Adverse effects of biologic anti-inflammatory agents on the respiratory system: A review

Joseph, D’Andrea; Tintinger, Gregory Ronald; Ker, James; Pannell, Nicolette

doi:10.7196/ajtccm.2021.v27i2.117

Cited by 7 publications

(3 citation statements)

References 81 publications

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“…Identification of the origin of pain would lead to treatments tailored specifically to individual RA patients, allowing the targeting of the pathogenetic pathways, which cause this pain, and help avoid over-treatment with DMARDs/biological drugs and often drug switching as well as severe adverse effects. Both treatments with synthetic (sDMARDs) and biologic DMARDs (bDMARDs), have adverse effects: sDMARDs quite often cause gastrointestinal distress (nausea, abdominal pain, diarrhoea), allergic reaction, bone marrow suppression, and hepatotoxicity [ 67 ], while bDMARDs may among other things cause susceptibility to infections and non-infectious pulmonary disease [ 68 ]. In Table I different methods of measuring pain and their benefits and limitations for RA patients with RP are presented.…”

Section: Discussionmentioning

confidence: 99%

The problem of residual pain in the assessment of rheumatoid arthritis activity

Motyl,

Krupka,

Maślińska

2024

Reumatologia

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Residual pain is a major unmet medical need observed in patients suffering from rheumatoid arthritis (RA), which decreases their quality of life, even after achieving remission or low disease activity. The article has two aims: 1) to present mechanisms involved in the pathophysiology of residual pain, both inflammatory and non-inflammatory, i.e. neuropathic and nociplastic pain, as well as secondary pain syndromes, i.e. osteoarthritis and fibromyalgia, which can contribute to residual pain; 2) to show the limitations of current disease activity measures recommended by European Alliance of Associations for Rheumatology (EULAR) and American College of Rheumatology (ACR), which raise the need for a separate assessment of pain, and examples of methods that could be used by medical professionals to assess the pain and make a differential diagnosis. In conclusion, establishing a valid method to assess pain is essential to identify the pathomechanism of residual pain and to create treatments tailored specifically to individual RA patients.

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Section: Discussionmentioning

confidence: 99%

The problem of residual pain in the assessment of rheumatoid arthritis activity

Motyl,

Krupka,

Maślińska

2024

Reumatologia

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“…While upper respiratory tract infections are generally not life-threatening, it is crucial to closely monitor patients receiving biologic therapy, especially if there is concern about bacterial infections involving organisms like Streptococcus pneumoniae and Streptococcus aureus. It is worth noting that infection is a common adverse effect of biologic therapy [80,94].…”

Section: Adverse Drug Reactionmentioning

confidence: 99%

Treatment of the cytokine storm in COVID-19: review of clinical pharmacology

Sapriati,

Rahmawati,

Nuryastuti

2023

J Sains Farm Klin

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The cause of the COVID-19 pandemic can be attributed to the Acute Respiratory Syndrome Virus-2 (SARS-CoV-2). COVID-19 manifests with severe symptoms in the upper respiratory tract and can progress to a critical condition due to an acute hyperinflammatory response that triggers a cytokine storm. The cytokine storm refers to an excessive or impaired production of proinflammatory cytokines, resulting in immune dysregulation and uncontrolled inflammatory activity. To effectively address the hyperinflammatory state induced by SARS-CoV-2 infection, it is imperative to explore promising strategies aimed at overcoming the cytokine storm, such as the prompt initiation of anti-inflammatory therapy. Several classes of drugs can potentially prevent the deterioration of COVID-19 patients by mitigating immune system dysregulation and suppressing uncontrolled inflammatory responses. These drug classes encompass corticosteroids, chloroquine and hydroxychloroquine, inhibitors of interleukin-1 (IL-1), inhibitors of interleukin-6 (IL-6), inhibitors of tumor necrosis factor (TNF), and anti-inflammatory drugs. Additionally, tumor necrosis factor alpha (TNF-α) inhibitors, as well as inhibitors targeting the Janus kinase signaling pathway and activator of transcription (JAK/STAT), have exhibited efficacy in treating COVID-19. This efficacy is evident when considering the drug's mechanism of action and pharmacokinetics, while also taking into account the tolerable side effects associated with their usage.

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“…Long-term use of steroids has been shown to contribute to osteoporosis and increased risk of bone fractures, fluid retention in the extremities and the lungs, high blood pressure, psychological effects such as confusion and delirium, thinning of the skin, slowed wound healing, glaucoma, and cataracts [1,4]. Although biologics, such 2 of 28 as anti-cytokine therapies and inhibitors of immune cell infiltration into tissues, have added to the arsenal of drugs used to treat inflammation in auto-immune and auto-inflammatory diseases, they may interfere with the ability of the patient to defend against infections and even cancer [1,5]. In some patients, biologics treatment can also result in the formation of antibodies against the therapies (e.g., infliximab), so that response rates may wary and wane over time.…”

Section: Introductionmentioning

confidence: 99%

Oxy210, a Semi-Synthetic Oxysterol, Exerts Anti-Inflammatory Effects in Macrophages via Inhibition of Toll-like Receptor (TLR) 4 and TLR2 Signaling and Modulation of Macrophage Polarization

Wang

Stappenbeck

Tang

et al. 2022

IJMS

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Inflammatory responses by the innate and adaptive immune systems protect against infections and are essential to health and survival. Many diseases including atherosclerosis, osteoarthritis, rheumatoid arthritis, psoriasis, and obesity involve persistent chronic inflammation. Currently available anti-inflammatory agents, including non-steroidal anti-inflammatory drugs, steroids, and biologics, are often unsafe for chronic use due to adverse effects. The development of effective non-toxic anti-inflammatory agents for chronic use remains an important research arena. We previously reported that oral administration of Oxy210, a semi-synthetic oxysterol, ameliorates non-alcoholic steatohepatitis (NASH) induced by a high-fat diet in APOE*3-Leiden.CETP humanized mouse model of NASH and inhibits expression of hepatic and circulating levels of inflammatory cytokines. Here, we show that Oxy210 also inhibits diet-induced white adipose tissue inflammation in APOE*3-Leiden.CETP mice, evidenced by the inhibition of adipose tissue expression of IL-6, MCP-1, and CD68 macrophage marker. Oxy210 and related analogs exhibit anti-inflammatory effects in macrophages treated with lipopolysaccharide in vitro, mediated through inhibition of toll-like receptor 4 (TLR4), TLR2, and AP-1 signaling, independent of cyclooxygenase enzymes or steroid receptors. The anti-inflammatory effects of Oxy210 are correlated with the inhibition of macrophage polarization. We propose that Oxy210 and its structural analogs may be attractive candidates for future therapeutic development for targeting inflammatory diseases.

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Adverse effects of biologic anti-inflammatory agents on the respiratory system: A review

Cited by 7 publications

References 81 publications

The problem of residual pain in the assessment of rheumatoid arthritis activity

The problem of residual pain in the assessment of rheumatoid arthritis activity

Treatment of the cytokine storm in COVID-19: review of clinical pharmacology

Oxy210, a Semi-Synthetic Oxysterol, Exerts Anti-Inflammatory Effects in Macrophages via Inhibition of Toll-like Receptor (TLR) 4 and TLR2 Signaling and Modulation of Macrophage Polarization

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