The use of anti-tumour necrosis factor therapy in HIV-positive individuals with rheumatic disease

Cepeda, Eduardo J; Williams, Francis M.; Ishimori, Mariko; Weisman, Michael H.; Reveille, John D.

doi:10.1136/ard.2007.081513

Cited by 179 publications

(123 citation statements)

References 13 publications

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“…Case reports exist regarding the successful use of tumor necrosis factor (TNF) antagonists. In the largest series, 8 patients were successfully treated, all of whom had CD4 counts Ͼ200 (20). Infectious complications arose in another patient with a CD4 count Ͻ50 treated with etanercept (21).…”

Section: Discussionmentioning

confidence: 99%

Human immunodeficiency virus infection presenting as an unusual arthropathy

Phillips

Reno

Atkinson

et al. 2011

Arthritis Care & Research

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Section: Discussionmentioning

confidence: 99%

Human immunodeficiency virus infection presenting as an unusual arthropathy

Phillips

Reno

Atkinson

et al. 2011

Arthritis Care & Research

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“…Benzer flekilde farkl› endikasyonlarla TNF antagonisti kullan›lmak zorunda kal›nan HIV + hastalarda bu ajanlar›n güvenle kullan›la-bilece¤i kaydedilmifltir. [107][108][109] Bu konuda yap›lan bir ça-l›flmada CD4 say›lar› >200 mm 3 ve HIV viral yükü <60 000 kopya /mm 3 olan olgularda TNF antagonistlerinin kullan›lan endikasyonlar›ndaki olumlu geliflme yan›nda hastalar›n CD4 say›lar›nda ve viral yüklerinde anlaml› bir de¤iflikli¤in olmad›¤› bildirilmifltir. 107 Immunolojik olarak TNF-α'n›n kona¤›n intrasellüler enfeksiyonlara karfl› korunmas›nda önemli bir rolü oldu¤u bilinmektedir Hayvan modeli çal›flmalar›na dayal› göz-lemlerde, hücresel immun sistem ve TNF-α salg›lanmas›-n›n fungal enfeksiyonlara karfl› kritik bir rolü oldu¤u saptanm›flt›r.…”

Section: Tnf Antagonistleriunclassified

New Treatment Alternatives in the Management of Non-İnfectious İntraocular İnflammations: Biologic Agents

Emre¹,

Tutkun²

2011

tjo

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ÖzetEnfeksiyöz olmayan üveitlerin tedavisinde son y›llara kadar genel olarak immün sistemi bask›layan ilaçlar kullan›lmak-tayd›. Ancak gen mühendisli¤indeki geliflmeler, inflamatuar süreçte yer alan özgün molekülleri hedefleyen proteinlerin sentezini ve bu proteinlerin terapötik olarak kullan›lmalar›n› mümkün k›lm›flt›r. Genel olarak protein yap›s›ndaki bu ajanlar biyolojik ajanlar olarak adland›r›lm›fllard›r. Oftalmologlar›n biyolojik ajanlar ile tecrübeleri s›n›rl› olsa da, bu ajanlar romatoloji ve dermatoloji baflta olmak üzere di¤er disiplinler taraf›ndan yo¤un biçimde kullan›lmaktad›rlar. ‹nterferon, infliksimab ve adalimumab baflta olmak üzere birçok biyolojik ajan›n üveit hastalar›nda kullan›m› ile ilgili literatür verisi olmas›na ra¤men henüz bu endikasyonda ruhsatl› kullan›mlar› yoktur. Ayr›ca bu ajanlar›n kullan›m› s›ras›nda dikkat edilmesi gereken güvenlik önlemleri ve önemli risk faktörleri mevcuttur. Bu derlemenin amac›, dirençli üveit hastalar›nda kullan›labilen biyolojik ajanlar konusunda güncel ve kapsaml› bilgi sunmakt›r. ( SummaryConventional immunosuppressive agents have been traditionally used for the treatment of noninfectious uveitis. Recent developments in genetic engineering have made it possible to synthesize proteins that target specific molecules playing role in the inflammatory response. These agents are generally in protein structure and are named biologic agents. While there is limited experience with biologics in the field of ophthalmology, they are commonly used in other disciplines such as rheumatology and dermatology. Although considerable data have accumulated in the uveitis literature regarding the use of biologic agents, including mainly interferon, infliximab, and adalimumab, their use for this indication is still off-label. Moreover, there are certain precautions that have to be taken into account, as well as important safety issues associated with their use. The purpose of this paper is to present an updated comprehensive review of biologic agents that may be used for the treatment of refractory uveitis. (Turk J Ophthalmol 2011; 41: 243-55 GiriflEnfeksiyöz olmayan üveitlerin tedavisinde kullan›lmakta olan immunsupresan ajanlar, ba¤›fl›kl›k sistemini genel olarak bask›lamakta veya sapt›rmaktad›rlar. Bu tedavi yöntem-lerinin sebep olduklar› ciddi yan etkiler ile tedaviye dirençli olgular, hekimleri yeni tedavi aray›fllar›na itmektedir. Son y›llarda araflt›r›lan biyolojik ajanlar, inflamatuar süreçteki öz-gün molekülleri (proteinleri) etkileyerek ba¤›fl›kl›k sisteminde daha s›n›rl› ancak etkin bir tedavi sa¤lamaktad›rlar. Biyolojik ajanlar, moleküler rekombinant DNA teknolojisi kullan›larak elde edilen proteinlerdir. Bu ajanlar›n büyük ço¤un-lu¤u monoklonal antikorlard›r. fiu an için enfeksiyöz olmayan üveitlerin tedavisinde bafll›ca kullan›lan biyolojik ajanlar 3 grupta s›n›fland›r›labilir; i. Interferon-α, ii. TNF-α antagonistleri ve iii. Çeflitli sitokin veya yüzey membran proteini gibi farkl› hedeflere yönelik antikorlar veya füzyon proteinleri.

