WorldWideScience

Sample records for behandling med infliximab

  1. Pneumocystepneumoni ved behandling med infliximab

    DEFF Research Database (Denmark)

    Josephson, Maria Eklund; Kristensen, Lena Hagelskjaer; Andersen, Vibeke

    2008-01-01

    The treatment of ulcerative colitis has improved since the appearance of Tumor Necrosis Factor (TNF)-alpha inhibitors. However, the use of TNF-alpha inhibitors increases the risk of opportunistic infections. We describe two cases of Pneumocystis jiroveci pneumonia during infliximab therapy...... for active ulcerative colitis. They were successfully treated with sulfametoxazole/trimetroprim. High awareness of P. jiroveci pneumonia in patients who develop pulmonary symptoms with hypoxia during TNF-alpha modulator therapy is recommended....

  2. Legionella pneumoni hos patienter, der er i behandling med infliximab

    DEFF Research Database (Denmark)

    Vinter, Hanne; Nielsen, Henrik Ib

    2009-01-01

    Therapy with tumour necrosis factor-alfa inhibitors is widely used in various inflammatory disorders, but adverse events from severe infections with intracellular pathogens may occur. We describe two cases of severe pulmonary legionellosis in patients treated with infliximab for Crohn's disease...

  3. Behandling af misbrugere med tilbagefald

    DEFF Research Database (Denmark)

    Sørensen, Johanne Korsdal

    igen er på stoffer og ønsker et nyt behandlingforløb. Tilbagefaldsbehandlingen består af 14 dages afgiftning på Kongens Ø, derefter seks ugers Gorski behandling på Knogens Ø, hvor der er fokus på tilbagefaldsproblematikken. Derefter kommer klienterne tilbage til Esbjerg, hvor de starter i...

  4. Psykomotorisk behandling og wellness til personer med demens

    DEFF Research Database (Denmark)

    Stamp, Anne Schinkel; Frausing, Kristian Park

    Rapporten evaluerer projektet Psykomotorisk behandling af personer med demens gennem fokusgruppeinterviews med deltagende studerende og personale fra deltagende centre. Samlet peges der på gavnligt udbytte for de demente beboere samt både personligt og fagligt udbytte for de deltagende studerende...

  5. Fysisk rehabilitering i forbindelse med behandling af hæmatologiske sygdomme

    DEFF Research Database (Denmark)

    Høgdal, Nina; Bartels, Frederik Reith; Smith, Nicholas Simon

    2015-01-01

    I denne statusartikel vurderes det, hvorvidt det eksisterende fysioterapeutiske træningstilbud under behandling af maligne sygdomme med højdosis kemoterapi og perifer stamcellestøtte (HD-ASCT) lever op til anbefalingerne i Kræftplan III. Alle seks hospitaler i Danmark, som behandler patienter med...

  6. Tværsektorielt samarbejde ved behandling af patienter med type 2-diabetes

    DEFF Research Database (Denmark)

    Munch, Lene; Røder, Michael E; Hansen, Ida H

    2018-01-01

    Hovedbudskaber • Sundhedsstyrelsen lægger vægt på tværsektorielt samarbejde omkring patienten med type 2-diabetes, men denne tankegang er dog ikke implementeret i det danske sundhedsvæsen • På organisatorisk niveau kan en stratificerings- og forløbsmodel give anvisninger til opgave- og...... udnyttelse af sundhedsvæsenets ressourcer samtidig med, at behandling af høj kvalitet fastholdes og udvikles for patienter med type 2-diabetes...

  7. Frakturerede fortænder – behandling med direkte plast

    DEFF Research Database (Denmark)

    Pallesen, Ulla; van Dijken, Jan WV

    2018-01-01

    Kompositte plastmaterialer og adhæsivteknik har gjort det muligt at restaurere frakturerede fortænder med minimal risiko for pulpale og parodontale komplikationer hos både børn og voksne. Behandlingen kan udføres umiddelbart efter traumet, hvis skaden ikke involverer parodontium eller knogle. Kla...

  8. Hvilken evidens er der for behandling af depression hos børn og unge med kognitiv terapi?

    DEFF Research Database (Denmark)

    Sørensen, Merete Juul; Thomsen, Per Hove

    2007-01-01

    Depression hos børn og unge er relativt hyppigt forekommende og kan have svære konsekvenser. Den specifikke antidepressive behandling kan være psykoterapeutisk eller medikamentel. I artiklen gennemgås på baggrund af systematisk litteratursøgning den videnskabelige evidens for effekten af kognitiv...... adfærdsterapi hos børn og unge med depression....

  9. Behandling af reumatoid artrit med anti-tumornekrosefaktor-alpha-antistof. Individuel monitorering af biotilgaengelighed og immunogenicitet-- sekundaerpublikation

    DEFF Research Database (Denmark)

    Bendtzen, Klaus; Geborek, Pierre; Svenson, Morten

    2007-01-01

    Remicade/infliximab is effective in rheumatoid arthritis (RA), but response failure is frequent. Sera from 106 RA patients were monitored using an RIA for functional infliximab and an RIA for anti-infliximab antibody (Ab). S-infliximab varied considerably, e.g. 0-22 microg/ml before the 3rd infus...

  10. Behandling af reumatoid artrit med anti-tumornekrosefaktor-alpha-antistof. Individuel monitorering af biotilgaengelighed og immunogenicitet-- sekundaerpublikation

    DEFF Research Database (Denmark)

    Bendtzen, Klaus; Geborek, Pierre; Svenson, Morten

    2007-01-01

    infusion, and 44% were Ab-positive after 6 months. Low s-infliximab was associated with Ab development and later therapeutic failure, and high Ab levels could be related to dose increases, side-effects and cessation of therapy. Pharmacological monitoring should help optimize anti-TNF therapies.......Remicade/infliximab is effective in rheumatoid arthritis (RA), but response failure is frequent. Sera from 106 RA patients were monitored using an RIA for functional infliximab and an RIA for anti-infliximab antibody (Ab). S-infliximab varied considerably, e.g. 0-22 microg/ml before the 3rd...

  11. Behandling med implanterbar defibrillator

    DEFF Research Database (Denmark)

    Roseva-Nielsen, Natasha G; Svendsen, Jesper Hastrup

    2003-01-01

    About 20 years ago the first patient received an implantable cardioverter defibrillator (ICD), and since then the number of implants have increased dramatically. The ICD can terminate ventricular fibrillation and ventricular tachycardia. Studies of secondary prophylaxis show that ICD treatment can...

  12. Svær interstitiel lungesygdom på grund af infliximab og azathioprin hos en patient med colitis ulcerosa

    DEFF Research Database (Denmark)

    Hansen, L. K.; Cecere, Stefano; Thøgersen, Thøger

    2014-01-01

    A 41-year-old man developed severe interstitial lung disease (ILD) after treatment with infliximab (IFX) and azathioprine (AZA). A relapse of ulcerative colitis was treated with corticosteroids (CS) and IFX as rescue therapy. Following remission AZA was given as prophylaxis. AZA was initiated...

  13. Behandling af hydatidose med albendazol

    DEFF Research Database (Denmark)

    Magnussen, P; Gelletlie, R; Bygbjerg, Ib Christian

    1989-01-01

    Eight patients with hydatidosis treated with albendazol in daily doses of 10 mg/kg daily in courses of 28 days (4-6 courses) were analysed. The patients came from Morocco, Spain, Turkey and Yugoslavia. Seven patients had a cyst (or cysts) in the liver and one had also cysts in the kidneys. One...

  14. Receptindløst anti-osteoporotisk behandling i Danmark

    DEFF Research Database (Denmark)

    Hansen, Carrinna; Konradsen, Hanne; Pedersen, Birthe D.

    den farmaceutiske behandling er fortsat uklare. Formål: At opnå en dybere forståelse af patienters liv med osteoporose ved at bestemme omfanget af, samt beskrive faktorer vedrørende receptindløst compliance og vedholdenhed af oral anti-osteoporotisk behandling blandt nye brugere af oral anti......-osteoporotisk medicin i Danmark. Metode: En epidemiologisk registerbaseret national åben kohorte undersøgelse af compliance og vedholdenhed af anti-osteoporotisk behandling. Undersøgelsen omfattede 100.949 mænd og kvinder. Statistiske analyser blev anvendt til at forklare årsager til behandlingssvigt, herunder backward...... præparater, hormon behandling, prednisolon og anti-depressiva, ko-morbiditeter særligt 3 og derover, lunge og reumatologisk lidelser. Konklusion: Studiets fund bidrager med ny viden vedrørende compliance problematikken, ved at beskrive afgørende faktorer for potentielle risikogrupper. Resultaterne peger...

  15. Eksperimentel bakteriofagterapi til behandling af kronisk Pseudomonas aeruginosaotitis hos hund

    DEFF Research Database (Denmark)

    Moodley, Arshnee; Mølgaard, Jesper

    2016-01-01

    Vi beskriver en case med anvendelsen af bakteriofager til behandling af kronisk otitis forårsaget af multiresistente Pseudomonas aeruginosa som en sidste behandlingsmulighed før aflivning. Trods gentagne behandlinger, både topikalt og systemisk, med op til seks forskellige antibiotika over en...

  16. Behandling af digital dermatitis på KFC

    DEFF Research Database (Denmark)

    Krogh, Kenneth; Thomsen, Peter

    2008-01-01

    På Kvægbrugets Forsøgscenter blev de rutinemæssige klovbade i maj 2007 erstattet med månedlige tjek af klove i beskærerboks og behandling af klovlidelser, herunder især Digital Dermatitis. Behandlingseffekten har været høj med 90 % helbredte efter en måned. Udgivelsesdato: april 2008......På Kvægbrugets Forsøgscenter blev de rutinemæssige klovbade i maj 2007 erstattet med månedlige tjek af klove i beskærerboks og behandling af klovlidelser, herunder især Digital Dermatitis. Behandlingseffekten har været høj med 90 % helbredte efter en måned. Udgivelsesdato: april 2008...

  17. Hvilken evidens er der for medikamentel behandling af depression hos børn og unge?

    DEFF Research Database (Denmark)

    Thomsen, Per Hove; Sørensen, Merete Juul

    2007-01-01

    Depression hos børn og unge er relativt hyppigt forekommende og kan have svære konsekvenser. Den specifikke antidepressive behandling kan være psykoterapeutisk eller medikamentel. I artiklen gennemgås på baggrund af systematisk litteratursøgning den videnskabelige evidens for medikamentel...... behandling af depression hos børn og unge med hovedvægten lagt på de mest veldokumenterede medikamenter: selektive serotoningenoptagelseshæmmere....

  18. Klinisk retningslinje for opsporing af angst og/eller depression hos indlagte og ambulante patienter med kronisk obstruktiv lungesygdom

    DEFF Research Database (Denmark)

    Strømstad, Grisja Vorre; Stassen, Ingelise Trosborg; Lassen Nielsen, Stine

    2015-01-01

    Formålet med den kliniske retningslinje er, at identificere screeningsredskaber der kan opspore angst og depression hos patienter med KOL, så patienter med angst og/eller depression bliver tilbudt relevant behandling....

  19. Behandling af Tourettes syndrom med aripiprazol

    DEFF Research Database (Denmark)

    Stenstrøm, Anne Dorte; Sindø, Ingrid

    2008-01-01

    Tourette's syndrome (TS) is a motoric disorder characterised by multiple motor and vocal tics. The treatment for patients with moderate to severe TS includes antipsychotic medication. A case report is described in which a 20 year-old male had taken antipsychotic medication since the age of five......, due to TS. The initial treatment consisted of pimozide and risperidone, both of which had an unsatisfactorily efficacy on tics and side effects in the form of weight gain and sedation. The patient is now treated with aripiprazole and there is a marked reduction of tics and no side effects...

  20. Bilateral akillesseneruptur efter behandling med ciprofloxacin

    DEFF Research Database (Denmark)

    Attarzadeh, Amir Pasha; Ryge, Camilla

    2013-01-01

    We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment...

  1. Behandling med kosmetiske bløddelsfyldere

    DEFF Research Database (Denmark)

    Thyssen, Jacob Pontoppidan; Christensen, Lise H; Zachariae, Claus O C

    2007-01-01

    An increasing number of patients undergo soft-tissue augmentation. The quality depends on the applied filler substance, the compliance of the patient and the physician. Long-term adverse reactions are referred to as nodules or granulomas. Nodules following degradable gels and polyacrylamide hydro...... hydrogel are always caused by bacteria. Nodules following inert, hydrophobic silicone gel and combination gels may emerge years after the injection. They are often caused by a low-grade infection with ensuing enhanced fibrosis and treatment requires a specialist....

  2. Bilateral akillesseneruptur efter behandling med ciprofloxacin

    DEFF Research Database (Denmark)

    Attarzadeh, Amir Pasha; Ryge, Camilla

    2013-01-01

    We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment with cipr......We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment...... with ciprofloxacin 500 mg twice daily and long-term treatment with prednisolon 10 mg once daily. This rare side effect caused by concurrent treatment with steroids and ciprofloxacin should be kept in mind. Any signs of tendinitis following this treatment should arouse the physicians' suspicion towards ciprofloxacin....

  3. Impotens forarsaget af behandling med methotrexat

    DEFF Research Database (Denmark)

    Penninga, Ida Elisabeth Irene; Larsen, H.K.; Andersen, S.E.

    2008-01-01

    impotence nine months after initiation of treatment. Two weeks after discontinuation of MTX the impotence subsided, but when MTX treatment was reintroduced, the impotence returned after two months. Only a few other cases of impotence associated with MTX have been described previously Udgivelsesdato: 2008/1/28...

  4. Nyrefunktionen under behandling med angiotensinkonverterende enzymhaemmere

    DEFF Research Database (Denmark)

    Rasmussen, K; Heitmann, M; Nielsen, J I

    1995-01-01

    -inhibitors on renal haemodynamics and kidney function, which may be positive, with preservation of kidney function in diabetic and other chronic nephropathy, or negative, for example in cases with atherosclerotic stenosis of large or small renal arteries. It is concluded, that in cases of diabetic nephropathy an ACE......The use of ACE-inhibitors has increased greatly during the last years. They were first used in treating hypertension, but nowadays cardiac diseases, mainly cardiac failure, are common indications. This means that the drugs are used in the treatment of more elderly patients who often have...... generalised atherosclerosis. This means that the patients must be controlled more often after initiation of treatment, especially concerning kidney function, since treatment with ACE-inhibitors can cause pronounced changes in renal haemodynamics and kidney function. This review focuses on the effects of ACE...

  5. Behandling af diabetes mellitus med biologiske laegemidler

    DEFF Research Database (Denmark)

    Larsen, Claus Morten; Mandrup-Poulsen, Thomas

    2008-01-01

    Biologic therapeutics are currently not approved for the treatment of patients with type 1 and type 2 diabetes. However, promising results from recent randomized controlled studies suggest that biologic therapeutics have therapeutic potential. This article summarizes the causal steps of the patho......Biologic therapeutics are currently not approved for the treatment of patients with type 1 and type 2 diabetes. However, promising results from recent randomized controlled studies suggest that biologic therapeutics have therapeutic potential. This article summarizes the causal steps...... of the pathogenesis of type 1 and type 2 diabetes which are targeted by biologic therapeutics and reviews the treatment results. Udgivelsesdato: 2008-Jun-9...

  6. Behandling af diabetes mellitus med biologiske laegemidler

    DEFF Research Database (Denmark)

    Larsen, Claus Morten; Mandrup-Poulsen, Thomas

    2008-01-01

    Biologic therapeutics are currently not approved for the treatment of patients with type 1 and type 2 diabetes. However, promising results from recent randomized controlled studies suggest that biologic therapeutics have therapeutic potential. This article summarizes the causal steps...... of the pathogenesis of type 1 and type 2 diabetes which are targeted by biologic therapeutics and reviews the treatment results. Udgivelsesdato: 2008-Jun-9...

  7. Behandling af ideopatisk hypereosinofilt syndrom med imatinib

    DEFF Research Database (Denmark)

    Sørensen, Anne Louise; Larsen, Herdis

    2008-01-01

    We here report a case of idiopathic hypereosinophilic syndrome with prompt response to treatment with imatinib. The patient presented with chest pain, myalgias, fatigue and weakness. Blood tests and bone marrow examination revealed striking eosinophilia. Clonal or reactive disorders were excluded...... by a wide range of diagnostic examinations. Treatment with high-dosis corticosteroids and hydroxyurea had little effect. Additional treatment with imatinib resulted in prompt symptomatic improvement and full haematological remission within five days of therapy. Udgivelsesdato: 2008-Jan-21...

  8. Behandl dig selv med honning"

    DEFF Research Database (Denmark)

    Mejrup, Kristian; Bjerring-Nielsen, Mattias

    2015-01-01

    with a heavenly figure, a potent Joseph lookalike, who reveals to her inexpressible secrets mediated in an exuberant honeycomb. The revelatory capacity of honey is stylistically rendered by means of repetition, pleonasm, chorus, reprises and gestures. The encounter with “Das ganz Andere” does not leave Aseneth...... entirely perturbed and paralysed. In fact, her free speech and wits remain as if protected by a honeysweetened agency. The article emphasizes the necessity of a ‘conversion’ by the reader enabling him to grasp the sublime potential of the aesthetics of sweetness....

  9. Gruppebaseret behandling af BED - et faseopdelt behandlingstilbud

    DEFF Research Database (Denmark)

    Laust, Jakob; Lau, Marianne Engelbrecht; Waaddegaard, Mette

    2015-01-01

    Titel: Afrapportering vedr. SATS-puljemidler til behandling og erfaringsopsamling vedr. BED for perioden 1. marts 2013 – 1. maj 2015. Baggrund: Binge Eating Disorder (BED), på dansk tvangsoverspisning, er en udbredt, men overset spiseforstyrrelse med alvorlige psykiske, fysiske og sociale...... konsekvenser. BED blev i 2013 optaget i DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) som en selvstændig diagnose og BED forventes medtaget i den forestående revision af det internationale diagnose system, ICD-11. Sundhedsstyrelsen gav på denne baggrund satspuljemidler til erfaringsopsamling...... vedr. BED. I den forbindelse ansøgte Ambulatorium for Spiseforstyrrelser på Psykoterapeutisk Center Stolpegård ovenstående midler til at udvikle en ambulant, primært psykoterapeutisk gruppebehandling til patienter med moderat til svær BED med fokus på såvel spiseforstyrrelse såvel som overvægt. Metode...

  10. Akupunktur til patienten med kvalme og opkastning i forbindelse med kemoterapi - er der evidens for dette?

    DEFF Research Database (Denmark)

    Pedersen, Birgith; Sørensen, Lene Bundgaard; Stricker, Lisbeth

    2008-01-01

      Patienter, der får kemoterapi med højemetogene stoffer lider stadig af kvalme og opkastning trods understøttende behandling med moderne antieemtika som 5HT3-antagonister eksempelvis ondansetron. Akupunkturstimulation anvendes for flere lidelser i sundhedsvæsenet og det undersøges om der er evid...

  11. Mindfulness som smertehåndteringsredskab for kvinder med endometriose

    DEFF Research Database (Denmark)

    Jensen, Mette Kold; Vedsted-Hansen, Hanne; Hansen, Tia G. B.

    2011-01-01

    Endometriose er en kronisk underlivssygdom med smerter og en række afledte problemer, som ikke nødvendigvis kan behandles med lægelige tiltag. Artiklen argumenterer for, at en mindfulness-baseret tilgang med fokus på smertehåndtering kan anvendes til denne klientgruppe. I vestlig terapeutisk samm...

  12. Farmakologisk behandling av antisosiale lidelser : en litteraturstudie av evidensgrunnlaget for famakologisk behandling av psykopati og assosierte antisosiale personlighetstrekk og atferdsmønster

    OpenAIRE

    Romberg, Sara Montes

    2016-01-01

    Bakgrunn: Psykoterapeutiske og atferdsbaserte intervensjoner har vist seg å ha liten effekt ved antisosiale lidelser. Individer med antisosiale lidelser anses derfor som en relativt behandlingsresistent pasientgruppe, hvilket tyder på et behov for utvikling av alternative behandlingstilnærminger. Med bakgrunn i dette søker følgende studie å utforske evidensgrunnlaget for farmakologiske behandling av antisosiale lidelser og trekk. Metode: Litteratursøk i databasene BIBSYS, ProQuest, Web of ...

  13. Forskning i ergoterapeutisk behandling indenfor neurorehabilitering - en stor udfordring og nødvendighed!

    DEFF Research Database (Denmark)

    Schow, Trine

    2011-01-01

    Der sker i disse år meget indenfor både forskning og behandling i neurorehabilitering. Både grundforskning og kliniske studier bidrager til viden om neuroplasticitet og til udvikling og dokumentation af forskellige behandlingsformer og det er vigtigt at det ergoterapeutiske felt følger med. Denne...

  14. Akut induceret diabetes mellitus hos en patient i behandling for metastaserende malignt melanom

    DEFF Research Database (Denmark)

    Bisgaard Jørgensen, Line; Yderstræde, Knud Bonnet

    2018-01-01

    Behandling med immuncheckpointhæmmere ved dissemineret malignt melanom har vundet betydeligt indpas i de seneste par år pga. effekten på overlevelsen hos patienterne med denne lidelse. Der er beskrevet en række endokrinologisk relaterede bivirkninger af behandlingen, herunder hypofysitis og...... tyroiditis/myksødem. På kasuistisk niveau er der desuden beskrevet få tilfælde af akut opstået diabetes mellitus...

