman University Digital Commons: https://digitalcommons.chapman.edu/pharmacy_articles/590 -
The Two Tontti Tudiul Lui Hi Ha Unit
THETWO TONTTI USTUDIUL 20170267753A1 LUI HI HA UNIT ( 19) United States (12 ) Patent Application Publication (10 ) Pub. No. : US 2017 /0267753 A1 Ehrenpreis (43 ) Pub . Date : Sep . 21 , 2017 ( 54 ) COMBINATION THERAPY FOR (52 ) U .S . CI. CO - ADMINISTRATION OF MONOCLONAL CPC .. .. CO7K 16 / 241 ( 2013 .01 ) ; A61K 39 / 3955 ANTIBODIES ( 2013 .01 ) ; A61K 31 /4706 ( 2013 .01 ) ; A61K 31 / 165 ( 2013 .01 ) ; CO7K 2317 /21 (2013 . 01 ) ; (71 ) Applicant: Eli D Ehrenpreis , Skokie , IL (US ) CO7K 2317/ 24 ( 2013. 01 ) ; A61K 2039/ 505 ( 2013 .01 ) (72 ) Inventor : Eli D Ehrenpreis, Skokie , IL (US ) (57 ) ABSTRACT Disclosed are methods for enhancing the efficacy of mono (21 ) Appl. No. : 15 /605 ,212 clonal antibody therapy , which entails co - administering a therapeutic monoclonal antibody , or a functional fragment (22 ) Filed : May 25 , 2017 thereof, and an effective amount of colchicine or hydroxy chloroquine , or a combination thereof, to a patient in need Related U . S . Application Data thereof . Also disclosed are methods of prolonging or increasing the time a monoclonal antibody remains in the (63 ) Continuation - in - part of application No . 14 / 947 , 193 , circulation of a patient, which entails co - administering a filed on Nov. 20 , 2015 . therapeutic monoclonal antibody , or a functional fragment ( 60 ) Provisional application No . 62/ 082, 682 , filed on Nov . of the monoclonal antibody , and an effective amount of 21 , 2014 . colchicine or hydroxychloroquine , or a combination thereof, to a patient in need thereof, wherein the time themonoclonal antibody remains in the circulation ( e . g . , blood serum ) of the Publication Classification patient is increased relative to the same regimen of admin (51 ) Int . -
Supplementary Material Table of Contents
Supplementary M aterial Table of Contents 1 - Online S u pplementary Methods ………………………………………………...… . …2 1.1 Study population……………………………………………………………..2 1.2 Quality control and principal component analysis …………………………..2 1.3 Statistical analyses………………………………………… ………………...3 1.3.1 Disease - specific association testing ……………………………… ..3 1.3.2 Cross - phenotype meta - analysis …………………………………… .3 1.3.3 Model search ……………………………………………………… .4 1.3.4 Novelty of the variants …………………………………………… ..4 1.3.5 Functional Enrichment Analy sis ………………………………… ...4 1.3.6 Drug Target Enrichment Analysis ………………………………… 5 2 - Supplementary Figures………………………………………...………………… . …. 7 3 - Members of the Myositis Genetics Consortium (MYOGEN) ……………………. ..16 4 - Members of the Scleroderma Genetics Consortium ………………… ……………...17 5 - Supplementary References………………………………………………………… . .18 6 - Supplementary Tables………………………………………………………… . ……22 1 Online supplementary m ethods Study population This study was conducted using 12,132 affected subjects and 23 ,260 controls of European des cent population and all of them have been included in previously published GWAS as summarized in Table S1. [1 - 6] Briefly, a total of 3,255 SLE cases and 9,562 ancestry matched controls were included from six countrie s across Europe and North America (Spain, Germany, Netherlands, Italy, UK, and USA). All of the included patients were diagnosed based on the standard American College of Rheumatology (ACR) classification criteria. [7] Previously described GWAS data from 2,363 SSc cases and 5,181 ancestry -
Informe 'El Valor Del Medicamento Desde Una Perspectiva Social'
EL VALOR DEL MEDICAMENTO DESDE UNA PERSPECTIVA SOCIAL El valor del medicamento desde una perspectiva social [ 1 ] Autor: Informe dirigido por: Álvaro Hidalgo-Vega Edita: © Fundación Weber C/ Las Norias, 123 28221 Majadahonda - Madrid email: [email protected] ISBN: 978-84-947 703-2-6 D.L.: M-8863 2018 Impreso en Madrid, marzo 2018 [ 2 ] ÍNDICE LISTADO DE ACRÓNIMOS ................................................................................................................... 5 1 PRESENTACIÓN ..................................................................................................................................... 7 2 LA CONTRIBUCIÓN DE LA INDUSTRIA FARMACÉUTICA A LA ECONOMÍA ............................. 9 El empleo en la industria farmacéutica ...........................................................................................10 Producción y valor añadido en la industria farmacéutica ...........................................................15 Investigación y desarrollo en la industria farmacéutica ..............................................................21 Otras magnitudes económicas de la industria farmacéutica .....................................................27 El potencial de la biotecnología ....................................................................................................33 3 AHORRO EN COSTES DIRECTOS E INDIRECTOS DE LOS MEDICAMENTOS .........................35 Ahorro en costes directos ..................................................................................................................36 -
Risk of Infections and Cardiovascular and Venous Thromboembolic Events Associated with JAK Inhibitors in Rheumatoid Arthritis