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“…Vaccination programs are significantly different across Europe for what concerns period of initiation of the programs age and target population (newborns, adolescent and pre-adolescent drugs in HIV infected subjects [1] . Several case series and case reports describing patients who are infected with HIV and were treated with anti-TNF medications for various indications have been published and all the patients who were submitted to therapy had a satisfactory CD4 cells count, no co-infection, and low HIV viral load [71] . However, because there are limited data on the effect of treatment with HAART on the course of concomitant HIV and IBD, no recommendations are available [1] .…”

Section: Cytomegalovirusmentioning

confidence: 99%

“…TST and QFT-TB Gold/QFT-TB Gold In-Tube had a rate of uniformity of 85% (95%CI: 77-90), while the conformity of TST and T-SPOT.TB was 72% (95%CI: [64][65][66][67][68][69][70][71][72][73][74][75][76][77][78]. A relevant problem in interpreting these results is the occurrence of indeterminate test.…”

Section: Mycobacterium Tuberculosismentioning

confidence: 99%

What is the best way to manage screening for infections and vaccination of inflammatory bowel disease patients?

Andrisani

Armuzzi

Marzo

et al. 2016

WJGPT

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increased risk of opportunistic infections, in particular of viral or bacterial etiology. Despite the existence of international guidelines, many gastroenterologists have not adopted routine screening and vaccination in those patients with IBD, which are candidate for biologic therapy. Available strategies to screen, diagnose and prevent bacterial and viral infections in patients with IBD prior to start biological therapy are discussed in this review. Core tip: The increasing use of biologics as a mainstay of therapy in inflammatory bowel disease (IBD) is associated with an increased risk for a variety of infections, many of which are preventable by prior screening and vaccination. While immunocompetent IBD patients can be vaccinated using standard vaccination schedule, special guidelines need to be followed for IBD patients getting immunosuppressive therapy (IST). This article provides a review of the issues surrounding immunizations in the IBD patient and a practical guide for clinicians regarding the appropriate screening for infections and vaccinations to administer both before and during IST. AbstractThe use of biological agents and immunomodulators for inflammatory bowel disease (IBD) is associated with an REVIEWSubmit a

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The use of anti-tumour necrosis factor therapy in HIV-positive individuals with rheumatic disease

Abstract: This retrospective series of eight patients suggests that treatment with anti-TNF-alpha therapy is a viable alternative in HIV patients without advanced disease with associated rheumatic diseases refractory to standard therapy.

Cited by 179 publications

References 13 publications

Human immunodeficiency virus infection presenting as an unusual arthropathy

Human immunodeficiency virus infection presenting as an unusual arthropathy

New Treatment Alternatives in the Management of Non-İnfectious İntraocular İnflammations: Biologic Agents

What is the best way to manage screening for infections and vaccination of inflammatory bowel disease patients?

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