  15. Infliximab-Related Infusion Reactions: Systematic Review

    Science.gov (United States)

    Ron, Yulia; Kivity, Shmuel; Ben-Horin, Shomron; Israeli, Eran; Fraser, Gerald M.; Dotan, Iris; Chowers, Yehuda; Confino-Cohen, Ronit; Weiss, Batia

    2015-01-01

    Objective: Administration of infliximab is associated with a well-recognised risk of infusion reactions. Lack of a mechanism-based rationale for their prevention, and absence of adequate and well-controlled studies, has led to the use of diverse empirical administration protocols. The aim of this study is to perform a systematic review of the evidence behind the strategies for preventing infusion reactions to infliximab, and for controlling the reactions once they occur. Methods: We conducted extensive search of electronic databases of MEDLINE [PubMed] for reports that communicate various aspects of infusion reactions to infliximab in IBD patients. Results: We examined full texts of 105 potentially eligible articles. No randomised controlled trials that pre-defined infusion reaction as a primary outcome were found. Three RCTs evaluated infusion reactions as a secondary outcome; another four RCTs included infusion reactions in the safety evaluation analysis; and 62 additional studies focused on various aspects of mechanism/s, risk, primary and secondary preventive measures, and management algorithms. Seven studies were added by a manual search of reference lists of the relevant articles. A total of 76 original studies were included in quantitative analysis of the existing strategies. Conclusions: There is still paucity of systematic and controlled data on the risk, prevention, and management of infusion reactions to infliximab. We present working algorithms based on systematic and extensive review of the available data. More randomised controlled trials are needed in order to investigate the efficacy of the proposed preventive and management algorithms. PMID:26092578

  16. At leve med osteoporose

    DEFF Research Database (Denmark)

    Hansen, Carrinna; Abrahamsen, Bo; Konradsen, Hanne

    Baggrund: Livet med kronisk sygdom, heriblandt osteoporose, giver anledning til verdensomspændende udfordringer. Osteoporose er ofte en usynlig tilstand før knoglebrud opstår, det er anslået, at hver tredje kvinde og en af fire mænd over 50 år i Europa vil opleve disse typer af knoglebrud og det...... med betydelig sygelighed og dødelighed til følge. At leve med en kronisk tilstand påvirker ofte menneskets livssituation, både specifikt, emotionelt og eksistentielt, hvordan dette opleves er individuelt og det er endnu uklart hvordan osteoporose påvirker den enkeltes livssituation. Formål: At opnå en...... dybere forståelse af livet med osteoporose ved at undersøge ny-diagnosticerede kvinders erfaringer med at leve med osteoporose når medicinsk behandling med henblik på frakturforebyggelse var ordineret. Metode: Et kvalitativt studie med en fænomenologisk-hermeneutisk tilgang, samt et longitudinelt design...

  17. Alternativ behandling og kræft

    DEFF Research Database (Denmark)

    Lunde, Anita; Johannessen, Helle

    2010-01-01

    Baggrund: Interessen for komplementær og alternativ behandling (KAB) er stadig stigende, og der kan dokumenteres et større forbrug af KAB blandt kræftpatienter. Patienter anvender primært KAB som supplement til deres konventionelle behandling, og mange så gerne KAB som en integreret praksis. Fler...

  18. Primary and secondary nonresponse to infliximab: mechanisms and countermeasures.

    Science.gov (United States)

    Wong, Uni; Cross, Raymond K

    2017-10-01

    Primary and secondary non-response to infliximab are common in patients with inflammatory bowel disease and remain a management challenge in clinical practice. Areas covered: This article describes the epidemiology, mechanisms and risk factors for primary and secondary nonresponse to infliximab in patients with inflammatory bowel disease. Data on proactive and reactive therapeutic drug monitoring are examined in this review. An algorithm for evaluation and management of non-response to infliximab is provided. Preventative measures are also discussed. Relevant articles were identified after a literature search using PubMed. Search terms included 'infliximab', 'loss of response', 'immunogenicity', and 'drug monitoring'. References of identified articles were also reviewed to identify additional references. Expert opinion: A common cause for primary and secondary non-response include inadequate dosing of infliximab; inadequate dosing can be identified through assessment of drug and anti-drug antibody levels. Therapeutic drug monitoring should be done in patients losing response to infliximab. Use of drug monitoring proactively is still under debate.

  19. Folkeretlige problemstillinger i forbindelse med konflikten mellem Ukraine og Rusland

    DEFF Research Database (Denmark)

    Buhl, Kenneth Øhlenschlæger

    Konflikten mellem Ukraine og Rusland udgør en trussel mod den internationale retsorden og dermed også hele den europæiske orden. Med henblik på at give et grundlag for at forstå omfanget af dette aspekt af konflikten behandles her lovligheden af nogle af de handlinger, som har været konfliktens...

  20. Decreased clinical response to infliximab in ankylosing spondylitis is correlated with anti-infliximab formation

    NARCIS (Netherlands)

    de Vries, Mirjam K.; Wolbink, Gerrit Jan; Stapel, Steven O.; de Vrieze, Henk; van Denderen, J. Christiaan; Dijkmans, Ben A. C.; Aarden, Lucien A.; van der Horst-Bruinsma, Irene E.

    2007-01-01

    OBJECTIVES: Correlation of serum trough infliximab levels and antibodies to infliximab (anti-infliximab) with clinical response in ankylosing spondylitis. METHODS: In accordance with the international ASsessment in Ankylosing Spondylitis (ASAS) consensus statement, patients were treated with

  1. Forebyggelse og behandling af osteoporose i forbindelse med behandling af ikke-metastaserende prostatacancer

    DEFF Research Database (Denmark)

    Eiken, Pia Agnete; Langdahl, Bente Lomholt; Eiken, Frederik L

    2011-01-01

    The prevention of cancer treatment-induced bone loss in patients with prostatae cancer due to gonadotropin-releasing hormone (GnRH)-agonist, GnRH-antagonist and orchidectomi therapy has a high priority. We present an algorithm for the prevention and treatment of osteoporosis during treatment of non......-metastatic prostate cancer....

  2. Den haemostatiske balance under behandling med nyere p-pillepraeparater

    DEFF Research Database (Denmark)

    Petersen, K R; Skouby, S O; Sidelmann, Johannes Jakobsen

    1994-01-01

    Thirty-four healthy young women were allocated to 12 consecutive cycles of treatment with monophasic combinations of: 20 micrograms ethinyl estradiol and 150 micrograms desogestrel (n = 15) or 30 micrograms ethinyl estradiol and 75 micrograms gestodene (n = 19). In both groups plasma levels of fi...

  3. Graviditet i livmoderhalsen kan behandles konservativt med methotrexat

    DEFF Research Database (Denmark)

    Sørensen, Marie; Clausen, Helle Vibeke

    2011-01-01

    with systemic methotrexate. The patient with the living cervical ectopic pregnancy had stable vital signs during the period of treatment. The patient with the fetal pole was admitted with heavy vaginal bleeding and anaemia and was stabilised before treatment was initiated. She was stable throughout......Two cases of cervical ectopic pregnancy after in vitro fertilization embryo transfer were managed conservatively. One living cervical ectopic pregnancy was treated with intra-amniotic and systemic injection of methotrexate, and the other cervical ectopic pregnancy with a fetal pole was treated...

  4. Omkostningseffektivitet ved behandling af type 1-diabetes med insulinpumpe

    DEFF Research Database (Denmark)

    Nørgaard, Kirsten; Sohlberg, Anna; Goodall, Gordan

    2010-01-01

    This study's aim was to project the long-term clinical and economic outcomes of continuous subcutaneous insulin infusion (CSII) treatment compared to multiple daily injections (MDI) in type 1 diabetes patients in Denmark.......This study's aim was to project the long-term clinical and economic outcomes of continuous subcutaneous insulin infusion (CSII) treatment compared to multiple daily injections (MDI) in type 1 diabetes patients in Denmark....

  5. Karakteristik, diagnostik og behandling af patienter med autoimmun hepatitis

    DEFF Research Database (Denmark)

    Ytting, Henriette; Larsen, Fin Stolze

    2012-01-01

    Autoimmune hepatitis is a relatively rare disease that may lead to rapidly progressing liver cirrhosis and even fulminant liver failure, if diagnosis and treatment is delayed or ineffective. Diagnosing the disease can be challenging, and one in five patients respond insufficiently to standard...... treatment. Patients, who are diagnosed late in the disease course or only respond partly to medical treatment, are at high risk of developing severe liver insufficiency. This article summarizes the present knowledge and evidence regarding diagnostics, therapy and disease course....

  6. Behandling af centralnervesystemlymfom efter transplantation med monoklonalt antistof og ganciclovir

    DEFF Research Database (Denmark)

    Hansen, P.B.; Al-Farra, G.

    2010-01-01

    A 35-year-old female was diagnosed with a primary central nervous system posttransplant Epstein-Barr-virus-associated lymphoproliferative disorder three years after a renal transplantation. The histological diagnosis of the brain tumour was a diffuse large B-cell lymphoma. The patient had had...... diabetes mellitus for 28 years and was treated with four weekly doses of the monoclonal antibody rituximab, the antiviral drug ganciclovir and high-dose prednisolone, and the immune suppression was reduced. After four weeks of treatment, a control magnetic resonance image showed complete regression...

  7. Behandling af metforminassocieret laktatacidose med hæmodialyse

    DEFF Research Database (Denmark)

    Schousboe, Karin; El Fassi, Daniel; Secher, Erik Lilja

    2012-01-01

    Metformin-associated lactate acidosis is rare but serious and characterized by metabolic acidosis and elevated lactate. We describe a single-institution experience of four cases in one year. Despite pH levels of 6.85 to 7.12 and lactate levels of 11-28 mmol/l three of the patients survived. Two...

  8. Behandling af juvenile angiofibromer med partikelembolisering og endoskopisk kirurgi

    DEFF Research Database (Denmark)

    Thuesen, Anne Daugaard; Jakobsen, John; Nepper-Rasmussen, Jørgen

    2005-01-01

    AND METHODS: A retrospective review of the eight patients who have been treated since 1997 was done. The embolization, which was carried out in the radiotherapy department, was done with polyvinyl alcohol particles in the vessels that supply the tumor. The operation was then performed in the ear, nose...... and throat department of OUH. The tumor was removed endoscopically in all cases in which it was possible. RESULTS: All eight patients were embolized preoperatively. The average preoperative bleeding was 375 ml, a little less when endoscopic access was possible. This is in agreement with the literature...

  9. Behandling af peritoneal karcinose med laparoskopisk intraperitoneal kemoterapi under tryk

    DEFF Research Database (Denmark)

    Graversen, Martin; Pfeiffer, Per; Mortensen, Michael Bau

    2016-01-01

    Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new treatment option in patients with peritoneal carcinomatosis (PC). PIPAC has proven efficacious in the treatment of PC from ovarian, colon and gastric cancer. PIPAC has a favourable profile regarding safety for patients and occupati......Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new treatment option in patients with peritoneal carcinomatosis (PC). PIPAC has proven efficacious in the treatment of PC from ovarian, colon and gastric cancer. PIPAC has a favourable profile regarding safety for patients...

  10. Medicinsk behandling af patienter med primær hyperparathyroidisme

    DEFF Research Database (Denmark)

    Vestergaard, Peter; Mosekilde, Leif

    2009-01-01

    Surgery is the recommended treatment for primary hyperparathyroidism. For exceptional medical treatment, the main drugs available are cinacalcet to normalize plasma calcium, and bisphosphonates to prevent bone loss. The patients eligible for medical therapy are those who cannot be operated or whose...

  11. Behandling af pilonidalcyster med neodynium-yttriumaluminiumgranat-laser

    DEFF Research Database (Denmark)

    Lindholt, Christine S; Lindholt, Jes S; Lindholt, Jan

    2008-01-01

    A 23 year-old woman with a nonsupporative pilonidal cyst was successfully treated causally with Nd-YAG laser, and without any recidivate after 9 months follow-up. The mechanism is presumed to be that YAG-laser has a wave-length of 1064 nm. Consequently, the wave penetration through the skin is de...... is deeper than most other lasers before the energy is absorbed in melanin and oxyhaemoglobin, so the contents of the cyst can be reached and destroyed. The treatment could be a very attractive alternative to open surgery. Udgivelsesdato: 2008-Jun-23...

  12. Behandling af pilonidalcyster med neodynium-yttriumaluminiumgranat-laser

    DEFF Research Database (Denmark)

    Lindholt, Christine S; Lindholt, Jes Sanddal; Lindholt, Jan

    2008-01-01

    A 23 year-old woman with a nonsupporative pilonidal cyst was successfully treated causally with Nd-YAG laser, and without any recidivate after 9 months follow-up. The mechanism is presumed to be that YAG-laser has a wave-length of 1064 nm. Consequently, the wave penetration through the skin is de...... is deeper than most other lasers before the energy is absorbed in melanin and oxyhaemoglobin, so the contents of the cyst can be reached and destroyed. The treatment could be a very attractive alternative to open surgery....

  13. Behandling af centralnervesystemlymfom efter transplantation med monoklonalt antistof og ganciclovir

    DEFF Research Database (Denmark)

    Hansen, P.B.; Al-Farra, G.

    2010-01-01

    A 35-year-old female was diagnosed with a primary central nervous system posttransplant Epstein-Barr-virus-associated lymphoproliferative disorder three years after a renal transplantation. The histological diagnosis of the brain tumour was a diffuse large B-cell lymphoma. The patient had had...

  14. Laktatacidose ved behandling af type 2-diabetes med metformin

    DEFF Research Database (Denmark)

    Holst, Helle; Eldrup, Ebbe; Guldstad, Nana Harriet

    2012-01-01

    Metformin (MET) is the first-line agent in treatment of type 2 diabetes. However, MET has been associated with lactic acidosis (MALA), a potential but rare complication which has influenced treatment strategies in decades. Recently, guidelines have been changed in regards of age and heart failure...... and the contradiction of chronic renal impairment has been debated. This article identifies potential risk groups and situations that would benefit from a temporary interruption in the MET treatment....

  15. Palliativ behandling af patienter med terminal kronisk obstruktiv lungesygdom

    DEFF Research Database (Denmark)

    von Plessen, Christian; Nielsen, Thyge L; Steffensen, Ida E

    2011-01-01

    Terminal chronic obstructive pulmonary disease (COPD) and advanced cancer have similar prognosis and symptom burden. However, palliative care of patients with terminal COPD has been neglected in Denmark. We describe the symptoms of terminal COPD and suggest criteria for defining the palliative ph...

  16. Muskuloskeletal behandling af 11-årig med artrogrypose

    DEFF Research Database (Denmark)

    Thomsen, Maria Morandi; Thomsen, Stig Aaberg; Due, Pernille

    2010-01-01

    A two-year-old patient was diagnosed with arthrogryposis because of inflected knees (15-20 degrees) and stiff hamstrings. All joints and reflexes were normal. Activities were described as age-appropriate, but the patient walked with inflected knees and increased lumbal lordosis. Physiotherapy and...... and botox did not improve the condition. Because of pain and hampered activities, the patient - now aged 11 years - was treated with musculoskeletal medicine. After treatment the patient could walk normally without pain and stand with stretched knees.......A two-year-old patient was diagnosed with arthrogryposis because of inflected knees (15-20 degrees) and stiff hamstrings. All joints and reflexes were normal. Activities were described as age-appropriate, but the patient walked with inflected knees and increased lumbal lordosis. Physiotherapy...

  17. Graviditet i livmoderhalsen kan behandles konservativt med methotrexat

    DEFF Research Database (Denmark)

    Sørensen, Marie; Clausen, Helle Vibeke

    2011-01-01

    Two cases of cervical ectopic pregnancy after in vitro fertilization embryo transfer were managed conservatively. One living cervical ectopic pregnancy was treated with intra-amniotic and systemic injection of methotrexate, and the other cervical ectopic pregnancy with a fetal pole was treated...... with systemic methotrexate. The patient with the living cervical ectopic pregnancy had stable vital signs during the period of treatment. The patient with the fetal pole was admitted with heavy vaginal bleeding and anaemia and was stabilised before treatment was initiated. She was stable throughout...

  18. HIV kan og skal behandles samtidig med tuberkulose

    DEFF Research Database (Denmark)

    von der Maase, Sarah; Gerstoft, Jan; Wejse, Christian

    2014-01-01

    The proper timing of antiretroviral therapy (ART) to HIV-patients co-infected with tuberculosis has been debated. We review three studies on this matter. One study found a significant reduced mortality for patients with CD4+ T-cell counts (CD4+) ≤ 200 per mm3 who received ART early, whereas...... the other two studies found this difference for patients with CD4+ HIV after the initiation of ART....

  19. Behandling af metforminassocieret laktatacidose med hæmodialyse

    DEFF Research Database (Denmark)

    Schousboe, Karin; El Fassi, Daniel; Secher, Erik Lilja

    2012-01-01

    Metformin-associated lactate acidosis is rare but serious and characterized by metabolic acidosis and elevated lactate. We describe a single-institution experience of four cases in one year. Despite pH levels of 6.85 to 7.12 and lactate levels of 11-28 mmol/l three of the patients survived. Two o...... of the patients had normal kidney function previous to hospitalization. Treatment includes fluid replacement, IV sodium bicarbonate and haemodialysis....

  20. Behandling af kroniske sygdomme hos patienter med demens

    DEFF Research Database (Denmark)

    Pedersen, Hanne; Klinkby, Kristian Skikkild; Waldorff, Frans Borch

    2017-01-01

    Comorbidity is common in patients with dementia, and due to the nature of the dementia disease, patients with dementia have special challenges in relation to comorbidity. This article is about dementia and heart failure, chronic obstructive pulmonary disease, urinary incontinence, falls...

  1. Trombosering af mekanisk mitralklapprotese under behandling med dabigatran

    DEFF Research Database (Denmark)

    Thomsen, Jakob Hartvig; Kjaergaard, Jesper; Saust, Laura Trolle

    2014-01-01

    Dabigatran has been approved for prevention of thromboembolic complications in nonvalvular atrial fibrillation. We present a case of thrombosis of a mechanical prosthetic mitral valve during anticoagulation with dabigatran, switched from warfarin. The patient presented with cardiogenic shock......, was treated with thrombolytic therapy and discharged with warfarin therapy. Dabigatran in patients with mechanical valve prosthesis should be avoided and echocardiography is indicated if dyspnoea develops in such patients....

  2. Myopati hos en patient i behandling med simvastatin og fluconazol

    DEFF Research Database (Denmark)

    Pedersen, Jens Kristian; Lydolph, Magnus Christian; Somnier, Finn

    2016-01-01

    A 69-year-old female was admitted due to progressive loss of muscle strength following addition of fluconazole to long-term simvastatin treatment. Rhabdomyolysis was suspected and both drugs were discontinued. Forced diuresis was initiated together with a short course of prednisolone. After 21...

  3. Infliximab dependency in children with Crohn's disease

    DEFF Research Database (Denmark)

    Duricova, D; Pedersen, N; Lenicek, M

    2009-01-01

    BACKGROUND: Recently, infliximab dependency has been described. AIM: To assess frequency of ID in 82 consecutive Crohn's disease children treated with infliximab 2000-2006 and to describe clinical and genetic predictors of long-term infliximab response. METHODS: A phenotype model of infliximab....../partial response. In long-term outcome, 22% maintained prolonged response, 12% had no response, while 66% became infliximab dependent. Perianal disease and no previous surgery were associated with infliximab dependency (OR 5.34, 95% CI: 1.24-22.55; OR 6.7, 95% CI: 1.67-26.61). No association was found with studied...... polymorphisms. The cumulative probability of surgery 50 months after starting infliximab was 10% in infliximab dependency, 30% in prolonged responders and 70% in nonresponders (P = 0.0002). CONCLUSIONS: Sixty-six per cent of children became infliximab dependent. Perianal disease and no surgery prior...

  4. Længerevarende behandling af børn og unge i sikrede pladser

    DEFF Research Database (Denmark)

    Bonke, Jens; Kofoed Rasmussen, Lene

    I slutningen af 1990'erne blev der åbnet for, at landets sikrede institutioner kunne anvendes til længerevarende behandlingsforløb for unge kriminelle eller kriminalitetstruede. Ordningen har kun været benyttet i ringe grad og har været praktiseret meget forskelligt i de involverede institutioner....... Denne evaluering bidrager således først og fremmest til at rejse en række spørgsmål, der kan være med til at kvalificere perspektiverne i at anbringe og behandle unge i sikret regi. Nogle institutioner har iværksat en egentlig behandlingsindsats, mens andre i højere grad har set det som deres opgave...... hurtigst muligt at få de unge anbragt i ikke-sikret regi. De unge er desuden meget forskellige, hvilket gør det vanskeligt at vurdere virkningen af længerevarende behandling i sikret regi. Evalueringen af ordningen bygger på interview med de respektive amter, med de implicerede institutioner, med unge der...

  5. Teknologiers mellemkomst i ambulant behandling og egenomsorg

    DEFF Research Database (Denmark)

    Ballegaard, Stinne Aaløkke; Aarhus, Rikke

    2009-01-01

    Vigtige tendenser i den danske sundhedssektor i disse år er centralisering af behandling og øget egenomsorg. Teknologi ses ofte som en del af denne udvikling, omend der eksisterer både dystopiske og utopiske forestillinger om, hvorvidt teknologi fremmedgør eller støtter patienten. I denne artikel...

  6. Infliximab: 12 years of experience

    Science.gov (United States)

    2011-01-01

    Rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are immune-mediated conditions that share an inflammatory mechanism fuelled by excessive cytokines, particularly TNF. Control of inflammation and rapid suppression of cytokines are important in treating these diseases. With this understanding and the corresponding advent of TNF inhibitors, RA patients, AS patients and PsA patients have found more choices than ever before and have greater hope of sustained relief. As a widely used TNF inhibitor, infliximab has a deep and established record of efficacy and safety data. Extensive evidence - from randomised controlled clinical trials, large registries and postmarketing surveillance studies - shows that infliximab effectively treats the signs and symptoms, provides rapid and prolonged suppression of inflammation, prevents radiologically observable disease progression and offers an acceptable safety profile in RA, AS and PsA. In very recent studies, investigators have observed drug-free remission in some patients. Additionally, infliximab may interfere with rapidly progressing disease in RA by early addition to methotrexate in patients with signs of an aggressive course. Finally, infliximab has been shown to reduce PsA clinical manifestations such as nail involvement. With our current understanding, substantial data and increasing confidence regarding use in practice, infliximab can be considered a well-known drug in our continued campaign against inflammatory rheumatic diseases. PMID:21624181

  7. Infliximab Biosimilar (CT-P13; Infliximab-dyyb): A Review in Autoimmune Inflammatory Diseases.

    Science.gov (United States)

    Blair, Hannah A; Deeks, Emma D

    2016-10-01

    Infliximab biosimilar (CT-P13/infliximab-dyyb; Remsima ® , Inflectra ® ) is approved in several countries for use in all indications for which reference infliximab (Remicade ® ) is approved, including rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis, psoriasis, Crohn's disease, and ulcerative colitis. Clinical data contributing to the EU approval of infliximab biosimilar were obtained from two pivotal double-blind clinical trials in patients with AS (PLANETAS) or RA (PLANETRA). Infliximab biosimilar demonstrated equivalence to reference infliximab in terms of its pharmacokinetic profile in patients with AS, patients with RA, and in healthy volunteers, and in terms of its efficacy in patients with RA. Clinical response rates in patients with RA or AS were maintained over the longer term (up to 102 weeks). In addition, the efficacy of infliximab biosimilar in patients with RA or Crohn's disease and ulcerative colitis [i.e. inflammatory bowel disease (IBD)] has been demonstrated in the real-world setting. Infliximab biosimilar was generally well tolerated, with a tolerability profile similar to that of reference infliximab. Switching from reference infliximab to infliximab biosimilar had no detrimental effect on efficacy, safety, or immunogenicity compared with continuous infliximab biosimilar therapy, according to the extensions of PLANETAS and PLANETRA, and real-world data in IBD. Current evidence therefore suggests that infliximab biosimilar is a useful alternative to reference infliximab in patients with autoimmune inflammatory diseases.