Open access Protocol BMJ Open: first published as 10.1136/bmjopen-2020-041420 on 31 December 2020. Downloaded from Risk of infections and cardiovascular and venous thromboembolic events associated with JAK inhibitors in rheumatoid arthritis: protocols of two systematic reviews and network meta- analyses Carlos Alves ,1,2 Ana Penedones ,2 Diogo Mendes,2 Francisco Batel- Marques1,2 To cite: Alves C, Penedones A, ABSTRACT Strengths and limitations of this study Mendes D, et al. Risk of Introduction Janus kinases (JAK) inhibitors demonstrated infections and cardiovascular to be effective in the treatment of adult patients with ► The Preferred Reporting Items for Systematic and venous thromboembolic moderate- to- severe active rheumatoid arthritis (RA) but events associated with JAK Review and Meta- Analysis for Network Meta- have been associated with serious cardiovascular and inhibitors in rheumatoid Analysis statement and the Centre for Reviews and serious events. Two systematic reviews and network meta- arthritis: protocols of two Dissemination’s guidance will be followed. analyses will be carried aiming to compare the relative systematic reviews and network ► The relative risk of cardiovascular and thrombo- safety of the different JAK inhibitors with regard to the risk meta- analyses. BMJ Open embolic events will be assessed for the first time of (1) cardiovascular and thromboembolic events and (2) 2020;10:e041420. doi:10.1136/ among the Janus kinases (JAK) inhibitors class. bmjopen-2020-041420 serious infections in patients with RA. ► Although an increased risk of herpes zoster was Methods and analysis PUBMED, Embase, Cochrane ► Prepublication history and identified for baricitinib in a previous network meta- Controlled Register of Trials and ClinicalTrials. -
Supplementary Materials
1 Supplementary Materials Figure S1. Flowchart of the Material and Methods: PRISMA flow diagram of the study. RCT, randomized controlled trial. 2 Table S1. Search strategies modified in MEDLINE (a), Embase (b), Cochrane CENTRAL (c), and Web of Science (d) a. Search strategy in MEDLINE (via Ovid MEDLINE(R), 1946–present; search date: 2021/01/29) # Search syntax Citations found 1 ("atopic dermatitis" OR eczema*).mp 2 exp "Dermatitis, Atopic"/ OR exp "Eczema"/ 3 ((Janus ADJ3 kinase* ADJ3 inhibit*) OR (JAK* ADJ3 inhibit*) OR Abrocitinib OR "PF-04965842" OR Baricitinib OR LY3009104 OR Olumiant OR INCB028050 OR Delgocitinib OR "JTE-052" OR Gusacitinib OR ASN002 OR Ruxolitinib OR INCB018424 OR INCA24 OR Tofacitinib OR Tasocitinib OR "Tofacitinib citrate" OR Xeljanz OR CP690550 OR Upadacitinib OR "ABT-494" OR RINVOQ OR Cerdulatinib OR "RVT-502" OR PRT062070 OR Peficitinib OR ASP015K OR Filgotinib OR GLPG0634 OR Solcitinib OR "1206163-45-2" OR GLPG0778 OR GSK2586184 OR SHR0302 OR "ATI-502" OR "ATI 50002" OR "A 301" OR "PF- 06700841" OR "RVT-501" OR Decernotinib OR "VX-509" OR Pacritinib OR SB1518 OR Oclacitinib OR Apoquel OR "PF-03394197" OR Fedratinib OR TG101348 OR SAR302503 OR "Fedratinib hydrochloride" OR Inrebic).mp 4 exp "Janus Kinase Inhibitors"/ 5 (1 OR 2) AND (3 OR 4) 195 b. Search strategy in Embase (via Ovid, 1974–present; search date: 2021/01/29) # Search syntax Citations found 1 ("atopic dermatitis" OR eczema*).mp 2 exp "atopic dermatitis"/ OR exp "eczema"/ 3 ((Janus ADJ3 kinase* ADJ3 inhibit*) OR (JAK* ADJ3 inhibit*) OR Abrocitinib -
1 Clinical Significance of Janus Kinase Inhibitor Selectivity
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Online Research @ Cardiff Clinical Significance of Janus Kinase Inhibitor Selectivity Professor Ernest H Choy Head of Rheumatology and Translational Research Division of Infection and Immunity Director of Arthritis Research UK and Health and Care Research Wales CREATE Centre Correspondence to: Professor Ernest Choy, CREATE Centre, Section of Rheumatology, Division of Infection and Immunity, Cardiff University School of Medicine, Tenovus Building, Heath Park, Cardiff, Wales, United Kingdom CF14 4XN. Email: [email protected] Key words: rheumatoid arthritis, Janus Kinase, treatment, targeted synthetic DMARDs, DMARDs Acknowledgement: The CREATE Centre was funded by Arthritis Research UK and Health and Care Research Wales. Statement: This manuscript has no funding supporting. Key messages: 1. JAKi selectively is relative and not absolute. 2. Current approved JAKi and those in development significantly inhibit JAK1 isoform. 3. JAK1 is an effective target in RA although zoster reactivation is a class effect. 1 Abstract Cytokines are key drivers of inflammation in rheumatoid arthritis (RA). Anti-cytokine therapy has improved the outcome of RA. Janus kinases (JAK) are intracellular tyrosine kinases linked to intracellular domains of many cytokine receptors. There are four JAK isoforms: JAK1, JAK2, JAK3 and TYK2. Different cytokine receptor families utilise specific JAK isoforms for signal transduction. Phosphorylation of JAK when cytokine binds to its cognate receptor leads to phosphorylation of other intracellular molecules that eventually leads to gene transcription. Oral JAK inhibitors have been developed as anti-cytokine therapy in RA. Two JAK inhibitors, tofacitinib and baricitinib. have been approved recently for the treatment of RA.