Long-term TNF-α Blockade in Patients with Amyloid A Amyloidosis Complicating Rheumatic Diseases

Fernández‐Nebro, Antonio; Olivé, Alejandro; Castro, M.C.; Varela, Angela Herranz; Riera, Elena; Irigoyen, M.V.; Yébenes, María Jesús García de; García‐Vicuña, Rosario

doi:10.1016/j.amjmed.2009.11.010

Cited by 54 publications

(37 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These studies have indicated that patients with nephrotic syndrome suffer from a worse prognosis [19]. Recently, it has been suggested that patients with chronic arthritis and proteinuria at baseline may predict mortality [20]. This suggestion is in line with some other studies, which show that reduced serum albumin is associated with a poor prognosis [21].…”

Section: Discussionsupporting

confidence: 78%

Renal Involvement in AA Amyloidosis: Clinical Outcomes and Survival

Yılmaz

Ünsal

Sokmen

et al. 2013

Kidney Blood Press Res

View full text Add to dashboard Cite

Background: The natural history of AA amyloidosis is typically progressive, leading to multiple organ failure and death. We analyzed the etiology as well as clinical and laboratory features of patients with biopsy-proven AA amyloidosis and evaluated the ultimate outcome. Methods: Seventy-three patients (24 female; mean age 41.85±15.89 years) were analyzed retrospectively. Demographic, clinical and laboratory features were studied and the outcome was assessed. Results: Familial Mediterranean Fever and tuberculosis were the most frequent causes of amyloidosis. Mean serum creatinine and proteinuria at diagnosis were 4.65±4.89 mg/dl and 8.04±6.09 g/day, respectively; and stage I, II, III, IV and V renal disease were present in 19.2%, 13.7%, 16.4%, 11%, and 39.7% of the patients, respectively. ESRD developed in 16 patients during the follow-up period. All of the ESRD patients started a dialysis programme. Thirty patients (41%) died during the follow-up period; median patient survival was 35.9±6.12 months. Old age, tuberculosis etiology, advanced renal disease and low serum albumin levels were associated with a worse prognosis. Serum albumin was a predictor of mortality in logistic regression analysis. Conclusion: The ultimate outcome of the patients with AA amyloidosis is poor, possibly due to the late referral to the nephrology clinics. Early referral may be helpful to improve prognosis.

show abstract

Section: Discussionsupporting

confidence: 78%

Renal Involvement in AA Amyloidosis: Clinical Outcomes and Survival

Yılmaz

Ünsal

Sokmen

et al. 2013

Kidney Blood Press Res

View full text Add to dashboard Cite

show abstract

“…Even if IL-6 signal transduction is inhibited, activation of NF-κB signal still remains. However, anti-IL-6 therapy, but not anti-TNF [20,21,[25][26][27] or IL-1 therapy [16], normalized the serum levels of SAA in AA amyloidosis patients [41][42][43][44][45]. It remains unclear whether STAT3, which is the main transcription factor of IL-6 signal transduction, plays a role in the transcriptional activation of the SAA gene.…”

Section: Molecular Mechanisms Of Serum Amyloid a Transcriptionmentioning

confidence: 97%

“…In a multivariate Cox regression analysis, the duration of amyloidosis and the level of proteinuria were independent predictors of anti-TNF treatment failure, and the level of proteinuria was the only predictor of mortality in AA amyloidosis. The number of infections was 3 times higher in AA amyloidosis patients [27]. In addition, it has been reported that anti-TNF treatment is effective for clinical improvement in AA amyloidosis associated with FMF [28] or Crohn's disease [29].…”

Section: Anti-tnf Therapy For Aa Amyloidosismentioning

confidence: 98%

Anti-Cytokine Therapy for AA Amyloidosis

Hagihara¹,

Kagawa²,

Kishida³

et al. 2013

Amyloidosis

View full text Add to dashboard Cite

“…The patients' tolerance was well, and the therapy was found to be effective to suppress proteinuria and protect renal functions. More recently, Fernández-Nebro et al 13 studied the results of 36 patients with AA-type amyloidosis, who had anti-TNF-alpha therapy approximately for 36 weeks, and compared them with the control group. The results were similar to the former: anti-TNFalpha agents are effective in improving proteinuria and stabilizing renal functions.…”

Section: Discussionmentioning

confidence: 99%

Complete Reversal of Nephrotic Syndrome Secondary to Amyloidosis with Use of Infliximab in a Patient with Inflammatory Bowel Disease and Ankylosing Spondylitis

et al. 2011

View full text Add to dashboard Cite

A 30-year-old woman was diagnosed with ulcerative colitis in January 2006. One year later, she presented because of severe back pain and was diagnosed with ankylosing spondylitis (AS). In February 2008, the patient, while still under standard treatment for ulcerative colitis and AS, was admitted because of massive proteinuria and related symptoms. Nephrotic syndrome was observed and renal biopsy revealed amyloid deposits. After treatment with infliximab, nephrotic syndrome disappeared. We aim to present a case of secondary amyloidosis complicating ulcerative colitis and associated spondyloarthropathy.

show abstract

Long-term TNF-α Blockade in Patients with Amyloid A Amyloidosis Complicating Rheumatic Diseases

Cited by 54 publications

References 11 publications

Renal Involvement in AA Amyloidosis: Clinical Outcomes and Survival

Renal Involvement in AA Amyloidosis: Clinical Outcomes and Survival

Anti-Cytokine Therapy for AA Amyloidosis

Complete Reversal of Nephrotic Syndrome Secondary to Amyloidosis with Use of Infliximab in a Patient with Inflammatory Bowel Disease and Ankylosing Spondylitis

Contact Info

Product

Resources

About