  8. A systematic review on the efficacy and safety of Infliximab in patients with psoriasis

    Science.gov (United States)

    Wang, Jin; Zhan, Qingxia; Zhang, Litao

    2016-01-01

    ABSTRACT Objective: To assess the efficacy and safety of infliximab for the treatment of psoriasis in a meta-analysis framework. Methods: Data were extracted by searching the EMBASE (1974–2014), PubMed(1966–2014) and the Cochrane library2013.4th databases. Only randomized and placebo-controlled studies were selected in this study. Results: Statistically significant differences in efficacy were found for the infliximab (3 or 5 mg/kg) group compared with the control group which received placebo in the treatment of psoriasis vulgaris [OR 13.55, 95%CI (11.14,16.48)]or[OR85.45, 95%CI (39.13,186.58)]. There were also significant differences in efficacy between the infliximab (5 mg/kg) group and the placebo control group during treatment of psoriasis arthritis (PsA) [OR8.36, 95%CI (5.63, 12.40)]. A controlled trial used infliximab (5 mg/kg) in the treatment of palmoplantar psoriasis. This study showed that the effective rate of the infliximab group was 33.3% (4/12) when compared to the placebo control group, which was 8.3% (1/12). Conclusion: Infliximab is significantly associated with symptom relief, skin lesion improvement, and an increase in the quality of life of psoriasis patients. The most common drug-induced adverse events were pain, hepatic dysfunction, and infusion reaction. PMID:26528924

  9. Cut-off levels and diagnostic accuracy of infliximab trough levels and anti-infliximab antibodies in Crohn's disease

    DEFF Research Database (Denmark)

    Steenholdt, Casper; Bendtzen, Klaus; Brynskov, Jørn

    2011-01-01

    Reasons for infliximab failure in Crohn's disease and ulcerative colitis are debated. Serum levels of infliximab and anti-infliximab antibodies have been associated with loss of response. We aimed at determining cut-off levels for infliximab and anti-infliximab antibody concentrations associated...

  10. Endring i adaptiv atferd hos eldre personer med utviklingshemning - en sammenligning mellom personer med Down syndrom og personer med annen utviklingshemning

    Directory of Open Access Journals (Sweden)

    Anne Marit Bygdnes

    2012-01-01

    Materiale og metode: Undersøkelsen omfatter 87 personer med utviklingshemning som tidligere har bodd på en sentralinstitusjon. Datainnsamling skjedde ved at omsorgspersoner fylte ut ABDQ.  Resultater: Det var 24 % i utvalget som hadde nedgang i adaptiv atferd. Fortolkning: ABDQ er et hjelpemiddel til å avdekke nedgang i adaptiv atferd. Det er viktig at svikt avdekkes tidligst mulig og videreformidles til helsepersonell for utredning, diagnostisering, relevant behandling og tilrettelagte helse- og omsorgstjenester. Mange personer med utviklingshemning mestrer ikke å informere om egen helsetilstand og er avhengig av at omsorgspersonalet kan avdekke sykdom og lidelser så tidlig som mulig i sykdomsforløpet.

  11. Guidelines for treatment with infliximab for Crohn's disease

    NARCIS (Netherlands)

    Hommes, D. W.; Oldenburg, B.; van Bodegraven, A. A.; van Hogezand, R. A.; de Jong, D. J.; Romberg-Camps, M. J. L.; van der Woude, J.; Dijkstra, G.

    2006-01-01

    Infliximab is an accepted induction and maintenance treatment for patients with Crohn's disease. The effectiveness of infliximab has been demonstrated for both active luminal disease and for enterocutaneous fistulisation. In addition, infliximab can be administered for extraintestinal symptoms of

  12. Guidelines for treatment with infliximab for Crohn's disease.

    NARCIS (Netherlands)

    Hommes, D.W.; Oldenburg, B.; Bodegraven, A.A; Hogezand, R.A. van; Jong, D.J. de; Romberg-Camps, M.; Woude, J. van der; Dijkstra, G.

    2006-01-01

    Infliximab is an accepted induction and maintenance treatment for patients with Crohn's disease. The effectiveness of infliximab has been demonstrated for both active luminal disease and for enterocutaneous fistulisation. In addition, infliximab can be administered for extraintestinal symptoms of

  13. Behandling med valproat under graviditet: beskrivelse af fire cases med føtalt valproatsyndrom

    DEFF Research Database (Denmark)

    Sabers, Anne; Larsen, Katja; Blichfeldt, Susanne

    2009-01-01

    INTRODUCTION: Treatment with valproate is associated with an increased risk of teratogenicity compared to other antiepileptic drugs and can cause a complex of serious symptoms usually referred to as "foetal valproate symdrome" which is characterised by major and minor malformations in association...... treated with valproate during pregnancy, were neuropediatrically and neuropsychologically examined in a non-acute setting. The mothers were screened for the 677C-T mutation. RESULTS: Four of seven examined children fulfilled the criteria for foetal valproate syndrome. Only one of the four mothers...... was heterozygote for the 677C-T mutation (CT, n = 1/4) and none of the mothers were homozygote (TT, n = 0/4) CONCLUSION: The foetal valproate syndrome is a complex of symptoms which is probably underdiagnosed and should be considered in the diagnostic evaluation program for children with developmental delay who...

  14. Behandling med valproat under graviditet: beskrivelse af fire cases med føtalt valproatsyndrom

    DEFF Research Database (Denmark)

    Sabers, Anne; Larsen, Katja; Blichfeldt, Susanne

    2009-01-01

    treated with valproate during pregnancy, were neuropediatrically and neuropsychologically examined in a non-acute setting. The mothers were screened for the 677C-T mutation. RESULTS: Four of seven examined children fulfilled the criteria for foetal valproate syndrome. Only one of the four mothers......INTRODUCTION: Treatment with valproate is associated with an increased risk of teratogenicity compared to other antiepileptic drugs and can cause a complex of serious symptoms usually referred to as "foetal valproate symdrome" which is characterised by major and minor malformations in association...... was heterozygote for the 677C-T mutation (CT, n = 1/4) and none of the mothers were homozygote (TT, n = 0/4) CONCLUSION: The foetal valproate syndrome is a complex of symptoms which is probably underdiagnosed and should be considered in the diagnostic evaluation program for children with developmental delay who...

  15. Angioneurotisk ødem i forbindelse med behandling med angiotensinkonverterende enzym-haemmer

    DEFF Research Database (Denmark)

    Johansen, E C; Johansen, J B; Døssing, H

    1996-01-01

    illustrate problems in the diagnosis and management of this life-threatening condition, and also demonstrate that angioedema re-occurs if the ACE inhibitor is not discontinued. If angioedema is suspected, therapy with any angiotensin converting-enzyme inhibitor should be discontinued promptly, respiratory...

  16. Epstein-Barr-virus-associeret lymfom hos en patient med colitis ulcerosa i behandling med azathioprin

    DEFF Research Database (Denmark)

    Kofoed, Kristian; Kiszka-Kanowitz, Marianne; Albrectsen, Jens Mørch

    2008-01-01

    A 28 year-old man with ulcerative colitis treated for 10 years with azathioprine (AZA) returned from Central Asia with fever, swollen lymph glands, hepatosplenomegaly, and pancytopenia. He was tested positive for acute Epstein-Barr virus (EBV) infection. Before the final diagnosis of EBV...

  17. Behandling med valproat under graviditet: beskrivelse af fire cases med føtalt valproatsyndrom

    DEFF Research Database (Denmark)

    Sabers, Anne; Larsen, Katja; Blichfeldt, Susanne

    2009-01-01

    INTRODUCTION: Treatment with valproate is associated with an increased risk of teratogenicity compared to other antiepileptic drugs and can cause a complex of serious symptoms usually referred to as "foetal valproate symdrome" which is characterised by major and minor malformations in association...

  18. Succesfuld behandling af svær dabigatranoverdosering med idarucizumab hos en patient med nyresvigt

    DEFF Research Database (Denmark)

    Poulsen, Christina Gjerlev; Bestle, Morten; Boesby, Lene

    2017-01-01

    In the course of an uncomplicated sigmoidostomy a 63-year-old male who had severe comorbidity developed a critical bleeding due to dabigatran intoxication induced by acute kidney injury. Massive blood transfusions, tranexamic acid, Octaplex and haemodialysis were not effective. Administration of ...... of idarucizumab induced immediate clinical and paraclinical improvement. Dabigatran should be carefully administrated in patients who have any degree of renal insufficiency. Idarucizumab may be effective in severe bleeding caused by dabigatran.......In the course of an uncomplicated sigmoidostomy a 63-year-old male who had severe comorbidity developed a critical bleeding due to dabigatran intoxication induced by acute kidney injury. Massive blood transfusions, tranexamic acid, Octaplex and haemodialysis were not effective. Administration...

  19. Antibodies toward infliximab are associated with low infliximab concentration at treatment initiation and poor infliximab maintenance in rheumatic diseases

    Science.gov (United States)

    2011-01-01

    Introduction A proportion of patients receiving infliximab have antibodies toward infliximab (ATI), which are associated with increased risk of infusion reaction and reduced response to treatment. We studied the association of infliximab concentration at treatment initiation and development of ATI as well as the association of the presence of ATI and maintenance of infliximab. Methods All patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA) receiving infliximab beginning in December 2005 were retrospectively followed until January 2009 or until infliximab discontinuation. Trough serum infliximab and ATI concentrations were measured at each visit. The patients were separated into two groups: ATIpos if ATI were detected at least once during the follow-up period and ATIneg otherwise. Repeated measures analysis of variance was used to study the association of infliximab concentration at treatment initiation and the development of ATI. Maintenance of infliximab in the two groups was studied by using Kaplan-Meier curves. Results We included 108 patients: 17 with RA and 91 with SpA. ATI were detected in 21 patients (19%). The median time to ATI detection after initiation of infliximab was 3.7 months (1.7 to 26.0 months). For both RA and SpA patients, trough infliximab concentration during the initiation period was significantly lower for ATIpos than ATIneg patients. RA patients showed maintenance of infliximab at a median of 19.5 months (5.0 to 31.0 months) and 12.0 months (2.0 to 24.0 months) for ATIneg and ATIpos groups, respectively (P = 0.08). SpA patients showed infliximab maintenance at a median of 16.0 months (3.0 to 34.0 months) and 9.5 months (3.0 to 39.0 months) for ATIneg and ATIpos groups, respectively (P = 0.20). Among SpA patients, those who were being treated concomitantly with methotrexate had a lower risk of developing ATI than patients not taking methotrexate (0 of 14 patients (0%) vs. 25 of 77 patients (32%); P = 0.03). Conclusions High

  20. Infliximab maintenance therapy for fistulizing Crohn's disease

    NARCIS (Netherlands)

    Sands, Bruce E.; Anderson, Frank H.; Bernstein, Charles N.; Chey, William Y.; Feagan, Brian G.; Fedorak, Richard N.; Kamm, Michael A.; Korzenik, Joshua R.; Lashner, Bret A.; Onken, Jane E.; Rachmilewitz, Daniel; Rutgeerts, Paul; Wild, Gary; Wolf, Douglas C.; Marsters, Paul A.; Travers, Suzanne B.; Blank, Marion A.; van Deventer, Sander J.

    2004-01-01

    Infliximab, a monoclonal antibody against tumor necrosis factor, is an effective maintenance therapy for patients with Crohn's disease without fistulas. It is not known whether infliximab is an effective maintenance therapy for patients with fistulas. We performed a multicenter, double-blind,

  1. Low Dose Infliximab for Prevention of Postoperative Recurrence of Crohn’s Disease: Long Term Follow-Up and Impact of Infliximab Trough Levels and Antibodies to Infliximab

    Science.gov (United States)

    Sorrentino, Dario; Marino, Marco; Dassopoulos, Themistocles; Zarifi, Dimitra; Del Bianco, Tiziana

    2015-01-01

    Objective In patients with postoperative recurrence of Crohn’s disease endoscopic and clinical remission can be maintained for up to 1 year with low infliximab doses (3 mg/Kg). However, in theory low-dose infliximab treated patients could develop subtherapeutic trough levels, infiximab antibodies, and might loose response to therapy. To verify this hypothesis infliximab pharmacokinetics and clinical/endoscopic response were checked in a group of patients treated in the long term with low infliximab doses. Design Infliximab antibodies, infliximab levels, highly-sensitive CRP and fecal calprotectin were measured during the 8-week interval in 5 consecutive patients in clinical (Crohn’s Disease Activity Index infliximab 3 mg/Kg. For comparison with reported standards, infliximab pharmacokinetics and inflammatory parameters were also tested in 6 Crohn’s disease patients who did not undergo surgery and who were in clinical remission while on infliximab 5 mg/Kg. Patients on low infliximab dose also underwent colonoscopy after 18 additional months of therapy. Results Highly sensitive CRP and fecal calprotectin increased in all patients during the 8-week interval. Infliximab trough levels were lower in patients treated with the low dose compared to controls (mean±SE: 2.0±0.3 vs 4.75±0.83 μg/mL respectively pInfliximab antibodies were present in two of the subjects treated with low infliximab dose and in none of the controls. However, in low dose-treated patients after 18 additional months of therapy endoscopy continued to show mucosal remission and none of them developed clinical recurrence or side effects. Conclusions Patients treated with low infliximab doses had lower trough levels compared to patients treated with 5 mg/Kg and some developed antibodies to infliximab. However, low infliximab doses sustained clinical and endoscopic remission for a total of 30 months of treatment. PMID:26670274

  2. Hjemtagning af dialysebehandling til grønlandske patienter med kronisk nyresvigt

    DEFF Research Database (Denmark)

    Kronborg, Christian; Kjær, Trine; Bech, Mickael

    en periode på 10 år forventes at medføre ekstraomkostninger på ca. 13,9 millioner kroner sammenlignet med at lade patienterne behandle som nu på Rigshospitalet i København. Det vil altså sige en gennemsnitlig ekstraomkostning på ca. 4 millioner kroner om året. Estimatet er dog påvirkeligt at flere...

  3. INFLIXIMAB IN TREATMENT OF REFRACTORY JUVENILE ARTHRITIS

    Directory of Open Access Journals (Sweden)

    I.P. Nikishina

    2010-01-01

    Full Text Available Inclusion to the clinical practice of genetically engineered biological medications opens new opportunities in treatment of juvenile arthritis. The article summarizes an experience of treatment of juvenile arthritis with infliximab in children’s department of Scientific Center of Rheumatology, Russian Academy of Medical Sciences. The analysis included 55 patients (16 children had systemic type, 23 — polyarticular type of juvenile arthritis, and 16 patients had juvenile spondylarthritis, treated with infliximab in 2002–2009 years. Infliximab was administrated in patients with high activity of the disease refractory to the modern basic therapy. Patients received intravenous infliximab 3–5 mg/kg daily according to the standard scheme (on 0, 2, 6 weeks and further every 8 weeks. Therapy with this drug was estimated as effective (improvement on 30% and more according ACRpedi in 80% of patients: 16% achieved ACR30, 29% — ACR50, 26% — ACR70, and 9% — ACR90. Unfavorable effects (infusion reactions were detected in 16% of cases. Infections, including one case of disseminated tuberculosis, developed in 20% of patients. Thus, treatment with infliximab is effective and has good «risk–benefit» ratio in treatment of patients with refractory juvenile arthritis. Key words: children, juvenile arthritis, infliximab, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1:142-149

  4. A Study Investigating the Association of Dermatological and Infusion Reactions to Infliximab and Infliximab Trough Levels

    Directory of Open Access Journals (Sweden)

    Vivian Wai-Mei Huang

    2015-01-01

    Full Text Available BACKGROUND: Although infliximab is an effective therapy for inflammatory bowel disease (IBD, it is associated with dermatological events and infusion reactions. It is not known whether a relationship between these adverse events (AEs and infliximab trough levels (ITLs exists.

  5. Comparison of Techniques for Monitoring Infliximab and Antibodies Against Infliximab in Crohn's Disease

    DEFF Research Database (Denmark)

    Steenholdt, Casper; Ainsworth, Mark A; Tovey, Michael

    2013-01-01

    Several techniques are used to measure infliximab (IFX) and anti-IFX antibodies (Abs) in Crohn's disease. The aim of this study was to compare different assays for this purpose.......Several techniques are used to measure infliximab (IFX) and anti-IFX antibodies (Abs) in Crohn's disease. The aim of this study was to compare different assays for this purpose....

  6. Outcomes After Primary Infliximab Treatment Failure in Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

    Buhl, Sine; Steenholdt, Casper; Rasmussen, Maria

    2017-01-01

    primary infliximab treatment failure, the majority of patients (n = 51, 63%) had inflammatory bowel disease-related surgery (Crohn's disease n = 19, 58%; ulcerative colitis n = 32, 67%; P = 0.49). There was a markedly increased risk of surgery in patients with primary infliximab treatment failure...... treated with infliximab as first-line anti-tumor necrosis factor treatment at a tertiary center. Primary infliximab treatment failure was defined as no clinical improvement during infliximab induction therapy resulting in discontinuation of infliximab therapy. RESULTS: A total of 560 patients (Crohn...... as compared to initial responders: odds ratio 6.3 (3.8-10.6), P disease 1 year after primary infliximab treatment failure. CONCLUSIONS: Primary infliximab treatment failure is associated with poor outcome including high risk...

  7. Infliximab, azathioprine, or combination therapy for Crohn's disease

    DEFF Research Database (Denmark)

    Colombel, Jean Frédéric; Sandborn, William J; Reinisch, Walter

    2010-01-01

    The comparative efficacy and safety of infliximab and azathioprine therapy alone or in combination for Crohn's disease are unknown.......The comparative efficacy and safety of infliximab and azathioprine therapy alone or in combination for Crohn's disease are unknown....

  8. Skattemæssig behandling af virtuelle valutaer

    DEFF Research Database (Denmark)

    Kjærsgaard, Louise Fjord; Weber, Katja Dyppel

    2018-01-01

    Udbredelsen og anvendelsen af virtuelle valutaer er stigende, og der synes derfor behov for en analyse af den skattemæssige kvalifikation og behandling heraf. Skatterådet har ved to lejligheder haft mulighed for at foretage denne analyse; i henholdsvis SKM2014.226.SR om Bitcoins og SKM2017.520.SR...

  9. Biosimilar infliximab use in paediatric IBD.

    Science.gov (United States)

    Richmond, Lisa; Curtis, Lee; Garrick, Victoria; Rogers, Pam; Wilson, Michelle; Tayler, Rachel; Henderson, Paul; Hansen, Richard; Wilson, David C; Russell, Richard K

    2018-01-01

    Biosimilar infliximab became available in the UK in 2015. Paediatric experience to date on its use is limited. We prospectively evaluated the safety and efficacy of biosimilar infliximab (Remsima) in two paediatric gastroenterology networks in patients with inflammatory bowel disease. Prospective clinical data were collected from laboratory reports, electronic patient records and case notes of 40 patients starting Remsima for the first time. Disease activity scores together with blood and stool biomarkers were used to assess response. Our data set highlights that Remsima was associated with a significant clinical and biochemical improvement (pinfliximab is as effective as originator infliximab and its use is associated with significant cost savings. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Infliximab in Russian clinical practice

    Directory of Open Access Journals (Sweden)

    G V Lukina

    2012-01-01

    Full Text Available The study of infliximab began (INF in Russia in 2001. It was the first genetically engineered biological agent (GEBA registered in our country to treat patients with rheumatoid arthritis (RA. With the advent of infliximab, a Russian biological rheumatoid arthritis therapy registry started its work. In October 2005, it was set up on the basis of GEBA centers founded in the leading rheumatology clinics of Russia. Objective: to generalize the Russian experience in using INF (its efficacy, tolerance, and side effects in patients with RA in real clinical practice within the framework of a multicenter observational study. Subjects and methods. The register included patients with a valid diagnosis of RA in whom INF treatment was first started. The main indication for this was previous basic therapy failure. This investigation analyzed 396 patients receiving INF therapy. Prior to INF administration, all the patients were examined to identify whether they had possible latent tuberculosis, by applying chest X-ray study and Mantoux test. The European League Against Rheumatism criteria were used to evaluate the efficiency of INF therapy. The relationship between the therapeutic effects of the drug and its cumulative dose was specially used. The trend in X-ray progression was estimated using the Sharp method modified by van der Heijde. INF was given in a dose of 3 mg/kg by the classical regimen: at 0, 2, and 6 weeks, then every 8 weeks. The main assessment periods were at 22 and 46—54 weeks. Results. Analysis of the data of real clinical practice in Russia demonstrates that the use of INF in RA patients with the inadequate effect of traditional disease-modifying antirheumatic drugs (DMARDs is able to cause a rapid and pronounced reduction in disease activity. There is significant evidence that the IFN-treated patients with RA had also suppressed bone destruction. INF treatment for early RA gives rise to remissions more frequently in the early stage of

  11. Infliximab eye drops treatment in corneal neovascularization.

    Science.gov (United States)

    Voiculescu, O B; Voinea, L M

    2015-01-01

    Corneal neovascularization is a serious condition that may arise secondary to chemical burns, ischemia, infection, trauma, and inflammation and represents a major cause of blindness. This study investigated the efficacy of topical application of infliximab [tumor necrosis factor-a (TNF-a) monoclonal antibody] in the treatment of corneal neovascularization in the rabbit model.

  12. Infliximab for the treatment of ulcerative colitis

    NARCIS (Netherlands)

    Eshuis, Emma J.; Bemelman, Willem A.; Stokkers, Pieter C. F.

    2009-01-01

    Infliximab (IFX), an anti-TNF biologic agent, has been demonstrated to offer benefits for the treatment of autoimmune disorders, such as rheumatoid arthritis and Crohn's disease. Several trials have also investigated the efficacy of IFX for the treatment of ulcerative colitis (UC). IFX was found to

  13. Relationship between serum trough infliximab levels, pretreatment C reactive protein levels, and clinical response to infliximab treatment in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Wolbink, G. J.; Voskuyl, A. E.; Lems, W. F.; de Groot, E.; Nurmohamed, M. T.; Tak, P. P.; Dijkmans, B. A. C.; Aarden, L.

    2005-01-01

    Objective: To investigate the relationship between serum trough infliximab levels and clinical response to infliximab treatment in patients with rheumatoid arthritis (RA). Methods: Disease activity and serum trough infliximab levels before and 2, 6, and 14 weeks after initiation of infliximab

  14. Antibodies to Infliximab Are Associated with Lower Infliximab Levels and Increased Likelihood of Surgery in Pediatric IBD

    Science.gov (United States)

    Zitomersky, Naamah L.; Atkinson, Benjamin J.; Fournier, Kerri; Mitchell, Paul D.; Stern, Julia Bender; Butler, Michael C.; Ashworth, Lori; Hauenstein, Scott; Heiner, Linda; Chuang, Emil; Singh, Sharat; Bousvaros, Athos

    2017-01-01

    Background Adult studies suggest antibodies to infliximab (ATI) correlate with loss of response in inflammatory bowel disease but pediatric data are limited. Methods We conducted a cross-sectional study of trough infliximab levels and ATI in 134 pediatric and young adult patients receiving infliximab. At the time serum was obtained demographics, disease phenotype, duration of infliximab therapy, use of combination therapy (methotrexate or 6-mercaptopurine with infliximab), and surgery were recorded. Results Assays were performed on 134 subjects currently receiving infliximab (85 male; mean age, 17.3 ± 4.3 years; 114 Crohn’s disease and 20 ulcerative colitis). Infliximab use ranged from 12 days to 12 years: median 2.0 (interquartile range [1.1–4.3]) years. Twenty-seven of 134 (20%) patients had ATI ≥5 U/mL. Of patients with ATI ≥5 U/mL, 59% had infliximab levels infliximab infusions. Sixty percent who underwent surgery had ATI ≥12 U/mL; in contrast, only 8% of patients who did not undergo surgery had ATI ≥12 U/mL (P = 0.01). At the time of serum sampling, 50 (37%) patients were receiving combination therapy, compared with 84 (63%) on infliximab alone. Combination therapy at the time of serum sampling did not correlate with either increase infliximab levels or lower ATI compared with infliximab monotherapy. However, prior immunomodulator use was associated with lower antibody levels (P = 0.007). Conclusions ATI correlates with reduction in infliximab level and a higher risk of surgery in patients with inflammatory bowel disease. PMID:25569737

  15. Short-Term Response to Infliximab in Rheumatoid Pattern Polyarthropathy Complicating Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    ilke Coskun Benlidayi

    2015-12-01

    Full Text Available Ulcerative colitis (UC is a progressive inflammatory disease (IBD of the bowel which can be accompanied by extra-intestinal findings such as peripheral and axial arthropathies. Patients with UC sometimes display rheumatoid pattern polyarthropathy which is challenging to differ from rheumatoid arthritis. We describe a case with rheumatoid pattern polyarthropathy complicating UC and her favourable response to infliximab therapy. A 25-year-old female with a diagnosis of UC was admitted due to swelling and pain in multiple joints. Laboratory tests revealed elevated acute phase reactants. Since the patient was refractory to the combination therapy comprising methotrexate, sulphasalazine and steroid, she was started on an infliximab regimen. She experienced an improvement both in terms of pain scores and biochemical findings. The patient was asymptomatic with reduced acute phase reactants following a 6-month-course of anti-tumor necrosis factor (anti-TNF therapy. Infliximab serves as an effective treatment option for the management of rheumatoid pattern peripheral polyarthritis associated with UC. [Cukurova Med J 2015; 40(4.000: 818-821

  16. Does smoking reduce infliximab's effectiveness against Crohn's disease?

    Science.gov (United States)

    Narula, Neeraj; Fedorak, Richard N

    2009-02-01

    Crohn's disease (CD) is an idiopathic inflammatory bowel disease and has no known cure. CD symptoms are treated using an array of medicines, including biological agents such as infliximab. However, infliximab therapy is expensive; therefore, identifying variables that can help predict response to infliximab is worthwhile. The present article reviews the impact of tobacco smoking on the efficacy of infliximab in CD. Earlier studies have speculated that smoking has a negative effect on the response to infliximab in CD, but the current literature is largely unable to identify a significant relationship between the two. Although smoking is known to have a negative effect on the course of CD, as well as other organ systems, presently, a CD patient's smoking status should not influence treatment decisions regarding infliximab therapy.

  17. A study investigating the association of dermatological and infusion reactions to infliximab and infliximab trough levels.

    Science.gov (United States)

    Huang, Vivian; Dhami, Neil; Fedorak, Darryl; Prosser, Connie; Shalapay, Carol; Kroeker, Karen I; Halloran, Brendan P; Dieleman, Levinus A; Fedorak, Richard N

    2015-01-01

    Although infliximab is an effective therapy for inflammatory bowel disease (IBD), it is associated with dermatological events and infusion reactions. It is not known whether a relationship between these adverse events (AEs) and infliximab trough levels (ITLs) exists. To report the prevalence of infliximab-associated AEs in IBD patients receiving stable maintenance infliximab therapy, and to correlate ITLs with dermatological and infusion reactions to infliximab. Adult IBD patients receiving stable maintenance infliximab therapy were recruited from the University of Alberta Infusion Clinic (Edmonton, Alberta). ITLs were measured in blood samples collected before infusion, and the patients' records were reviewed for dermatological and infusion reactions to infliximab. One-quarter (18 of 71 [25.4%]) of patients experienced dermatological or infusion reactions to infliximab: nine (12.7%) dermatological events and nine (12.7%) infusion reactions. The median ITL was similar among patients with and without these AEs (7.2 μg⁄mL [interquartile range (IQR) 2.0 μg⁄mL to 13.3 μg⁄mL] versus 6.6 μg⁄mL [IQR 3.2 μg⁄mL to 12.7 μg⁄mL]; P=0.648). The median ITL of patients who experienced infusion reactions (2.0 μg⁄mL [IQR 0.1 μg⁄mL to 5.7 μg⁄mL]) was lower than that of patients who experienced no such AEs (6.6 μg⁄mL [IQR 3.2 μg⁄mL to 12.7 μg⁄mL]; P=0.008]) and lower than that of patients who experienced dermatological AEs (13.3 μg⁄mL [IQR 8.8 μg⁄mL to 17.4 μg⁄mL]; P<0.001). One-quarter of IBD outpatients receiving stable maintenance infliximab therapy experienced dermatological and infusion reactions. Low ITLs were correlated with infusion reactions, and normal or high ITLs with dermatological events.

  18. Serious adverse events with infliximab: analysis of spontaneously reported adverse events.

    Science.gov (United States)

    Hansen, Richard A; Gartlehner, Gerald; Powell, Gregory E; Sandler, Robert S

    2007-06-01

    Serious adverse events such as bowel obstruction, heart failure, infection, lymphoma, and neuropathy have been reported with infliximab. The aims of this study were to explore adverse event signals with infliximab by using a long period of post-marketing experience, stratifying by indication. The relative reporting of infliximab adverse events to the U.S. Food and Drug Administration (FDA) was assessed with the public release version of the adverse event reporting system (AERS) database from 1968 to third quarter 2005. On the basis of a systematic review of adverse events, Medical Dictionary for Regulatory Activities (MedDRA) terms were mapped to predefined categories of adverse events, including death, heart failure, hepatitis, infection, infusion reaction, lymphoma, myelosuppression, neuropathy, and obstruction. Disproportionality analysis was used to calculate the empiric Bayes geometric mean (EBGM) and corresponding 90% confidence intervals (EB05, EB95) for adverse event categories. Infliximab was identified as the suspect medication in 18,220 reports in the FDA AERS database. We identified a signal for lymphoma (EB05 = 6.9), neuropathy (EB05 = 3.8), infection (EB05 = 2.9), and bowel obstruction (EB05 = 2.8). The signal for granulomatous infections was stronger than the signal for non-granulomatous infections (EB05 = 12.6 and 2.4, respectively). The signals for bowel obstruction and infusion reaction were specific to patients with IBD; this suggests potential confounding by indication, especially for bowel obstruction. In light of this additional evidence of risk of lymphoma, neuropathy, and granulomatous infections, clinicians should stress this risk in the shared decision-making process.

  19. Effectiveness of infliximab after adalimumab failure in Crohn's disease.

    Science.gov (United States)

    Chaparro, María; Andreu, Montserrat; Barreiro-de Acosta, Manuel; García-Planella, Esther; Ricart, Elena; Domènech, Eugeni; Esteve, María; Merino, Olga; Nos, Pilar; Peñalva, Mireia; Gisbert, Javier P

    2012-10-07

    To evaluate the effectiveness of infliximab as a second-line therapy in Crohn's disease patients after adalimumab failure. A historical cohort study in a community-based gastroenterology practice evaluated Crohn's disease patients treated with infliximab (induction plus maintenance) after adalimumab failure. Patients were identified using a large Spanish database (ENEIDA). We included 15 Crohn's disease patients who received infliximab after adalimumab failure. Five patients discontinued adalimumab due to loss of response, 3 due to adverse events and 7 due to partial response. After infliximab therapy was started, all patients who had interrupted adalimumab due to loss of efficacy regained response. All patients who discontinued adalimumab due to adverse events responded to infliximab and maintained this response; one of these patients had an uneventful course on infliximab, but 2 developed adverse events. None of the 7 patients who interrupted adalimumab due to partial response reached remission with infliximab. Switching from adalimumab to infliximab may be useful in patients who develop adverse effects or loss of response, however, the benefit of infliximab in primary nonresponders was not established.

  20. Noninvasiv behandling af slid og erosion

    DEFF Research Database (Denmark)

    Pallesen, Ulla; Dijken, Jan van

    2012-01-01

    Slid og erosion af tænder synes i dag at være et voksende problem for mange patienter. I de fleste tilfælde kan tandlægens tidlige diagnostik føre til, at forebyggende tiltag iværksættes i tide, så fortsatte skader ophører, eller progressionen begrænses. Desværre er det ikke altid muligt, og hvis...... restaureret med fuldkroner på alle tænder. Hvis behandlingen udføres med direkte plast, kan det også betyde, at omkostningerne bliver mindre, så flere får mulighed for at få udført en nødvendig rekonstruktion af tandsættet. I det følgende vil forskellige faktorer i forbindelse med tandslid og erosion blive...

  1. A study investigating the association of dermatological and infusion reactions to infliximab and infliximab trough levels

    Science.gov (United States)

    Huang, Vivian Wai-Mei; Dhami, Neil; Fedorak, Darryl; Prosser, Connie; Shalapay, Carol; Kroeker, Karen Ivy; Halloran, Brendan Phillip; Dieleman, Levinus Albert; Fedorak, Richard Neil

    2015-01-01

    BACKGROUND: Although infliximab is an effective therapy for inflammatory bowel disease (IBD), it is associated with dermatological events and infusion reactions. It is not known whether a relationship between these adverse events (AEs) and infliximab trough levels (ITLs) exists. OBJECTIVES: To report the prevalence of infliximab-associated AEs in IBD patients receiving stable maintenance infliximab therapy, and to correlate ITLs with dermatological and infusion reactions to infliximab. METHODS: Adult IBD patients receiving stable maintenance infliximab therapy were recruited from the University of Alberta Infusion Clinic (Edmonton, Alberta). ITLs were measured in blood samples collected before infusion, and the patients’ records were reviewed for dermatological and infusion reactions to infliximab. RESULTS: One-quarter (18 of 71 [25.4%]) of patients experienced dermatological or infusion reactions to infliximab: nine (12.7%) dermatological events and nine (12.7%) infusion reactions. The median ITL was similar among patients with and without these AEs (7.2 μg/mL [interquartile range (IQR) 2.0 μg/mL to 13.3 μg/mL] versus 6.6 μg/mL [IQR 3.2 μg/mL to 12.7 μg/mL]; P=0.648). The median ITL of patients who experienced infusion reactions (2.0 μg/mL [IQR 0.1 μg/mL to 5.7 μg/mL]) was lower than that of patients who experienced no such AEs (6.6 μg/mL [IQR 3.2 μg/mL to 12.7 μg/mL]; P=0.008]) and lower than that of patients who experienced dermatological AEs (13.3 μg/mL [IQR 8.8 μg/mL to 17.4 μg/mL]; Pinfliximab therapy experienced dermatological and infusion reactions. Low ITLs were correlated with infusion reactions, and normal or high ITLs with dermatological events. PMID:25706572

  2. Adjuverende medicinsk behandling tilpatienter med lokoregionalt recidiv af brystkræft

    DEFF Research Database (Denmark)

    Farooq, Farah Choudary; Kamby, Claus

    2016-01-01

    There is 10-30% risk of developing isolated locoregional recurrence (ILRR) after mastectomy for primary breast cancer. Currently, there is no standard treatment for ILRR and therefore patients with ILRR cause an oncological task. This review investigates existing literature concerning relevant ra...

  3. Vellykket behandling af supraventrikulær takykardi med modificeret Valsalvas manøvre

    DEFF Research Database (Denmark)

    Wallentin, Johan; Sjøl, Anette

    2016-01-01

    Supraventricular tachycardia (SVT) is a frequent challenge in medical emergency units. Adenosine, the drug of choice, may cause severe discomfort. The Danish Society of Cardiology's National Treatment Guidelines for SVT recommend first aid treatment with ''vagus stimulation such as carotid massage...

  4. Akut iliofemoral venøs trombose bør behandles med kateterbaseret trombolyse

    DEFF Research Database (Denmark)

    Broholm, Rikke; Just, Sven; Jørgensen, Maja

    2012-01-01

    Treatment of acute iliofemoral deep venous thrombosis (DVT) with catheter-directed thrombolysis (CDT) has been performed in Denmark since 1999. The purpose of CDT is to dissolve thrombus and to restore the venous lumen as fast as possible and thereby save venous valve function and prevent...

  5. Risiko for anastomoselækage ved postoperativ behandling med nonsteroide antiinflammatoriske stoffer

    DEFF Research Database (Denmark)

    Klein, M.; Gögenür, Ismayil; Rosenberg, J.

    2010-01-01

    Anastomotic leakage is the most serious complication following colorectal resection. Recently, focus has been on possible effects of non-steroidal anti-inflammatory drugs (NSAIDs). Animal studies have found a correlation between treatment with NSAIDs and increased leakage rate, impaired anastomotic...... strength and reduced deposition of hydroxyproline. Retrospective human studies have reported increased leakage rates after postoperative diclofenac and celecoxib treatment. We recommend that diclofenac and celecoxib be omitted from analgesic regimens after colorectal surgery involving an anastomosis...

  6. Et Patientperspektivistisk Studie i Brug af Alternativ Behandling hos Danske Patienter med Diabetes

    DEFF Research Database (Denmark)

    Gerbild, Helle Nygaard

    2008-01-01

    prevalence in use of CAM, which is generally rather low, especially the CAM used specifically for diabetes. The objective of this paper is to develop concepts to understand patients having experiences and positions of diabetes in their use of CAM. Methods: This qualitative study its inspiration from grounded...... treatment, and this to a relatively low degree. Analyses show that they do not have the strength to follow the conventional recommendations and the alternative self-care management (CAM) at the same time, which may contribute to the understanding of diabetic non-CAM positions. Some of the established...... clients, however, are positioned as user of both complementary and alternative medicine and conventional treatments, such as biological, homeopathic, and traditional Chinese medicine. The main factors that drive them to this are the aim, the hope, the belief, and knowledge how to cure diabetes. Conclusion...

  7. Akut iliofemoral venøs trombose bør behandles med kateterbaseret trombolyse

    DEFF Research Database (Denmark)

    Broholm, Rikke; Just, Sven; Jørgensen, Maja

    2012-01-01

    Treatment of acute iliofemoral deep venous thrombosis (DVT) with catheter-directed thrombolysis (CDT) has been performed in Denmark since 1999. The purpose of CDT is to dissolve thrombus and to restore the venous lumen as fast as possible and thereby save venous valve function and prevent...... postthrombotic syndrome. Danish studies have shown that treatment of acute iliofemoral DVT using CDT results in good patency, preserves venous valve function, reduces the frequency of PTS, and is associated with a higher quality of life....

  8. Behandling med dopaminagonister i den tidlige fase af Parkinsons sygdom: gennemgang af et Cochrane-review

    DEFF Research Database (Denmark)

    Bode, Matthias

    2009-01-01

    The Cochrane analysis confirms some well-known facts: initial therapy with dopamine agonists (DA) delays the incidence of motor complications, but is associated with inferior motor control and a higher frequency of non-motor adverse events (AE) compared with levodopa. Some serious AE are missing...

  9. Risiko for anastomoselækage ved postoperativ behandling med nonsteroide antiinflammatoriske stoffer

    DEFF Research Database (Denmark)

    Klein, M.; Gögenür, Ismayil; Rosenberg, J.

    2010-01-01

    strength and reduced deposition of hydroxyproline. Retrospective human studies have reported increased leakage rates after postoperative diclofenac and celecoxib treatment. We recommend that diclofenac and celecoxib be omitted from analgesic regimens after colorectal surgery involving an anastomosis...

  10. Kardiovaskulære risici ved behandling med nonsteroide antiinflammatoriske lægemidler

    DEFF Research Database (Denmark)

    Schmidt, Morten; Fosbøl, Emil Loldrup; Torp-Pedersen, Christian

    2016-01-01

    cyclooxygenase-2 inhibitors has been associated with a substantial vascular risk but increasing concern also relates to traditional NSAIDs, in particular diclofenac. This review summarizes the current evidence regarding the cardiovascular safety of NSAIDs and presents recommendations for their use....

  11. Manglende evidens for skadelig effekt på knogleheling ved behandling med NSAID

    DEFF Research Database (Denmark)

    Janum, Susanne; Kristensen, Billy Bjarne

    2012-01-01

    The use of NSAIDs for postoperative pain management following orthopaedic surgery or during conservative treatment of fractures is controversial. Experimental animal models suggest NSAIDs inhibit bone healing. In a review of the literature, there was no clinical evidence to support categorical...... discard of NSAID for postoperative pain relief in uncomplicated cases. However, NSAID should be considered a potentiel risk factor of impaired bone healing and avoided in patients with a high risk of pseudoarthrosis. Recommended daily doses should be respected and duration of treatment should be limited....

  12. Behandling med antidepressiva på geriatriske afdelinger. Forekomst og journalforing

    DEFF Research Database (Denmark)

    Rosholm, Jens-Ulrik; Mortensen, Hanne Hollaender; Svensson, Birthe Hjorth

    2003-01-01

    INTRODUCTION: The aim of the present study was to describe the occurrence of antidepressant treatment in geriatric departments in Denmark and assess the notes of the patient records in connection with prescription. MATERIAL AND METHODS: Patient records for consecutively referred patients in seven...

  13. Udredning og behandling af osteoporose hos patienter med prostatacancer uden knoglemetastaser

    DEFF Research Database (Denmark)

    Eiken, Pia A; Langdahl, Bente Lomholt; Eiken, Frederik L

    2011-01-01

    The prevention of cancer treatment-induced bone loss in patients with prostate cancer due to gonadotropin-releasing hormone (GnRH)-agonist, GnRH-antagonist and orchidectomi therapy has a high priority. We present an algorithm for the prevention and treatment of osteoporosis during treatment of non...

  14. Organisation af behandling og opfølgning af patienter med type 2-diabetes

    DEFF Research Database (Denmark)

    Drivsholm, Thomas Bo; Snorgaard, Ole

    2012-01-01

    The organization of treatment and control of type 2 diabetic patients in Denmark has undergone a major development within the last decade. From being based on local hospital guidelines, treatment and control have moved towards a more organized collaboration between primary and secondary care based...... on common national guidelines. Quality indicators from primary and secondary care are collected routinely, and gradually an increasingly precise depiction is documented in the National Indicator Project....

  15. Forskelle i behandling af børn med idiopatisk trombocytopenisk purpura

    DEFF Research Database (Denmark)

    Edslev, Pernille Wendtland; Kjærsgaard, Mimi; Rosthøj, Steen

    2010-01-01

    INTRODUCTION: Idiopathic thrombocytopenic purpura (ITP) is a rare immune-mediated bleeding disorder that usually takes a self-limiting and benign course. Due to the risk of intracranial haemorrhage, treatment regimens tend to be active. We present treatment data from 17 paediatric departments...

  16. Spaedbørnsdiabetes kan ofte behandles med sulfonylurinstof i stedet for insulin

    DEFF Research Database (Denmark)

    Lauridsen, Mette Høj; Boesgaard, Trine Welløv; Pedersen, Oluf Borbye

    2009-01-01

    A two-month-old Danish girl was admitted to the hospital in diabetic ketoacidosis and diagnosed with permanent neonatal diabetes mellitus (PNDM). She received continuous insulin treatment until she was genetically tested at the Steno Diabetes Centre. She carried a KCNJ11 Arg201His mutation...

  17. Spædbørnsdiabetes kan ofte behandles med sulfonylurinstof i stedet for insulin

    DEFF Research Database (Denmark)

    Lauridsen, Mette Høj; Boesgaard, Trine Welløv; Pedersen, Oluf Borbye

    2009-01-01

    A two-month-old Danish girl was admitted to the hospital in diabetic ketoacidosis and diagnosed with permanent neonatal diabetes mellitus (PNDM). She received continuous insulin treatment until she was genetically tested at the Steno Diabetes Centre. She carried a KCNJ11 Arg201His mutation...

  18. Behandling af kardiogent shock med perkutan mekanisk cirkulationsstøtte

    DEFF Research Database (Denmark)

    Junker, Anders; Kaltoft, Anne Kjer; Hassager, Christian

    2013-01-01

    Despite rapid revascularisation with circulatory support using inotropes and intra-aortic balloon counterpulsation, the mortality of cardiogenic shock complicating acute myocardial infarction still exceeds 50%. An alternative treatment strategy is restoration of cardiac output by using a ventricu......Despite rapid revascularisation with circulatory support using inotropes and intra-aortic balloon counterpulsation, the mortality of cardiogenic shock complicating acute myocardial infarction still exceeds 50%. An alternative treatment strategy is restoration of cardiac output by using...... a ventricular assist device which can be inserted in the acute setting using the Impella device, a catheter-based flow pump. DanShock is a Danish multicentre study that will assess whether circulatory support using the Impella device will improve the outcome of cardiogenic shock compared to conventional...

  19. Sekundær prævention af apopleksi med effektiv antihypertensiv behandling

    DEFF Research Database (Denmark)

    Boye Knudsen, Signe; Strandgaard, Svend; Paulson, Olaf B

    2013-01-01

    In this meta-analysis, four of five placebo-controlled studies showed that antihypertensive treatment prevented stroke recurrence, most markedly in a study with a combination of an angiotensin-converting enzyme inhibitor and a diuretic. Studies with beta-blockers were not included. Two head......-to-head comparisons of a calcium antagonist and an angiotensin receptor antagonist showed no clear difference. Danish studies show that approximately 60% of patients with stroke are hypertensive one year after discharge from hospital. Antihypertensive treatment should be started or intensified in such patients....

  20. Sekundær prævention af apopleksi med effektiv antihypertensiv behandling

    DEFF Research Database (Denmark)

    Knudsen, Signe Boye; Strandgaard, Svend; Paulson, Olaf B.

    2013-01-01

    In this meta-analysis, four of five placebo-controlled studies showed that antihypertensive treatment prevented stroke recurrence, most markedly in a study with a combination of an angiotensin-converting enzyme inhibitor and a diuretic. Studies with beta-blockers were not included. Two head......-to-head comparisons of a calcium antagonist and an angiotensin receptor antagonist showed no clear difference. 
Danish studies show that approximately 60% of patients with stroke are hypertensive one year after discharge from hospital. Antihypertensive treatment should be started or intensified in such patients....

  1. Udredning og behandling af osteoporose hos patienter med kronisk obstruktiv lungesygdom

    DEFF Research Database (Denmark)

    Eiken, Pia Agnete; Brask-Lindemann, Dorte; Vestbo, Jørgen

    2012-01-01

    Patients with chronic obstructive pulmonary disease have a high risk of osteoporosis and fractures. We present an algorithm for the prevention and treatment of osteoporosis in patients with chronic obstructive pulmonary disease....

  2. Udredning og behandling af osteoporose hos patienter med prostatacancer uden knoglemetastaser

    DEFF Research Database (Denmark)

    Eiken, Pia Agnete; Langdahl, Bente Lomholt; Eiken, Frederik L

    2011-01-01

    The prevention of cancer treatment-induced bone loss in patients with prostate cancer due to gonadotropin-releasing hormone (GnRH)-agonist, GnRH-antagonist and orchidectomi therapy has a high priority. We present an algorithm for the prevention and treatment of osteoporosis during treatment of no...

  3. Medicinsk behandling af osteoporose hos patienter med moderat til svaert nedsat nyrefunktion

    DEFF Research Database (Denmark)

    Eiken, Pia A; Vestergaard, Peter

    2012-01-01

    Both chronic kidney disease and osteoporosis are frequent conditions in the general population. Most drugs for treating osteoporosis seem safe in terms of affecting renal function for patients with mildly to moderate decreased renal function. There are very few data on the efficacy (reduction in ...

  4. Behandling af blødende øsofagusvaricer med selvekspanderende metalstenter

    DEFF Research Database (Denmark)

    Dahlerup, Jens F; Kruse, Aksel; Grønbaek, Henning

    2007-01-01

    We report that haemostasis was obtained by the use of SEMS in two patients with bleeding oesophageal varices which failed conventional therapy (vasoactive drugs, antibiotics, endoscopy, and Sengstaken balloon tamponade). One patient subsequently died of sepsis; the other was treated with TIPS...

  5. Spaedbørnsdiabetes kan ofte behandles med sulfonylurinstof i stedet for insulin

    DEFF Research Database (Denmark)

    Lauridsen, Mette Høj; Boesgaard, Trine Welløv; Pedersen, Oluf

    2009-01-01

    , an activating mutation in the KCNJ11-gene which encodes the ATP-sensitive potassium subunit Kir6.2 in the beta cell which is responsible for insulin secretion. As recommended in the literature, she was successfully shifted from insulin therapy to sulfonylurea tablets at the age of three years and nine months...

  6. Diagnostik og behandling af kvinder med urin-inkontinens på danske gynaekologiske afdelinger

    DEFF Research Database (Denmark)

    Vejtorp, M; Fischer-Rasmussen, W; Blaabjerg, J

    1990-01-01

    The routine practice in the diagnosis and treatment of urinary incontinence was investigated by means of a questionnaire to which all 32 departments replied. Miction charts were employed routinely in 17 departments and for selected patients in eight departments. Weighing of diapers was employed...... differences in the routine practices in Danish gynaecological departments in the diagnosis and treatment of utinary incontinence. This appears to be a suitable field for so called reference programmes....... in 13 departments for all patients investigated for incontinence, but only for selected patients in ten departments. Cystometry was employed in cases of stress-incontinence in 23 departments and in cases of urge-incontinence in 30 departments. As regards the choice of operative treatment, 22 departments...

  7. Behandling og diagnostik af tuberkulose: fremad med små skridt

    DEFF Research Database (Denmark)

    Andersen, Ase Bengård; Lillebæk, Troels; Bang, Didi

    2011-01-01

    Development of new drugs for the treatment of drug sensitive and drug resistent tuberculosis is badly needed. Substantial progress has been made in the field and presently six new drug components are in clinical phase I and II trials. Drugs approved for other indications e.g. newer fluoroquinolones...

  8. Behandling af højt blodtryk hos patienter med akut apopleksi

    DEFF Research Database (Denmark)

    Olsen, T S; Jørgensen, H S; Garde, E

    1995-01-01

    The study was performed to investigate how often reduction of high blood pressure (> or = 220 mmHg systolic and or > or = 120 mmHg diastolic) was attempted in patients with acute stroke or transient ischemic attacks (TIA). Of 1351 consecutive patients with acute stroke or TIA 119 had high blood...... encephalopathy. It is concluded that reduction of high blood pressure in patients with stroke or TIA is attempted too often. As autoregulation is commonly impaired in acute stroke, reduction of systemic blood pressure may enhance ischaemic tissue damage. Reduction of blood pressure in acute stroke should...... pressure on admission. In 15 patients the stroke was so severe that treatment was not considered. In the remaining 104 patients reduction of the blood pressure was attempted in 28 (27%); in 23 patients immediately following admission. None of the patients had symptoms or signs of hypertensive...

  9. Diagnostik og behandling af kvinder med urin-inkontinens på danske gynaekologiske afdelinger

    DEFF Research Database (Denmark)

    Vejtorp, M; Fischer-Rasmussen, W; Blaabjerg, J

    1990-01-01

    The routine practice in the diagnosis and treatment of urinary incontinence was investigated by means of a questionnaire to which all 32 departments replied. Miction charts were employed routinely in 17 departments and for selected patients in eight departments. Weighing of diapers was employed...

  10. Blødningskomplikationer ved behandling med clopidogrel og acetylsalicylsyre efter akut koronart syndrom

    DEFF Research Database (Denmark)

    Kjær, Janus; Larsen, Christian Hastrup; Poulsen, Tina Svenstrup

    2006-01-01

    INTRODUCTION: The Clopidogrel in Unstable Angina to Prevent Recurrent Events (CURE) study showed that patients with unstable angina pectoris (UAP) and non-ST-elevation myocardial infarction (NSTEMI) benefit from combined therapy with acetylsalicylic acid (ASA) and clopidogrel. However, only...

  11. Behandling af kardiogent shock med perkutan mekanisk cirkulationsstøtte

    DEFF Research Database (Denmark)

    Junker, Anders; Kaltoft, Anne Kjer; Hassager, Christian

    2013-01-01

    a ventricular assist device which can be inserted in the acute setting using the Impella device, a catheter-based flow pump. DanShock is a Danish multicentre study that will assess whether circulatory support using the Impella device will improve the outcome of cardiogenic shock compared to conventional...

  12. Infliximab-induced autoantibodies: a multicenter study.

    Science.gov (United States)

    Vaz, João Luiz Pereira; Fernandes, Vander; Nogueira, Felipe; Arnóbio, Adriano; Levy, Roger A

    2016-02-01

    The purpose of this study was to assess autoantibody incidence in patients treated with infliximab for various diseases, and the development of autoimmune diseases using a multicenter, longitudinal, open-label, phase IV observational study. All patients received anti-tumor necrosis factor (anti-TNF) according to local treatment guidelines. The autoantibodies assessed before and after infliximab treatment were ANA, anti-Sm, anti-dsDNA, anticardiolipin IgM/IgG, anti-Scl70, anti-centromere B, anti-chromatin, anti-ribosomal P, anti-Sm-RNP, anti-RNP A, anti-RNP 68 kD, anti-La/SSB, anti-Ro/SSA 52 kD and 60 kD, and anti-Jo1. ANA was determined by indirect immunofluorescence on HEp-2 cells (INOVA); the remaining was assessed using BioPlexTM 2200. The Fisher exact test, Wilcoxon test, and the McNemar were used when appropriate.Two hundred eighty-six patients were included (139 with rheumatoid arthritis, 77 with ankylosing spondylitis, 29 with inflammatory bowel disease, 27 with psoriatic arthritis, and 14 with psoriasis), 167 females and 119 males, with mean age of 46.3 years. Subjects received at least five infusions of infliximab (6-month treatment). A significant difference was observed in antinuclear antibody (ANA) detection between samplings (p = 0.001). Among patients that had ANA before treatment (n = 92), six became ANA-negative, 48 had increased titers, 29 maintained, and nine decreased titers after treatment; a total of 186 patients had a positive ANA after treatment. Fine speckled nuclear pattern was most commonly observed (both before and after infliximab treatment). The number of patients with anti-dsDNA had a statistically significant increase (p = 0.003). No significant differences were noted for anticardiolipin and the remaining autoantibodies tested. Among the 286 patients included in the study, only one (0.35 %) showed clinical signs of drug-induced lupus, presenting elevated ANA and anti-dsDNA titers that normalized once treatment was

  13. Infliximab stability after reconstitution, dilution, and storage under refrigeration.

    Science.gov (United States)

    Beer, Paul M; Wong, Susan J; Schartman, Jerome P; Kulas, Karen E; Hartman, Coby L; Giganti, Monica; Falk, Naomi S

    2010-01-01

    The purpose of this study was to investigate the stability of reconstituted infliximab solutions and determine whether infliximab is suitable for compounding for potential intravitreal use. Infliximab was reconstituted, and the solution was aliquoted and stored refrigerated. On each day of testing, an aliquot was serially diluted to concentrations ranging from 50,000 pg/mL to 69 pg/mL. Each dilution was assayed by microsphere immunoassay daily for 5 days and weekly for a total of 6 weeks. The outcome measure was median fluorescence intensity measured by dual laser flow analysis of fluorochrome-labeled secondary antibodies to infliximab bound to tumor necrosis factor-alpha-coated microspheres. There was an increasing median fluorescence intensity for increasing infliximab concentration in a sigmoidal dose-response curve with a variable slope that was equivalent for each time point. Each respective concentration of infliximab showed nearly equivalent median fluorescence intensity for every time point over the 6-week period. The authors found that the immunoreactivity of 2 different concentrations of infliximab stored at 4 degrees C over a 6-week period remained stable. Infliximab is suitable for compounding and could be a cost-effective intravitreal medication for use in clinical practice if further study supports its safety and efficacy.

  14. Infliximab (Remicade), a new biological treatment for Crohn's disease

    NARCIS (Netherlands)

    D'Haens, G. R.

    1999-01-01

    Tumour necrosis factor plays a pivotal role in Crohn's disease intestinal inflammation. Blocking this cytokine by means of the chimeric monoclonal antibody infliximab has led to a rapid reduction in mucosal inflammation. More than 65% of refractory Crohn's disease patients treated with infliximab

  15. Extensive preclinical evaluation of an infliximab biosimilar candidate.

    Science.gov (United States)

    Velasco-Velázquez, M A; Salinas-Jazmín, N; Hisaki-Itaya, E; Cobos-Puc, L; Xolalpa, W; González, G; Tenorio-Calvo, A; Piña-Lara, N; Juárez-Bayardo, L C; Flores-Ortiz, L F; Medina-Rivero, E; Pérez, N O; Pérez-Tapia, S M

    2017-05-01

    Infliximab is therapeutic monoclonal antibody (mAb) against TNF-α employed in the treatment of immunoinflammatory diseases. The development of biosimilar mAbs is a global strategy to increase drug accessibility and reduce therapy-associated costs. Herein we compared key physicochemical characteristics and biological activities produced by infliximab and infliximab-Probiomed in order to identify functionally relevant differences between the mAbs. Binding of infliximab-Probiomed to TNF-α was specific and had kinetics comparable to that of the reference product. Both mAbs had highly similar neutralizing efficacy in HUVEC cell cultures stimulated with TNF-α. In vitro induction of CDC and ADCC were also similar between the evaluated products. In vivo comparability was assessed using a transgenic mouse model of arthritis that expresses human TNF-α in a 13-week multiple-administration study. Infliximab and infliximab-Probiomed showed comparable efficacy, safety, and pharmacokinetic profiles. Our results indicate that infliximab-Probiomed has highly similar activities to infliximab in preclinical models, warranting a clinical evaluation of its biosimilarity. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Relationship between inflammation and infliximab pharmacokinetics in rheumatoid arthritis

    Science.gov (United States)

    Ternant, David; Ducourau, Emilie; Perdriger, Aleth; Corondan, Anca; Le Goff, Benoît; Devauchelle-Pensec, Valérie; Solau-Gervais, Elisabeth; Watier, Hervé; Goupille, Philippe; Paintaud, Gilles; Mulleman, Denis

    2014-01-01

    Aims Infliximab, an anti-tumour necrosis factor-α monoclonal antibody, is indicated in rheumatoid arthritis (RA). Our objective was to evaluate the influence of the sources of infliximab pharmacokinetic variability in RA. Methods Eighty-four patients treated with infliximab for RA were included in a prospective noncomparative study. They were analysed between two consecutive infliximab infusions. Infliximab concentrations were measured before the infusion, 2 h, 1 and 4 weeks after the infusion and immediately before the next infusion. Infliximab concentrations were described using a two-compartment population pharmacokinetic model. Results The mean (interindividual standard deviation) estimated central volume of distribution was 2.3 l (36%) and systemic clearance was 0.019 l h−1 (37%). The central volume of distribution increased with bodyweight; it was doubled between 50 and 90 kg. Systemic clearance increased with pre-infusion C-reactive protein concentration by 20%, varying from 3 to 14 mg l−1, and was decreased by 30% when methotrexate was coadministered. Conclusions The influence of methotrexate and inflammation on infliximab clearance suggests that individual adjustment of infliximab doses according to disease activity may be useful in RA. PMID:24354889

  17. Evaluering af ordning med psykologbehandling af personer med let til moderat depression

    DEFF Research Database (Denmark)

    Fjeldsted, Rita; Christensen, Kaj Sparle

    tidligere evaluering af forsøgsordning af psykologbehandling af depression i perioden 2005-06. 18.419 personer i alderen 18-37 år blev henvist til psykolog i den undersøgte ordning i perioden 1.2.2009 – 31.1.2010, svarende til en henvisningshyppighed på 1,6 % af baggrundsbefolkningen i samme aldersgruppe...... samme niveau som fandtes i evalueringen fra 2007. Remissionsraten for personer med depression ved behandlingsstart er 87 % målt med MDI. Patienters selvrapporterede effekt er 95 %. I opfølgningsgruppen har 89 % ingen depression 3 år efter afsluttet behandling, 56 % har oplevet mindst én ny...... for begge køn, og der ses et fald på 40 % for kvinder og 70 % for mænd over de givne 3 år. Tidsperspektivet er for denne gruppe mere relevant for overordnet vurdering, men der savnes en sammenligningsgruppe. Ifølge spørgeskemadata øges andelen af personer, der er i arbejde, selvforsørgelse eller på SU fra...

  18. Infusion reactions during infliximab treatment are not associated with IgE anti-infliximab antibodies

    NARCIS (Netherlands)

    van Schie, Karin A.; Ooijevaar-de Heer, Pleuni; Kruithof, Simone; Plasencia, Chamaida; Jurado, Teresa; Pascual Salcedo, Dora; Brandse, Johannan F.; D'Haens, Geert Ram; Wolbink, Gerrit Jan; Rispens, Theo

    2017-01-01

    Controversy exists on the role of IgE antidrug antibodies (IgE-ADA) in infusion reactions (IR) on infliximab treatment, partly due to the lack of a positive control used for assay validation. We sought to (1) develop a robust assay to measure IgE-ADA, including a positive control, (2) determine the

  19. Effects of infliximab retreatment after consecutive discontinuation of infliximab and adalimumab in refractory Crohn's disease

    NARCIS (Netherlands)

    Brandse, Johannan F.; Peters, Charlotte P.; Gecse, Krisztina B.; Eshuis, Emma J.; Jansen, Jeroen M.; Tuynman, Hans A.; Löwenberg, Mark; Ponsioen, Cyriel Y.; van den Brink, Gijs R.; Dʼhaens, Geert R.

    2014-01-01

    Switches between anti-tumor necrosis factor agents in the treatment of Crohn's disease (CD) occur in case of treatment failure, intolerance, or patient preference. No data are currently available on the usefulness of a second infliximab treatment after earlier discontinuation and previous switch to

  20. Infusion reactions during infliximab treatment are not associated with IgE anti-infliximab antibodies.

    Science.gov (United States)

    van Schie, Karin A; Ooijevaar-De Heer, Pleuni; Kruithof, Simone; Plasencia, Chamaida; Jurado, Teresa; Pascual Salcedo, Dora; Brandse, Johannan F; d'Haens, Geert Ram; Wolbink, Gerrit Jan; Rispens, Theo

    2017-07-01

    Controversy exists on the role of IgE antidrug antibodies (IgE-ADA) in infusion reactions (IR) on infliximab treatment, partly due to the lack of a positive control used for assay validation. We sought to (1) develop a robust assay to measure IgE-ADA, including a positive control, (2) determine the association between IgE-ADA and IR and (3) determine the incidence of IgE-ADA in infliximab treated patients. A recombinant human IgE anti-infliximab monoclonal antibody was developed as standard and positive control. With this antibody, we set up a novel robust assay to measure IgE-ADA. IgE-ADA was determined in three retrospective cohorts (n=159) containing IR+ (n=37) and IR- (n=39), and longitudinal sera of 83 spondyloarthritis. IgE-ADA was found in 0/39 IR-, whereas 4/37 (11%) IR+ showed low levels (0.1-0.3 IU/mL, below the 0.35 IU/mL threshold associated with elevated risk of allergic symptoms). All patients who were IgE-ADA positive also had (very) high IgG-ADA levels. The incidence of IgE-ADA in patients with infliximab-treated spondyloarthritis was estimated at less than approximately 1%. IgE-ADA is rarely detected in infliximab-treated patients. Moreover, the absence of IgE-ADA in the majority of IR+ patients suggests that IgE-ADA is not associated with infusion reactions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Infliximab dependency in pediatric Crohn's disease: Long-term follow-up of an unselected cohort

    OpenAIRE

    Ridder, Lissy; Rings, Edmond; Damen, Gerard; Kneepkens, Frank; Schweizer, J.; Kokke, Freddy; Benninga, Marc; Norbruis, Obbe; Hoekstra, Hans; Gijsbers, Carolien; Escher, Johanna

    2008-01-01

    textabstractBackground: Infliximab is effective for induction and maintenance of remission in Crohn's disease. It is unknown how long patients should be kept on infliximab therapy. The primary aim of this study was to assess duration of effective maintenance therapy and infliximab dependency in pediatric CD patients initially responding to infliximab therapy. Methods: All pediatric patients treated with infliximab by pediatric gastroenterologists in the Netherlands because of severe luminal o...

  2. Etanercept maintains the clinical benefit achieved by infliximab in patients with rheumatoid arthritis who discontinued infliximab because of side effects

    Science.gov (United States)

    Iannone, Florenzo; Trotta, Francesco; Monteccuco, Carlomaurizio; Giacomelli, Roberto; Galeazzi, Mauro; Matucci‐Cerinic, Marco; Ferri, Clodoveo; Cutolo, Maurizio; Bambara, Lisa Maria; Triolo, Giovanni; Ferraccioli, Gianfranco; Valentini, Gabriele; Lapadula, Giovanni

    2007-01-01

    Objective To evaluate the efficacy of switching to etanercept treatment in patients with rheumatoid arthritis who already responded to infliximab, but presented side effects. Methods Charts of 553 patients with rheumatoid arthritis were retrospectively reviewed to select patients who responded to the treatment with infliximab and switched to etanercept because of occurrence of adverse effects. Clinical data were gathered during 24 weeks of etanercept treatment and for the same period of infliximab treatment before infliximab was stopped. Disease Activity Score computed on 44 joints (DAS‐44), erythrocyte sedimentation rate (ESR) 1st hour, Visual Analogue Scale (VAS) of pain, Health Assessment Questionnaire (HAQ), and C reactive protein (CRP) were assessed every 8 weeks. Results 37 patients were analysed. Adverse events to infliximab were mostly infusion reactions. No statistically significant difference between infliximab, before withdrawal, and etanercept, after 24 weeks, was detected in terms of DAS‐44 (2.7 and 1.9, respectively), HAQ (0.75 and 0.75, respectively), ESR (21 and 14, respectively) and CRP (0.5 and 0.3, respectively). VAS pain decreased significantly after switching to etanercept treatment (40 and 24, respectively; p<0.05). Conclusions Our study shows that etanercept maintains the clinical benefit achieved by infliximab, and suggests that a second tumour necrosis factor (TNF) α inhibitor can be the favourable treatment for rheumatoid arthritis when the first TNFα blocker has been withdrawn because of adverse events. PMID:16837489

  3. Imaging and serum analysis of immune complex formation of radiolabelled infliximab and anti-infliximab in responders and non-responders to therapy for rheumatoid arthritis

    NARCIS (Netherlands)

    van der Laken, C. J.; Voskuyl, A. E.; Roos, J. C.; Stigter van Walsum, M.; de Groot, E. R.; Wolbink, G.; Dijkmans, B. A. C.; Aarden, L. A.

    2007-01-01

    BACKGROUND: Many patients with rheumatoid arthritis are currently successfully treated with infliximab (anti-tumour necrosis factor); however, about 30% of the patients do not respond to infliximab. One of the postulated hypotheses of not responding is the fast clearance of infliximab due to the

  4. Monitoring patients treated with anti-TNF-alpha biopharmaceuticals: assessing serum infliximab and anti-infliximab antibodies

    DEFF Research Database (Denmark)

    Svenson, M; Geborek, P; Saxne, T

    2007-01-01

    Infliximab is an anti-tumour necrosis factor-alpha (TNF-alpha) mouse-human IgG1/kappa antibody used to treat patients with rheumatoid arthritis (RA) and other inflammatory diseases. Unfortunately, response failure and side-effects due to immunogenicity of the drug are not rare. In this study, we...... have compared different methods of assessing drug levels and anti-infliximab antibodies (Abs) and analysed the character of these Abs in sera of RA patients treated with infliximab for 1.5-18 months....

  5. Infliximab and complications after colectomy in patients with ulcerative colitis

    DEFF Research Database (Denmark)

    Bregnbak, David; Mortensen, Christian; Bendtsen, Flemming

    2012-01-01

    Infliximab treatment may increase the risk of subsequent postoperative complications in patients with ulcerative colitis. The main purpose of the present study therefore was to assess postoperative complications in patients who have undergone colectomy for ulcerative colitis with and without...

  6. [Peripheral neuropathy during Infliximab therapy: a case study].

    Science.gov (United States)

    Zinebi, Ali; Akhouad, Youssef; Rkiouak, Adil; Reggad, Ahmed; Kasmy, Zohour; Boudlal, Mostafa; Rabhi, Monsef; Ennibi, Khalid; Chaari, Jilali

    2016-01-01

    Anti TNF alpha treatments are wide spectrum therapies. Multiple side effects have been reported in recent years, particularly peripheral neuropathies. We report a case of axonal neuropathy occurring three months after starting treatment with Infliximab. Our study focused on a 60-year old female patient treated for therapy-resistant hemorrhagic rectocolitis, requiring treatment with infliximab. Three months later, the patient had sensory axonal neuropathy. Etiologic assessment remained negative and dose reduction was accompanied by an improvement in symptoms. The time between initiation of treatment with Infliximab and the onset of clinical manifestations as well as improvement after dose reduction advocate the responsibility of infliximab in the occurrence of sensory neuropathy. Its management is not standardized and should be discussed case by case.

  7. Infliximab-induced intertriginous psoriasis in patient with Crohn's disease

    OpenAIRE

    Mola, Federica; Motolese, Alberico

    2011-01-01

    Tumor necrosis factor-α (TNFα) inhibition is an effective treatment of moderate-to-severe psoriasis and other diseases (rheumatoid arthritis, ankylosing spondylitis, psoriasis or Crohn’s disease). We report a case of a 32- years-old patient affected by Crohn’s disease since the age of 25 who started infliximab infusion after four years of treatment with prednisone and azathioprine per os without improvement. After the fifth infusion of infliximab, he developed a form of intertriginous psorias...

  8. EFFECTIVENESS OF INFLIXIMAB IN PATIENTS WITH JUVENILE ANKYLOSING SPONDYLARTHRITIS

    Directory of Open Access Journals (Sweden)

    A.L. Kozlova

    2009-01-01

    Full Text Available The objective of open-labeled study was estimation of effectiveness and safety of infliximab — monoclonal antibodies to tumor necrosis factor (TNF - in treatment of 48 patients with juvenile ankylosing spondylarthritis. Duration of observation was 6 weeks — 1,5 years. Anticytokine treatment was administrated on the ground of therapy with immunosuppressive agents in 96% of patients. Infliximab was administrated in median dose 7,4 ± 3,7 mg/kg of body weight by standard scheme (0–2–6 — week and further every 8 weeks intravenously. Results of a trial showed that infliximab has evident anti-inflammatory effect. Treatment with infliximab provided development of remission of articular syndrome, decreasing and normalization of laboratory indices of activity of disease, the rate of disability, and increasing of quality of life in 84% of patients. Effect of this medication was registered after first infusion and continued during all period of follow up. Adverse effects included transfusion reactions: fever, head ache, nausea/vomiting in 10% of patients, allergic arthritis — in 2% of patients. Thus, treatment of infliximab is pathogenetically grounded, effective and safe in patients with juvenile ankylosing spondylarthritis.Key words: children, juvenile ankylosing spondylarthritis, infliximab, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(2:20-26

  9. Dramatic response to infliximab in refractory neurosarcoidosis

    Directory of Open Access Journals (Sweden)

    Chintamaneni Sreekanth

    2010-01-01

    Full Text Available Sarcoidosis is a systemic disease characterized by noncaseating granulomas in the involved organs. Neurologic manifestations involving the central and/or peripheral nervous system occur in about 5% of patients. Neurosarcoidosis is often refractory to conventional treatment and therefore more effective treatment options are needed. While the etiology of the disease is still unknown, there is now a better understanding of its pathogenesis on a molecular level. It is clear that tumor necrosis factor-α (TNFα plays a pivotal role in the development of the granulomas and it is believed to be a key cytokine involved in the pathogenesis of the disease. Taking advantage of this better understanding of disease pathogenesis, anti-TNFα agents are being increasingly used to treat refractory sarcoidosis. We report a patient with refractory neurosarcoidosis who showed dramatic improvement in the clinical and radiological manifestations following treatment with infliximab; he suffered a relapse upon discontinuation of the medication.

  10. MedSun Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medical Product Safety Network (MedSun) is an adverse event reporting program launched in 2002. The primary goal for MedSun is to work collaboratively with the...

  11. Kritik med objektets forrang

    DEFF Research Database (Denmark)

    Liebst, Lasse Suonperä; Stamer, Naja Buono

    2010-01-01

    Nærværende artikel vil i lyset af den idealistiske epistemologis fremtrædende position i sociologien foreslå, at et fremadrettet brud med denne idealisme kan ske med en tilbagevenden til Theodor W. Adornos negative dialektik. Det frugtbare ved denne særegne dialektik er, hvordan den med en tildel...

  12. Previous infliximab therapy and postoperative complications after proctocolectomy with ileum pouch anal anastomosis

    NARCIS (Netherlands)

    Eshuis, Emma J.; Al Saady, Rana L.; Stokkers, Pieter C. F.; Ponsioen, Cyriel Y.; Tanis, Pieter J.; Bemelman, Willem A.

    2013-01-01

    It is unclear whether infliximab treatment induces increased complication rates after surgery for ulcerative colitis. Aim was to compare complication rates after pouch surgery in refractory ulcerative colitis patients with versus without previous infliximab therapy. We performed a retrospective

  13. Infliximab-associated alveolitis after treatment for severe left-sided ulcerative colitis.

    LENUS (Irish Health Repository)

    Veerappan, Sundaram G

    2012-02-01

    Here we describe a patient with ulcerative colitis who developed alveolitis after infliximab therapy. With earlier case reports of development of alveolitis in rheumatoid arthritis patients after infliximab infusion, the temporal relationship between the infliximab therapy and the development of alveolitis in this case, raises the possibility that the two might be causally related. With an increasing trend towards treating moderate to severely active ulcerative colitis patients with infliximab as a rescue therapy, clinicians should be aware of this potentially serious complication.

  14. Low infliximab serum trough levels and anti-infliximab antibodies are prevalent in rheumatoid arthritis patients treated with infliximab in daily clinical practice: results of an observational cohort study

    Science.gov (United States)

    2012-01-01

    Background To get insight in the prevalence of high, or low/no serum infliximab trough levels in patients with low disease activity and if serum trough levels are stable and reliable longitudinally we conducted a prospective cohort study Methods In a longitudinal, observational cohort of RA patients treated with infliximab for at least 6 months, treatment interval, DAS28, infliximab trough levels and anti-infliximab antibodies were assessed. Prevalence of low (5 mg/l) infliximab serum trough levels and anti-infliximab antibodies was recorded. Relationship of a change in anti-infliximab antibodies and treatment interval was described. Reliability of consecutive infliximab serum trough levels and anti-infliximab antibodies in patients with stable DAS28 and treatment was analysed with Spearman correlation and kappa-analysis. Results 147 patients with a mean disease duration of 11 years (sd7) and DAS28 of 3.5 (sd1.3) at baseline were followed during 1.5 years. Inter-individual variability in infliximab levels in patients with low DAS28 was high (median 1.4 mg/L, IQR 3.35), with 31% (95%CI: 20-42%) having low (5 mg/L). Interestingly also in RA patients with DAS28 ≤ 3.2, anti-infliximab antibodies were found in one-third of the patients, with half of them having antibodies every visit during a median of more than one year. Agreement for consecutive measurements of serum trough levels and anti-infliximab antibodies was high in stable patients: r = 0.97 (p = 0.00001) and kappa = 1.0 (SE 0.14) Anti-infliximab antibody appearance was influenced by interval increases (relative risk (RR) 5.2, 2.6-10.7), but patients still showed low infliximab levels. Conclusions Low (and high) infliximab serum trough levels are prevalent, interestingly also in patients with low disease activity. Consecutive measurements of serum trough levels and anti-infliximab antibodies are reliable in stable patients. These test could be used to lower or stop infliximab in

  15. The Tolerability and Efficacy of Rapid Infliximab Infusions in Patients with Inflammatory Bowel Disease.

    Science.gov (United States)

    Qazi, Taha; Shah, Bhavesh; El-Dib, Mohammed; Farraye, Francis A

    2016-02-01

    Few studies have assessed the loss of efficacy or patient and caregiver satisfaction with rapid infliximab infusions. The aim of this study is to assess the tolerability, loss of efficacy and to describe the impact on resource utilization and patient satisfaction in rapid infliximab infusions. Subjects with inflammatory bowel disease receiving rapid infliximab infusions were included in the study. Subjects received maintenance infusions from June 2011 to June 2013. Incidence of adverse reactions and the total number of rapid infliximab infusions were recorded. Efficacy was compared to published studies evaluating the long-term efficacy of infliximab infusions. Patient satisfaction was addressed through a survey following the implementation of the rapid infusion protocol. Seventy-five subjects with IBD were included in the study. Five hundred and twenty-two rapid infliximab infusions were provided to patients. There were no acute or delayed infusion reactions. Ten subjects (13 %) required either a dose escalation or interval adjustment between infliximab infusions. A majority of patients reported increased satisfaction with 1-h infliximab infusions, and 97 % of surveyed patients opted to continue rapid infusions. The rapid infliximab infusion protocol increased infusion unit efficiency by increasing capacity by 15 %. Cost savings in the elimination of nursing time translated to approximately $108,150 savings at our institution. Rapid infliximab infusions do not appear to increase the risk of loss of response compared to historical studies of long-term infliximab efficiency. A rapid infliximab infusion protocol improved efficiency in our infusion unit and increased patient and nursing satisfaction.

  16. The infliximab biosimilar in the treatment of moderate to severe plaque psoriasis.

    Science.gov (United States)

    Dapavo, Paolo; Vujic, Igor; Fierro, Maria Teresa; Quaglino, Pietro; Sanlorenzo, Martina

    2016-10-01

    The infliximab originator's patent recently expired, leading to the production of biosimilar versions of the drug. The biosimilars' efficacy was not tested on patients with psoriasis but most regulatory authorities approved their use in psoriasis because of an extrapolation of data from studies conducted in other diseases. We sought to describe the use of the infliximab biosimilar (Remsima; CT-P13) in patients with psoriasis. Objective (Psoriasis Area and Severity Index) and subjective (visual analog pain scale) measurements of disease activity were collected in 2 cohorts of patients with moderate to severe plaque psoriasis: cohort 1 patients switched from the infliximab originator to the infliximab biosimilar; and cohort 2 patients were infliximab-naïve and started on the infliximab biosimilar. We observed no changes of Psoriasis Area and Severity Index and visual analog pain scale scores in 30 patients who switched from the infliximab originator to the biosimilar. Four of 5 infliximab-naïve patients who started infliximab biosimilar treatment achieved 75% improvement or better from baseline Psoriasis Area and Severity Index score at the end of the induction phase. Number of patients and length of follow-up was limited. Patients with psoriasis taking infliximab originator treatment can switch to the infliximab biosimilar without experiencing a significant change in clinical response or additional adverse events. The use of the infliximab biosimilar could reduce the growing pressure on health care budgets. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  17. Intestinal fibrosis is associated with lack of response to Infliximab therapy in Crohn's disease.

    Science.gov (United States)

    de Bruyn, Jessica R; Becker, Marte A; Steenkamer, Jessica; Wildenberg, Manon E; Meijer, Sybren L; Buskens, Christianne J; Bemelman, Willem A; Löwenberg, Mark; Ponsioen, Cyriel Y; van den Brink, Gijs R; D'Haens, Geert R

    2018-01-01

    Overt fibrostenotic disease is a relative contraindication for anti-TNF therapy in Crohn's disease. We hypothesized that subclinical fibrosis may also contribute to an incomplete response to anti-TNF therapy before the onset of symptomatic stenosis. In a previous trial, patients with ileocecal Crohn's disease were randomized to either immediate ileocecal resection or medical treatment with Infliximab. In case of insufficient response to Infliximab, the latter underwent secondary ileocecal resection. We compared specimens from those patients undergoing immediate resection (Infliximab naïve, n = 20) to those who failed Infliximab therapy (n = 20). Infliximab naïve and Infliximab failure patients had similar severity of inflammation when assessed by CRP levels (median 14 vs 9 mg/L) and histology (Geboes-D'Haens-score, median 10 vs 11 points). On immunohistochemistry, collagen-III and fibronectin depositions were increased in patients previously exposed to Infliximab compared to patients naïve to Infliximab. On mRNA level, procollagen peptidase showed significantly more mucosal mRNA expression in Crohn's disease patients who failed Infliximab. Infliximab responders showed no increase of this marker after 4 weeks of successful Infliximab treatment. Failure to Infliximab therapy is associated with subclinical fibrosis in Crohn's disease.

  18. Comparison of infliximab drug measurement across three commercially available ELISA kits.

    Science.gov (United States)

    Lee, Monique Wei Meng; Connor, Susan; Ng, Watson; Toong, Catherine Mei-Ling

    2016-10-01

    The monitoring of infliximab drug levels aids in the management of several autoimmune diseases, notably inflammatory bowel disease. Several commercial kits are now available and approved by the Therapeutic Goods Administration (TGA) for the measurement of infliximab levels, but there have been limited verification or comparison studies to date. Finding an assay that most accurately measures infliximab is essential for optimal drug titration and patient management. We performed this study to compare the performance of the Grifols Promonitor, Theradiag Lisatracker and R-Biopharm Ridascreen enzyme linked immunosorbent assay (ELISA) kits. Preparations of serum containing known concentrations of infliximab were assayed using each kit, including in the presence of interference from anti-infliximab antibodies, autoantibodies and other biological agents. The Lisatracker kit provided the most accurate determination of infliximab drug levels, however it yielded false positive results at low concentrations of infliximab. The average coefficients of variation (CVs) for the kits were 8% for Lisatracker, 5% for Ridascreen and 11% for Grifols. Infliximab measurements across all kits were affected by interference from antibodies to infliximab (ATI). This study identified the Lisatracker kit as the most accurate in quantifying infliximab levels, although it was limited by false positive results at low concentrations of infliximab as well as interference from ATI. This has important implications for the monitoring and management of patients receiving infliximab therapy. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  19. Infliximab dependency in pediatric Crohn's disease : Long-term follow-up of an unselected cohort

    NARCIS (Netherlands)

    de Ridder, Lissy; Rings, Edmond H. H. M.; Damen, Gerard M.; Kneepkens, C. M. Frank; Schweizer, Joachim J.; Kokke, Freddy T. M.; Benninga, Marc A.; Norbruis, Obbe F.; Hoekstra, J. Hans; Gijsbers, Carolien F. M.; Escher, Johanna C.

    Background: Infliximab is effective for induction and maintenance of remission in Crohn's disease. It is unknown how long patients should be kept on infliximab therapy. The primary aim of this study was to assess duration of effective maintenance therapy and infliximab dependency in pediatric CD

  20. Infliximab dependency in pediatric Crohn's disease: Long-term follow-up of an unselected cohort

    NARCIS (Netherlands)

    L. de Ridder (Lissy); E.H.H.M. Rings (Edmond); G.M. Damen (Gerard); C.M.F. Kneepkens (Frank); J. Schweizer; F.T.M. Kokke (Freddy); M.A. Benninga (Marc); O.F. Norbruis (Obbe); J.H. Hoekstra (Hans); C.F.M. Gijsbers (Carolien); J.C. Escher (Johanna)

    2008-01-01

    textabstractBackground: Infliximab is effective for induction and maintenance of remission in Crohn's disease. It is unknown how long patients should be kept on infliximab therapy. The primary aim of this study was to assess duration of effective maintenance therapy and infliximab dependency in

  1. Infliximab dependency in pediatric Crohn's disease: long-term follow-up of an unselected cohort

    NARCIS (Netherlands)

    de Ridder, Lissy; Rings, Edmond H. H. M.; Damen, Gerard M.; Kneepkens, C. M. Frank; Schweizer, Joachim J.; Kokke, Freddy T. M.; Benninga, Marc A.; Norbruis, Obbe F.; Hoekstra, J. Hans; Gijsbers, Carolien F. M.; Escher, Johanna C.

    2008-01-01

    BACKGROUND: Infliximab is effective for induction and maintenance of remission in Crohn's disease. It is unknown how long patients should be kept on infliximab therapy. The primary aim of this study was to assess duration of effective maintenance therapy and infliximab dependency in pediatric CD

  2. Infliximab dependency in pediatric Crohn's disease: long-term follow-up of an unselected cohort.

    NARCIS (Netherlands)

    Ridder, L.; Rings, E.H.; Damen, G.M.; Kneepkens, C.M.; Schweizer, J.J.; Kokke, F.T.; Benninga, M.A.; Norbruis, O.F.; Hoekstra, J.H.; Gijsbers, C.F.M.; Escher, J.C.

    2008-01-01

    BACKGROUND: Infliximab is effective for induction and maintenance of remission in Crohn's disease. It is unknown how long patients should be kept on infliximab therapy. The primary aim of this study was to assess duration of effective maintenance therapy and infliximab dependency in pediatric CD

  3. Review article: dose optimisation of infliximab for acute severe ulcerative colitis

    NARCIS (Netherlands)

    Hindryckx, P.; Novak, G.; Vande Casteele, N.; Laukens, D.; Parker, C.; Shackelton, L. M.; Narula, N.; Khanna, R.; Dulai, P.; Levesque, B. G.; Sandborn, W. J.; D'Haens, G.; Feagan, B. G.; Jairath, V.

    2017-01-01

    Although optimal medical management of acute severe ulcerative colitis (UC) is ill-defined, infliximab has become a standard of care. Accumulating evidence suggests an increased rate of infliximab clearance in patients with acute severe UC and a reduced colectomy rate with an intensified infliximab

  4. Infliximab in the treatment of plaque type psoriasis

    Directory of Open Access Journals (Sweden)

    Rosita Saraceno

    2009-04-01

    Full Text Available Rosita Saraceno, Andrea Saggini, Lucia Pietroleonardo, Sergio ChimentiDepartment of Dermatology, University of Rome Tor Vergata, Rome, Viale Oxford 81, Rome, ItalyAbstract: Psoriasis is a chronic and immunomediated skin disease characterized by erythematous scaly plaques. Psoriasis affects approximately 1% to 3% of the Caucasian population. Tumor necrosis factor alpha (TNF-α is a proinflammatory cytokine that plays a critical role in the pathogenesis of psoriasis. Infliximab is an anti-TNF-α drug widely used for the treatment of plaque type psoriasis and psoriatic arthritis. Controlled clinical trials demonstrated that infliximab is characterized by a high degree of clinical response in moderate to severe plaque psoriasis. Moreover infliximab showed rapid efficacy in nail psoriasis which represents a therapeutic challenge for dermatologists and a relevant source of distress for patients with plaque psoriasis. This anti-TNF-α has an encouraging safety profile, especially as long as physicians are watchful in prevention and early diagnosis of infections and infuse reactions. The efficacy, tolerability and safety profiles suggest infliximab as a suitable anti-psoriatic drug in the long-term treatment of a chronic disease such as plaque-type psoriasis.Keywords: psoriasis, nail psoriasis, infliximab, long-term treatment

  5. Use of infliximab and anti-infliximab antibody measurements to evaluate and optimize efficacy and safety of infliximab maintenance therapy in Crohn's disease

    DEFF Research Database (Denmark)

    Steenholdt, Casper

    2013-01-01

    Infliximab (IFX) is a therapeutic monoclonal antibody (Ab) against TNF-α, which is used to induce and maintain remission in patients with moderate to severe Crohn's disease. Despite its effectiveness, approximately one third of patients experience primary treatment failure, and another one third...

  6. Kvinder indlagt med svær præeklampsi efterlyser sammenhæng

    DEFF Research Database (Denmark)

    Stenshøj, Jette; Aagaard, Hanne

    2014-01-01

    Præeklampsi rammer 2-5 % af alle gravide i Danmark. Sygdommen kan udvikle sig alvorligt og eneste behandling er forløsning af det ofte præmature barn. Kvinder med svær præeklampsi gennemlever psykologisk stress, og de er samtidig i risiko for en efterfødselsreaktion. Formålet med studiet er......, at undersøge kvinders oplevelse og vurdering af den stress, der kan være forbundet med indlæggelse med svær præeklampsi. Studiet er baseret på interview med tre kvinder efter indlæggelse med svær præeklampsi. Benner og Wrubels forståelse af stress er anvendt som teoretisk ramme for udarbejdelse af...... forskningsspørgsmål. Data er analyseret og fortolket ved brug af indholdsanalyse. Følgende fire temaer er generet: Tryghed- utryghed, Moderrollen som stressende eller helbredende, Manglende kontrol, Behov for at blive lyttet til. Samlet beskriver studiet at utryghed i akutte situationer, en ændret moderrolle og...

  7. Processeringsoptimering med Canons software

    DEFF Research Database (Denmark)

    Precht, Helle

    2009-01-01

    . Muligheder i software optimering blev studeret i relation til optimal billedkvalitet og kontrol optagelser, for at undersøge om det var muligt at acceptere diagnostisk billedkvalitet og derved tage afsæt i ALARA. Metode og materialer Et kvantitativt eksperimentelt studie baseret på forsøg med teknisk og...... humant fantom. CD Rad fantom anvendes som teknisk fantom, hvor billederne blev analyseret med CD Rad software, og resultatet var en objektiv IQF værdi. Det humane fantom var et lamme pelvis med femur, der via NRPB’ er sammenlignelig med absorptionen ved et femårigt barn. De humane forsøgsbilleder blev...

  8. Infliximab dependency is related to decreased surgical rates in adult Crohn's disease patients

    DEFF Research Database (Denmark)

    Pedersen, N.; Duricova, D.; Lenicek, M.

    2010-01-01

    Background Infliximab dependency in children with Crohn's disease (CD) has recently been described and found to be associated with a decreased surgery rate. Aim To assess infliximab dependency of adult CD patients, evaluate the impact on surgery, and search for possible clinical and genetic...... predictors. Methods Two hundred and forty-five CD patients treated with infliximab were included from Danish and Czech Crohn Colitis Database (1999-2006). Infliximab response was assessed as immediate outcome, 1 month after infliximab start: complete, partial, and no response. Three months outcome, after...

  9. Stabilization of Bilateral Progressive Rheumatoid Corneal Melt with Infliximab

    Directory of Open Access Journals (Sweden)

    Sheelah F. Antao

    2012-01-01

    Results. A patient with rheumatoid arthritis presented with bilateral PUK following a 2-month history of ocular discomfort and redness. His systemic prednisolone (PDN and methotrexate (MTX were increased and, despite an initial favorable response, bilateral recurrent corneal perforations ensued. Both eyes underwent cyanoacrylate glue repair, amniotic membrane transplantation (AMT, and penetrating keratoplasty (PKP. Recurrence of the disease and bilateral perforations of the second PKP in both eyes prompted administration of intravenous infliximab immediately after the fourth PKP. The disease activity rapidly settled in both eyes, and at eighteen-month followup, after 12 infliximab infusions, the PUK remains quiescent with no further graft thinning or perforation. Conclusion. Infliximab can be used to arrest the progression of severe bilateral rheumatoid PUK in cases that are refractory to conventional treatment.

  10. Orale senfølger af behandling for hoved-halscancer

    DEFF Research Database (Denmark)

    Assaad, Hala; Dynesen, Anja Weirsøe; Thisted, Lise Bjerrum

    2014-01-01

    Forebyggelse af orale senfølger af behandling for hoved-hals-cancer er vigtig for orale funktioner og livskvalitet Patienter, der er strålebehandlet for hovedhals-cancer, oplever betydelige senfølger i mundhulen; herunder xerostomi og hyposalivation, oral candidose, ubehag og smerte fra...... orale senfølger....

  11. Long-term outcomes of refractory neurosarcoidosis treated with infliximab.

    Science.gov (United States)

    Cohen Aubart, Fleur; Bouvry, Diane; Galanaud, Damien; Dehais, Caroline; Mathey, Guillaume; Psimaras, Dimitri; Haroche, Julien; Pottier, Corinne; Hie, Miguel; Mathian, Alexis; Devilliers, Hervé; Nunes, Hilario; Valeyre, Dominique; Amoura, Zahir

    2017-05-01

    Central nervous system localizations of sarcoidosis may be refractory to conventional treatment such as steroids and immunosuppressive drugs. Infliximab, a TNF-α antagonist chimeric antibody, has been shown to be effective for treatment of these localizations. The aim of this study was to evaluate the efficacy and safety, in particular the long-term outcomes, of the use of infliximab for the treatment of neurosarcoidosis. We retrospectively reviewed medical records of patients with neurosarcoidosis who had been treated with infliximab between 2009 and 2015. All patients had histologically proven non-caseating granulomas. Eighteen patients with histologically proven sarcoidosis were included in this study. All had neurological involvement consisting of meningeal (n = 16), cerebral (n = 10), spinal cord (n = 6), and/or optic nerve (n = 5) involvement. Sixteen patients had previously received at least one immunosuppressive drug in addition to corticosteroids, including cyclophosphamide in 11 patients. All patients received treatment with infliximab (3-7.5 mg/kg) associated with corticosteroids (n = 18), low-dose methotrexate (n = 15), azathioprine (n = 2), or mycophenolate (n = 1). Sixteen out of 18 patients improved clinically (initial median modified Rankin scale score of 3, final median score of 1; p infliximab, six patients obtained complete remission (33%), ten attained partial remission (56%), and two had stable disease (11%). The median follow-up time was 20 months (range 6-93). Nine patients relapsed during follow-up (50%). Eight patients developed toxic side effects and seven of these side effects were infectious events. Infliximab is an efficacious treatment of refractory neurosarcoidosis. However, relapses frequently occurred during follow-up.

  12. Virtuelt skrivebord med open office

    DEFF Research Database (Denmark)

    Nielsen, Kurt Gammelgaard

    2009-01-01

    SDUs erfaringer med projektet Port 22: en virtuel platform med Open Office som kontorpakke til studerende.......SDUs erfaringer med projektet Port 22: en virtuel platform med Open Office som kontorpakke til studerende....

  13. Advancing PubMed?

    DEFF Research Database (Denmark)

    Wildgaard, Lorna Elizabeth; Lund, Haakon

    2016-01-01

    Purpose Systematic reviews of biomedical literature are used to inform patient treatment. Yet the acquisition of relevant literature is proving increasingly challenging due to the large volume of information that needs to be searched, filtered and collocated. There is a need to improve...... the efficiency of biomedical literature searches. PubMed remains the primary resource for biomedical literature, and as PubMed makes the Medline data and Entrez PubMed Programming utilities freely available, any developer can produce alternative tools to search the database. The authors question if PubMed still...... 11 aspects. A systematic search in PubMed was used as study control. Findings The 16 tools limited rather than advanced the sorting, filtering, and export functionality required in a systematic search. The reproducibility of the searches in these sources was reduced. The study shows that Pub...

  14. Infliximab en pacientes con enfermedad ocular inflamatoria, refractarios a DARMES

    Directory of Open Access Journals (Sweden)

    Elmer R. García-Salazar

    2013-07-01

    Full Text Available Se describe la experiencia con infliximab (anticuerpo monoclonal con una potente acción antiinflamatoria en el tratamiento de enfermedades oculares inflamatorias secundarias a patologías reumáticas y refractarias a drogas antirreumáticas modificadoras de la enfermedad (DARMES. Se evaluó el caso de una paciente de 50 años con artritis reumatoide (AR de fondo activo y una paciente de 37 años con vasculitis anticuerpos anticitoplasma de neutrófilos especifico para mieloperoxidasa (ANCA MPO sin compromiso de órgano noble, ambas con escleritis bilateral y perforación con prolapso de iris del ojo izquierdo. Ellas recibieron infliximab EV en dosis de 3 a 5 mg/kg/dosis, según el esquema, a las 0, 2, 6 y 8 semanas. Infliximab resultó eficaz y seguro para el tratamiento de escleritis asociada a AR y vasculitis ANCA MPO positivo, refractaria a tratamiento con DARMES y corticoides en dosis altas. Los injertos de tejido esclerocorneal evolucionaron favorablemente con infliximab.

  15. Potential role of infliximab therapy in twelve Libyan patients with ...

    African Journals Online (AJOL)

    Potential role of infliximab therapy in twelve Libyan patients with Behçet's disease. E Basma, T Rajab, M Amani, E Borhan, B Gamal, M Eshabani. Abstract. Background: The blocking of tumour necrosis factor-α (TNF-α) with the socalled anti TNF-α agents has turned into the most important tool in the management of a variety ...

  16. Infliximab (Revellex(R)): a promise fulfilled?: medicine in practice ...

    African Journals Online (AJOL)

    Infliximab (Revellex(R)): a promise fulfilled?: medicine in practice. JP Wright. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

  17. Changing Infliximab Prescription Patterns in Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

    Larsen, Lone; Drewes, Asbjørn Mohr; Broberg, Marie Christine Hede

    2018-01-01

    Background: Long-term data on real life use of infliximab (IFX) for inflammatory bowel disease (IBD) are lacking. We studied prescription patterns during the first 16 years following marketing authorization. Methods: In a population-based cohort from the North Denmark Region, all IBD patients...

  18. Med-E-Tel

    National Research Council Canada - National Science Library

    Lievens, Frank; Jordanova, Malina

    2006-01-01

    .... The Med-e-Tel 2006 conference program covered over 130 presentations on topics such as homecare and health management, healthcare challenges, tele-education, eHealth in developing countries, telecardiology...

  19. Slut med skuffeprojekter

    DEFF Research Database (Denmark)

    Holm, Lisbeth; Pedersen, Preben Ulrich; Scheel, Linda Schumann

    2003-01-01

    En etårig tværfaglig uddannelse i projektledelse og evidensbaseret praksis for sundhedspersonale med mellemlange uddannelser har allerede medført konkrete ændringer i klinisk praksis til gavn for patienterne....

  20. PubMed

    CERN Document Server

    PubMed is the National Library of Medicine's search service that provides access to over 10 million citations in MEDLINE, PreMEDLINE, and other related databases, with links to participating online journals.

  1. PubMed

    Data.gov (United States)

    U.S. Department of Health & Human Services — PubMed comprises more than 26 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to...

  2. DailyMed

    Data.gov (United States)

    U.S. Department of Health & Human Services — DailyMed provides high quality information about marketed drugs. This information includes FDA labels (package inserts). This Web site provides health information...

  3. Med-E-Tel

    National Research Council Canada - National Science Library

    Lievens, Frank; Jordanova, Malina

    2006-01-01

    ..., and more. The Med-e-Tel 2006 exhibition showcased products and technologies in the areas of medication compliance, home telehealth and vital sign monitoring, clinical software, electronic medical records...

  4. Personer med handicap

    DEFF Research Database (Denmark)

    Larsen, Brian; Jonassen, Anders Bruun; Høgelund, Jan

    væsentligt i perioden frem til 2006. Det især personer med nedsat hørelse, som er kommet i beskæftigelse. Undersøgelsen er finansieret af Arbejdsmarkedskommissionen. Den bygger på oplysninger om personer med handicap, som havde en målt funktionsnedsættelse i 1995, og personer uden et handicap i 1995. Disse...

  5. Leg med vision

    DEFF Research Database (Denmark)

    Munk, Mette; Bertelsen, Katrine

    2011-01-01

    Bogen henvender sig primært til det pædagogiske personale med målgruppen daginstitutioner. Bogen skal stimulere arbejdet med at gøre bevægelse til en integreret del af kulturen i daginstitutioner - at få det pædagogiske personale til - at sætte ord på og spørgsmålstegn ved deres pædagogiske bevæg...

  6. B cell epitopes on infliximab identified by oligopeptide microarray with unprocessed patient sera.

    Science.gov (United States)

    Homann, Arne; Röckendorf, Niels; Kromminga, Arno; Frey, Andreas; Jappe, Uta

    2015-10-29

    Autoimmune diseases like rheumatoid arthritis and inflammatory bowel disease are treated with TNF-alpha-blocking antibodies such as infliximab and adalimumab. A common side effect of therapeutic antibodies is the induction of anti-drug antibodies, which may reduce therapeutic efficacy. In order to reveal immunogenic epitopes on infliximab which are responsible for the adverse effects, sera from patients treated with infliximab were screened by ELISA for anti-infliximab antibodies. Sera containing high levels of anti-drug-antibodies (>1.25 µg/ml) were analyzed in an oligopeptide microarray system containing immobilized 15-meric oligopeptides from the infliximab amino acid sequence. Immunogenic infliximab IgG-epitopes were identified by infrared fluorescence scanning and comparison of infliximab-treated patients versus untreated controls. Six relevant epitopes on infliximab were recognized by the majority of all patient sera: 4 in the variable and 2 in the constant region. Three of the epitopes in the variable region are located in the TNF-alpha binding region of infliximab. The fourth epitope of the variable part of infliximab is located close to the TNF-alpha binding region and contains an N-glycosylation sequon. The sera positive for anti-infliximab antibodies do not contain antibodies against adalimumab as determined by ELISA. Thus, there is no infliximab-adalimumab cross-reactivity as determined by these systems. Our data shall contribute to a knowledge-based recommendation for a potentially necessary therapy switch from infliximab to another type of TNF-alpha-blocker. The characterization of immunogenic epitopes on therapeutic monoclonal antibodies using unprocessed patient sera shall lead to direct translational aspects for the development of less immunogenic therapeutic antibodies. Patients benefit from less adverse events and longer lasting drug effects.

  7. Personer med handicap

    DEFF Research Database (Denmark)

    Amilon, Anna; Larsen, Lena Bech; Østergaard, Stine Vernstrøm

    Danmark har været omfattet af FN’s handicapkonvention siden 2009. I tråd med konventionen har den danske handicappolitik til hensigt at skabe lige muligheder for mennesker med handicap og den øvrige befolkning. Denne undersøgelse belyser, i hvilket omfang dette sigte er opfyldt for mennesker med...... handicap i 2016, sammenholdt med den øvrige voksne befolkning. Undersøgelsen sætter fokus på forhold omkring uddannelse, beskæftigelse, forsørgelse, livskvalitet og sundhed, deltagelse og tilgængelighed samt sagsbehandling og diskrimination. Rapporten giver på den måde et bredt billede af, dels hvordan...... forholdene er for mennesker med handicap i 2016, og dels hvordan forholdene har udviklet sig siden den første undersøgelsesrunde i 2012. Undersøgelsen viser, at der er store forskelle på mennesker med og uden handicap, også når det gælder helt fundamentale områder for velfærdssamfundet så som uddannelse og...

  8. Monitoring patients treated with anti-TNF-alpha biopharmaceuticals: assessing serum infliximab and anti-infliximab antibodies

    DEFF Research Database (Denmark)

    Svenson, M; Geborek, P; Saxne, T

    2007-01-01

    Infliximab is an anti-tumour necrosis factor-alpha (TNF-alpha) mouse-human IgG1/kappa antibody used to treat patients with rheumatoid arthritis (RA) and other inflammatory diseases. Unfortunately, response failure and side-effects due to immunogenicity of the drug are not rare. In this study, we ...

  9. Knowledge of Fecal Calprotectin and Infliximab Trough Levels Alters Clinical Decision-making for IBD Outpatients on Maintenance Infliximab Therapy.

    Science.gov (United States)

    Huang, Vivian W; Prosser, Connie; Kroeker, Karen I; Wang, Haili; Shalapay, Carol; Dhami, Neil; Fedorak, Darryl K; Halloran, Brendan; Dieleman, Levinus A; Goodman, Karen J; Fedorak, Richard N

    2015-06-01

    Infliximab is an effective therapy for inflammatory bowel disease (IBD). However, more than 50% of patients lose response. Empiric dose intensification is not effective for all patients because not all patients have objective disease activity or subtherapeutic drug level. The aim was to determine how an objective marker of disease activity or therapeutic drug monitoring affects clinical decisions regarding maintenance infliximab therapy in outpatients with IBD. Consecutive patients with IBD on maintenance infliximab therapy were invited to participate by providing preinfusion stool and blood samples. Fecal calprotectin (FCP) and infliximab trough levels (ITLs) were measured by enzyme linked immunosorbent assay. Three decisions were compared: (1) actual clinical decision, (2) algorithmic FCP or ITL decisions, and (3) expert panel decision based on (a) clinical data, (b) clinical data plus FCP, and (c) clinical data plus FCP plus ITL. In secondary analysis, Receiver-operating curves were used to assess the ability of FCP and ITL in predicting clinical disease activity or remission. A total of 36 sets of blood and stool were available for analysis; median FCP 191.5 μg/g, median ITLs 7.3 μg/mL. The actual clinical decision differed from the hypothetical decision in 47.2% (FCP algorithm); 69.4% (ITL algorithm); 25.0% (expert panel clinical decision); 44.4% (expert panel clinical plus FCP); 58.3% (expert panel clinical plus FCP plus ITL) cases. FCP predicted clinical relapse (area under the curve [AUC] = 0.417; 95% confidence interval [CI], 0.197-0.641) and subtherapeutic ITL (AUC = 0.774; 95% CI, 0.536-1.000). ITL predicted clinical remission (AUC = 0.498; 95% CI, 0.254-0.742) and objective remission (AUC = 0.773; 95% CI, 0.622-0.924). Using FCP and ITLs in addition to clinical data results in an increased number of decisions to optimize management in outpatients with IBD on stable maintenance infliximab therapy.

  10. Med handicap i vuggestuen

    DEFF Research Database (Denmark)

    Bendix-Olsen, Kurt

    2017-01-01

    Artiklen udforsker det deltagelsesmæssige råderum, som vuggestuebørn med handicap har i hverdagens inklusionspraksis i ressourcebørnehuse. Ressourcebørnehusenes inklusionsarrangementer er i fokus med henblik på at undersøge, på hvilke måder børn med handicap deltager i hverdagen og får erfaringer...... med og mulighed for at udvikle rådighed. Artiklen fremanalyserer, at inklusionsarrangementer tilvejebringes gennem tre væsensforskellige organiseringer af pædagogisk praksis, der hver på sin måde tilbyder børn med handicap særlige deltagelsesbetingelser: 1) Et kapacitetsfokuseret arrangement 2) Et...... rummende omsorgsarrangement 3) Et repertoireskabende arrangement. De to førstnævnte arrangementer peger på, at handicap er knyttet til binære forståelser af børns behov som almene eller særlige. Hvor de professionelle i det kapacitetsfokuserede arrangement vægtlægger udvikling af barnets kropsfunktioner og...

  11. Acute and delayed hypersensitivity reactions to infliximab and adalimumab in a patient with Crohn's disease

    DEFF Research Database (Denmark)

    Steenholdt, Casper; Svenson, Morten; Bendtzen, Klaus

    2012-01-01

    A 61 year old woman with active luminal Crohn's disease was successfully treated with infliximab induction therapy followed by 5 infusions every 8 weeks. However, symptoms returned in the weeks preceding the 7th and 8th infusions. The 9th infusion was therefore given only 4 weeks after the 8th...... infusion, but an acute severe anaphylactoid reaction occurred immediately after start of the infusion. Anti-infliximab IgG antibody concentration was high (100 U/ml) prior to the 8th infusion and up to 1 year after infliximab discontinuation (81 U/ml). Anti-infliximab IgE antibodies were not found......, and the anti-infliximab antibodies did not cross react with adalimumab. One week after the anaphylactoid reaction to infliximab, adalimumab therapy was initiated. Twelve days after the first adalimumab administration (80 mg), a delayed hypersensitivity reaction occurred. This was likely caused by rapidly...

  12. Clinical Use and Mechanisms of Infliximab Treatment on Inflammatory Bowel Disease: A Recent Update

    Science.gov (United States)

    Guo, Yuan; Lu, Nonghua; Bai, Aiping

    2013-01-01

    The pathogenesis and treatment of inflammatory bowel disease (IBD) have been recently advanced, while it is still challenged with high morbidity and poor prognosis. Infliximab, a monoclonal antibody of tumor necrosis factor (TNF), has emerged as an efficient treatment with many clinical benefits such as quick disease activity reduction and IBD patient life quality improvement. However, the biological effects of infliximab on IBD need to be elucidated. This paper reviewed the clinical use and recently advanced biological action of infliximab on IBD. By forming the stable complex with the soluble or the membrane form of TNF in fluid environment or on cell surface of immune cell, fibroblast, endothelium, and epithelium, infliximab quenches TNF activity and performs the important biological actions which lead to amelioration and remission of immune responses. The mechanisms of infliximab treatment for IBD were intensively discussed. The recent advances on two topics including predictors and side effects of infliximab treatment were also reviewed. PMID:23484133

  13. Infliximab dependency in a national cohort of children with Crohn's disease

    DEFF Research Database (Denmark)

    Wever, Anne Vibeke; Riis, Lene; Vind, Ida

    2006-01-01

    AIM: The aim was to evaluate the pattern of responsiveness and to monitor side effects of episodic administration of infliximab in children with active Crohn's disease (CD) treated in Denmark from 1999 to 2003. MATERIAL AND METHODS: The National Danish Crohn Colitis Database of infliximab was used...... to identify all Danish CD patients treated at pediatric departments with infliximab. The clinical outcome was assessed by pattern recognition of the disease course 30 days after the first infliximab infusion and 90 days after intended end of treatment. RESULTS: During a 3 year period, infliximab was given...... to 24 CD patients (9 male/15 female) aged median 15.4 (range 9.8-18.6) years with a median disease duration of 26 (range 0.7-93) months and a median number of infusions of 6 (range 2-11). Five milligrams of infliximab per kilogram infusions were given intravenously. Immediate response was as follows: 8...

  14. Higher infliximab trough levels are associated with perianal fistula healing in patients with Crohn's disease.

    Science.gov (United States)

    Yarur, A J; Kanagala, V; Stein, D J; Czul, F; Quintero, M A; Agrawal, D; Patel, A; Best, K; Fox, C; Idstein, K; Abreu, M T

    2017-04-01

    Infliximab has been found to be efficacious in the treatment of fistulas in the setting of Crohn's disease, even though some patients do not benefit from therapy. To assess the correlation between perianal fistula healing and trough levels of infliximab. In this cross-sectional study, we identified patients with Crohn's disease who had perianal fistulas and were treated with infliximab for at least 24 weeks. We excluded patients who underwent a faecal diversion procedure or proctectomy. Predictive variables included demographics, disease phenotype, disease activity, infliximab levels, anti-infliximab antibodies. The primary outcome was fistula healing defined as the absence of drainage. The secondary outcome was complete fistula closure and mucosal healing. 117 patients were included. Patients with fistula healing had significantly higher median serum infliximab levels when compared to those with active fistulas [15.8 vs. 4.4 μg/mL, respectively (P infliximab levels. The AUC for the association between fistula healing and infliximab levels was 0.82 (P infliximab levels and fistula closure was 0.69 (P = 0.014). Patients with anti-infliximab antibodies had a lower chance of achieving fistula healing (OR: 0.04 [95%CI: 0.005-0.3], P infliximab levels and rates of fistula healing. Achieving infliximab levels ≥10.1 mcg/mL in patients with Crohn's disease and perianal fistulas may improve outcomes as part of a treat-to-target strategy. © 2017 John Wiley & Sons Ltd.

  15. Characteristics and outcomes of rheumatoid arthritis patients who started biosimilar infliximab.

    Science.gov (United States)

    Sung, Yoon-Kyoung; Cho, Soo-Kyung; Kim, Dam; Won, Soyoung; Choi, Chan-Bum; Bang, So-Young; Hong, Seung-Jae; Kim, Hyoun Ah; Koh, Eun-Mi; Lee, Hye-Soon; Suh, Chang-Hee; Yoo, Dae-Hyun; Bae, Sang-Cheol

    2017-06-01

    To compare the characteristics of rheumatoid arthritis (RA) patients receiving either biosimilar or originator infliximab and to identify the effectiveness and safety of biosimilar infliximab in RA patients in real-world practice. RA patients who started either biosimilar or originator infliximab were selected using the prospective biologic disease-modifying anti-rheumatic drugs (DMARDs) registry: BIOlogics Pharmacoepidemiologic StudY (BIOPSY). Baseline characteristics of the two groups were compared, and short-term treatment outcomes, including DAS28-ESR and HAQ-DI scores, were compared after initiation of biosimilar or originator infliximab. The drug retention rates of the two groups were also compared. A total of 100 RA patients, 55 biosimilar, and 45 originator infliximab users were included in this analysis. Baseline characteristics of age, disease duration, and previous or current medications were similar in the two groups. Baseline DAS28-ESR was higher in the originator infliximab group (6.3 ± 1.1 vs. 5.8 ± 1.1, p = 0.02). The early DAS28-ESR remission rates observed 7.9 ± 1.8 months after starting biosimilar and originator infliximab were 15.0 and 25.0%, respectively (p = 0.47). The change in HAQ-DI did not differ between the two groups (0.4 ± 0.7 vs. 0.4 ± 0.8, p = 0.94). Patients treated with biosimilar infliximab in clinical practice had lower disease activity at the start of treatment than those receiving originator infliximab. Biosimilar infliximab was well-tolerated, safe, and of similar clinical effectiveness to originator infliximab. Larger number of patient and longer follow-up data will be needed to confirm the effectiveness and safety of biosimilar infliximab in clinical practice.

  16. Infliximab Modulates Cisplatin-Induced Hepatotoxicity in Rats

    Directory of Open Access Journals (Sweden)

    Medine Cumhur Cüre

    2016-10-01

    Full Text Available Background: Cisplatin (Cis is one of the most commonly used antineoplastic drugs. It is used as chemotherapy for many solid organ malignancies such as brain, neck, male and female urogenital, vesical and pulmonary cancers. Infliximab blocks tumor necrosis factor alpha (TNF-α. Several studies have reported that infliximab ameliorates cell damage by reducing cytokine levels. Aims: We aimed to investigate whether infliximab has a preventive effect against cisplatin-induced hepatotoxicity and whether it has a synergistic effect when combined with Cis. Study Design: Animal experimentation. Methods: Male Wistar albino rats were divided in three groups as follows: Cis group, infliximab + Cis (CIN group and the control group. Each group comprised 10 animals. Animals in the Cis group received an intraperitoneal single-dose injection of Cis (7 mg/kg. In the CIN group, a single dose of infliximab (7 mg/kg was administered 72 h prior to the Cis injection. After 72 h, a single dose of Cis (7 mg/kg was administered. All rats were sacrificed five days after Cis injection. Results: TNF-α levels in the Cis group were significantly higher (345.5±40.0 pg/mg protein than those of the control (278.7±62.1 pg/mg protein, p=0.003 and CIN groups (239.0±64.2 pg/mg protein, p=0.013. The Cis group was found to have high carbonic anhydrase (CA-II and low carbamoyl phosphate synthetase-1 (CPS-1 levels. Aspartate transaminase (AST and alanine transaminase (ALT levels were lower in the CIN group as compared to the Cis group. Total histological damage was greater in the Cis group as compared to the control and CIN groups. Conclusion: Cis may lead to liver damage by increasing cytokine levels. It may increase oxidative stress-induced tissue damage by increasing carbonic anhydrase II (CA-II enzyme levels and decreasing CPS-1 enzyme levels. Infliximab decreases Cis-induced hepatic damage by blocking TNF-α and it may also protect against liver damage by regulating CPS-1 and

  17. Infliximab Dependency in a National Cohort of Children with Crohn's Disease

    DEFF Research Database (Denmark)

    Wewer, Anne Vibeke; Riis, L; Vind, Ida

    2006-01-01

    AIM: The aim was to evaluate the pattern of responsiveness and to monitor side effects of episodic administration of infliximab in children with active Crohn's disease (CD) treated in Denmark from 1999 to 2003. MATERIAL AND METHODS: The National Danish Crohn Colitis Database of infliximab was used...... of symptoms requiring reinfusions of infliximab to regain CR or PR, and 6 (25%) had NR. Six (25%) patients needed surgery during or after treatment with infliximab. Side effects were seen in four (17%) patients. No serious events were noted. CONCLUSION: Seventy-one percent of the children appeared to benefit...

  18. Infliximab dependency in a national cohort of children with Crohn's disease

    DEFF Research Database (Denmark)

    Wever, Anne Vibeke; Riis, Lene; Vind, Ida

    2006-01-01

    AIM: The aim was to evaluate the pattern of responsiveness and to monitor side effects of episodic administration of infliximab in children with active Crohn's disease (CD) treated in Denmark from 1999 to 2003. MATERIAL AND METHODS: The National Danish Crohn Colitis Database of infliximab was used...... of symptoms requiring reinfusions of infliximab to regain CR or PR, and 6 (25%) had NR. Six (25%) patients needed surgery during or after treatment with infliximab. Side effects were seen in four (17%) patients. No serious events were noted. CONCLUSION: Seventy-one percent of the children appeared to benefit...

  19. Infliximab-Induced Hypothyroidism: A Novel Case and Postulations concerning the Mechanism

    Directory of Open Access Journals (Sweden)

    Brett Cerniglia

    2013-01-01

    Full Text Available We report a patient with cutaneous sarcoidosis who developed hypothyroidism following 17 months of infliximab therapy. To our knowledge, this is the first reported case of hypothyroidism following infliximab administration. While it is possible that the patient’s hypothyroidism was unrelated to the use of infliximab, the time course and lack of alternative explanations make such an association plausible. We postulate that hypothyroidism in this patient may have been related to the development of autoantibodies to infliximab that triggered the development of an autoimmune thyroiditis. Regardless of the mechanism, we would encourage clinicians to keep the potential mechanisms of TNF- in mind when treating patients with TNF- antagonist medications.

  20. Infliximab alleviates the mortality, mesenteric hypoperfusion, aortic dysfunction, and multiple organ damage in septic rats.

    Science.gov (United States)

    Ozer, Erdem Kamil; Goktas, Mustafa Tugrul; Kilinc, Ibrahim; Toker, Aysun; Bariskaner, Hulagu; Ugurluoglu, Ceyhan; Iskit, Alper Bektas

    2017-07-01

    Tumor necrosis factor-alpha (TNF-α) is a pivotal mediator that triggers inflammatory process, oxidative stress, and multiple organ injury in sepsis. We investigated the effects of infliximab on survival, mesenteric artery blood flow (MBF), vascular reactivity, and oxidative and inflammatory injuries in cecal ligation and puncture (CLP)-induced sepsis. Wistar rats were divided into Sham, CLP, Sham+infliximab, and CLP+infliximab subgroups. Twenty-four hours before the operations, rats were injected intraperitoneally with infliximab (7 mg/kg) or vehicle (saline; 1 mL/kg). Twenty hours after the operations, MBF and phenylephrine responses of isolated aortic rings were measured. Tissue damages were examined biochemically and histopathologically. Furthermore, survival rates were monitored throughout 96 h. Infliximab improved survival, mesenteric perfusion, and aortic function after CLP. Increases of serum AST, ALT, LDH, BUN, Cr, and inflammatory cytokines (tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6) induced by CLP were blocked by infliximab. Infliximab prevented malondialdehyde elevations in septic liver, lung, spleen, and kidney tissues, as well as glutathione reductions in septic liver, spleen, and kidney tissues. Protective effects of infliximab on multiple organ damage were also observed histopathologically. Infliximab showed protective effects in sepsis due to its improvement effects on mesenteric perfusion, aortic function, and its anti-inflammatory and antioxidative effects.

  1. Treatment of experimental autoimmune uveoretinitis with intravitreal injection of infliximab encapsulated in liposomes.

    Science.gov (United States)

    Zhang, Rui; Qian, Jiang; Li, Xiaofeng; Yuan, Yifei

    2017-12-01

    To evaluate the safety and efficacy of intravitreal injection of liposomes encapsulating infliximab in experimental autoimmune uveoretinitis (EAU) rats. Liposomes containing infliximab were prepared and characterised for mean particle size, entrapment efficiency, polydispersity index (PDI) and zeta potential. In vitro release profile and the stability of infliximab-lip were evaluated. EAU rats were intravitreally injected with saline, infliximab, infliximab-lip or unloaded liposomes. Clinical signs and ocular histological sections were graded. Infliximab concentrations were determined with competitive ELISA. Safety of the intravitreal injections was evaluated by electroretinography (ERG) and histopathological examination. Retinal biodistribution and clearance of rhodamine-conjugated liposomes containing infliximab were evaluated with a laser scanning confocal microscope. The mean particle size of infliximab liposomes was 351.3±58 nm and entrapment efficiency was 90.65%±2.68%. PDI and zeta potential of infliximab liposomes were 0.386 and -20.8±9.78 mV, respectively. Stability test data showed that the infliximab-lip was stable for 60 days at room temperature. In EAU rats, intravitreal injection of infliximab and infliximab-lip greatly reduced intraocular inflammation determined by clinical scores and histopathological analyses (n=4). The mean concentrations of infliximab decreased quickly in infliximab injection group and were lower than those in infliximab-lip injection group (n=4 eyes, pinfliximab-lip in ERG (n=4 rats, p>0.05) and histopathological sections compared with normal rats. Confocal microscopy showed that fluorescent liposomes were observed in almost every layer of the retina and remained detectable for >30 days after injection. Intravitreal injection of liposomal infliximab can prolong the persistence of the drug in vitreous body and demonstrated a satisfactory safety and significant therapeutic potentials in EAU. The use of biodegradable

  2. Direct effect of infliximab on intestinal mucosa sustains mucosal healing: exploring new mechanisms of action.

    Science.gov (United States)

    Petito, Valentina; Lopetuso, Loris Riccardo; Arena, Vincenzo; Stigliano, Egidio; Boninsegna, Alma; Bibbò, Stefano; Poscia, Andrea; Alfieri, Sergio; Rosa, Fausto; Amato, Arianna; Cammarota, Giovanni; Papa, Alfredo; Sgambato, Alessandro; Gasbarrini, Antonio; Scaldaferri, Franco

    2016-04-01

    Infliximab is effective in inflammatory bowel disease through several mechanisms, possibly acting at the mucosal level. To assess the role of infliximab on intestinal mucosa and whether it contributes to mucosal healing. Human colonic mucosal biopsies were incubated with or without infliximab. Cultured biopsies were evaluated for histological staining, CD68, CD3, E-cadherin and phospho-extracellular signal-regulated kinases (ERK) expression, and apoptosis. A scratch assay and MTT assay were performed with Caco2 cells in the presence of infliximab and/or tumour necrosis factor (TNF)-α or treated with supernatants obtained from human peripheral blood mononuclear cells or human intestinal fibroblasts treated with TNF-α and infliximab alone or in association. Infliximab-treated biopsies displayed a better histological appearance, reduced inflammation with an increase of E-cadherin, phospho-ERK and apoptosis. Supernatants showed lower TNF-α, IL-17, IL-6 and IL-8 concentration, with an increase in fibroblast-growth-factor. Motility at scratch assay and proliferation at MTT assay of Caco2 cells displayed differential modulation by TNF-α and infliximab, directly or through supernatants of human intestinal fibroblasts and human peripheral blood mononuclear cells exposed to them. Infliximab contributes to the mucosal healing process by acting directly at an intestinal mucosal level; infliximab indirectly affects epithelial cell migration and proliferation by acting on both fibroblasts and leukocytes. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. MED COMMITTEE STRUCTURE

    Science.gov (United States)

    It is beneficial to share good Diversity-related practices with other NHEERL Divisions. Sharing of this information will help MED showcase the many activities that are in place for Diversity that we are using to help us become a level 4 organization.

  4. Professionalisme med innovativt potentiale

    DEFF Research Database (Denmark)

    Nielsen, Inger Marie

    To teoretiske sværvægtere bliver koblet sammen i Inger Marie Larsen-Nielsen arbejdspapir om professionalisme med innovativt potentiale. De to teoretikere er læringsteoretikeren John Dewey og socialpsykologen Georg Herbert Mead, som er sat sammen i en teoretisk forståelsesramme omkring professionel...

  5. Intrauterin insemination med donorsaed. Behandling af ufrivillig barnløshed på grund af mandlig infertilitet

    DEFF Research Database (Denmark)

    Vilsbøll, Tina; Helmsøe-Zinck, Lise; Andersen, A N

    1994-01-01

    Intrauterine insemination with cryopreserved donor semen was performed in 114 women in a total of menstrual 381 cycles during the period 1.2.1991 to 15.5.1993. Eighty-one pregnancies were recorded corresponding to a conception rate of 21% per insemination cycle. After ten cycles the probability...... of conception and expected delivery was respectively 96% and 86%. The results show that intrauterine insemination with donor semen is a good treatment for couples with male infertility. Ultrasonic measurement of the follicles and timing of hCG injection were used for optimal timing of intrauterine donor...... insemination. The quality of the semen used for insemination is important. It is recommended to inseminate with at least two million of spermatozoa where at least 20% have normal motility....

  6. Behandling med duodenal-jejunal bypass-sleeve ved svær overvægt

    DEFF Research Database (Denmark)

    Rohde, Ulrich; Gylvin, Silas; Vilmann, Peter

    2014-01-01

    Overweight and obesity are risk factors for several co-morbidities reducing life expectancy. Conservative treatment of obesity is generally ineffective in the long-term. Bariatric surgery has proven effective, but is associated with potential complications. Duodenal-jejunal bypass sleeve is a novel...

  7. Medicinsk vs. kirurgisk behandling af svært overvægtige patienter med type 2-diabetes

    DEFF Research Database (Denmark)

    Svane, Maria Saur; Bojsen-Møller, Kirstine Nyvold; Madsbad, Sten

    2016-01-01

    Bariatric surgery induces large and sustainable weight loss in obese patients and improves glycaemic control in patients with Type 2 diabetes. Eleven randomized controlled trials have shown superior glycaemic outcomes after bariatric procedures vs. medical therapy/intensive lifestyle interventions...... in obese patients with Type 2 diabetes. Furthermore, many patients experience remission of Type 2 diabetes after surgery but relapse may occur during follow-up. Data from observational studies show reduced incidence of micro- and macrovascular complications in addition to reduced cardiovascular and total...... mortality after surgery....

  8. Forebyggelse af infektioner hos patienter, der har kronisk inflammatorisk tarmsygdom og er i behandling med TNF-hæmmere

    DEFF Research Database (Denmark)

    Risager Christensen, Katrine; Steenholdt, Casper

    2014-01-01

    suppression of the immune system. National and international guidelines recommend screening and vaccination for selected infectious agents prior to anti-TNF initiation as well as during ongoing anti-TNF therapy. This review focuses on current available recommendations and discusses physicians’ and patients......Prevention of infections in patients with inflammatory bowel disease during TNF inhibitor treatment Treatment of inflammatory bowel disease with anti-tumour necrosis factor (TNF)-alpha biopharmaceuticals is generally well tolerated, but increases the risk of infections due to globally induced...

  9. Skandinaviske kliniske retningslinjer for præhospital behandling af patienter med svære hovedtraumer

    DEFF Research Database (Denmark)

    Juul, Niels; Sollid, Snorre; Sundstrøm, Terje

    2008-01-01

    . Evidence-based guidelines already exist that focus on all steps in the management. This article, which was written by members of the Scandinavian Neurotrauma Committee, presents recommendations on the pre-hospital management of traumatic brain injury adapted to the infrastructure of Scandinavia...

  10. Heterotop graviditet efter IVF-behandling med excision af rumperet interstitiel graviditet og senere kejsersnit nær termin

    DEFF Research Database (Denmark)

    Elers, Jimmi; Zingenberg, Helle; Bing, Mette Hornum

    2017-01-01

    We describe a rare case of heterotopic pregnancy following in vitro fertilization with transferring of two embryos in a 39-year-old woman with previous bilateral salpingectomy. An ultrasound examination was performed on the day before admission showing a vital intrauterine pregnancy and no ectopic...... pregnancy. The woman was admitted with a ruptured cornual pregnancy at ten weeks of gestation. Laparotomy was performed on vital indication with excision of the ruptured haemorrhagic cornual pregnancy. The intrauterine pregnancy continued uneventfully with obstetric and fetal medicine specialist monitoring...

  11. Heterotop graviditet efter IVF-behandling med excision af rumperet interstitiel graviditet og senere kejsersnit nær termin

    DEFF Research Database (Denmark)

    Elers, Jimmi; Zingenberg, Helle; Bing, Mette H

    2016-01-01

    We describe a rare case of heterotopic pregnancy following in vitro fertilization with transferring of two embryos in a 39-year-old woman with previous bilateral salpingectomy. An ultrasound examination was performed on the day before admission showing a vital intrauterine pregnancy and no ectopic...... pregnancy. The woman was admitted with a ruptured cornual pregnancy at ten weeks of gestation. Laparotomy was performed on vital indication with excision of the ruptured haemorrhagic cornual pregnancy. The intrauterine pregnancy continued uneventfully with obstetric and fetal medicine specialist monitoring...

  12. Behandling med statiner medfører en øget risiko for udvikling af type 2-diabetes

    DEFF Research Database (Denmark)

    Solis, Anette Bratt; Pilemann-Lyberg, Sascha; Gæde, Peter

    2014-01-01

    Statins are important in the prevention of cardiovascular (CV) disease. However, they are associated with new-onset diabetes in a dose-dependent manner, particularly when the patient is already in risk of contracting diabetes. Meta-analyses estimate that the risk is increased by 9%. In absolute t...

  13. Behandling af våd aldersrelateret makuladegeneration med vaskulaer endotel vaekstfaktorhaemmer. Gennemgang af et Cochrane-review

    DEFF Research Database (Denmark)

    Bloch, Sara Brandi; Larsen, Michael

    2009-01-01

    This evaluation of a Cochrane-review including five clinical trials of good methodological quality indicates that the antiangiogenic therapeutic agents, pegaptanib and ranibizumab, are effective treatment strategies for neovascular Age-Related Macular Degeneration (AMD). The review does not include...

  14. En krobjektiv lidelse? Forståelse og behandling af kroniske, diffuse smertelidelser med fibromyalgi som eksempel

    Directory of Open Access Journals (Sweden)

    Rie Lykke Danielsen

    2011-12-01

    Full Text Available The article deals with the disease field chronic diffuse pains, here exemplified by fibromyalgia, where patients are frequently rendered homeless in an objectivity focused medical treatment system, whose specialities (ideally seen are mutually exclusive, and where the absence of a diagnosis therefore poses a fundamental problem. In the treatment field there is, however, also a bio-psycho-social approach, and these two treatment regimes are respectively termed as a chrObjective approach and a holistic subject approach.By empirical examples, from stories by both therapists and patients, the article describes how the actors navigate between the two treatment regimes, to which the patients must necessarily adapt in their wish for acceptance and assistance from both sides. The authors further discuss to which degree the two treatment regimes are actually incompatible. The interviews and observation of participants, which constitute the empirical basis for the article, were carried out among therapists and patients in Denmark in 2010.

  15. Behandling med acetylsalicylsyre kan forebygge præeklampsi hos gravide kvinder i højrisiko

    DEFF Research Database (Denmark)

    Käehne, Line Vedel; Lundin, Ingeborg Christina Rørbye

    2017-01-01

    Pre-eclampsia is a major contributor to perinatal morbidity and mortality. Large studies of high-risk pregnant women have shown reduced risk of developing pre-eclampsia when they are treated with low-dose acetylsalicylic acid in early pregnancy. Treatment is also effective in preventing...... of acetylsalicylic acid can be started early in pregnancy....

  16. Behandling af renovaskulær hypertension med transluminal angioplastik--13 års erfaring--sekundærpublikation

    DEFF Research Database (Denmark)

    Øvrehus, Kristian Altern; Andersen, Poul Erik; Jacobsen, Ib Abildgaard

    2008-01-01

    angioplasty. A total of 124 patients were treated; 31% were normotensive immediately after angioplasty, 59% had improved blood pressure control and 10% had unchanged hypertension. The corresponding figures after six months and at the latest follow-up were 13, 72 and 15%. Udgivelsesdato: 2008-Jan-21......The result of treatment of renovascular hypertension by renal angioplasty over a period of 13 years was analysed. Patients with a positive diagnostic work-up with renography or renal vein renin measurement had renal angiography performed and in cases of renal artery stenosis, transluminal...

  17. Infliximab-induced intertriginous psoriasis in patient with Crohn's desease

    Directory of Open Access Journals (Sweden)

    Federica Mola

    2011-10-01

    Full Text Available Tumor necrosis factor-α (TNFα inhibition is an effective treatment of moderate-to-severe psoriasis and other diseases (rheumatoid arthritis, ankylosing spondylitis, psoriasis or Crohn’s disease. We report a case of a 32- years-old patient affected by Crohn’s disease since the age of 25 who started infliximab infusion after four years of treatment with prednisone and azathioprine per os without improvement. After the fifth infusion of infliximab, he developed a form of intertriginous psoriasis which was approached with topical steroid cream. The patient never presented psoriasis in the past. New onset of psoriasis in patients without history for skin diseases (as in our case is a quite uncommon complication of TNFα inhibitor therapy. The increased production of IFNα during TNFα inhibitor therapy is a possible pathophysiologic explanation for this paradoxical effect of the anti-TNFα.

  18. Polyarthritis flare in patient with ankylosing spondylitis treated with infliximab

    Directory of Open Access Journals (Sweden)

    E. Filippucci

    2011-06-01

    Full Text Available Over the last ten years, the treatment of seronegative spondyloarthropathies has changed dramatically with the introduction of the anti-tumor necrosis factor alpha (TNFα agents. Nevertheless, there is a growing number of studies describing several adverse reactions in patients treated with biological agents. In the present report we describe the case of a 22-year-old male patient with ankylosing spondylitis who developed a “paradoxic” adverse reaction, while receiving infliximab.

  19. Infliximab therapy in pediatric Crohn’s disease: a review

    Directory of Open Access Journals (Sweden)

    Kalyan Ray Parashette

    2010-06-01

    Full Text Available Kalyan Ray Parashette1, Raghavendra Charan Makam2, Carmen Cuffari31Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA; 2Department of Internal Medicine, Berkshire Medical Center, Pittsfield, MA, USA; 3Division of Pediatric Gastroenterology, The Johns Hopkins Children’s Center, Baltimore, MD, USAAbstract: Anti-tumor necrosis factor alpha (TNF-α therapy has re-defined our treatment paradigms in managing patients with Crohn’s disease (CD and ulcerative colitis. Although the ACCENT studies showed proven efficacy in the induction and maintenance of disease remission in adult patients with moderate to severe CD, the pediatric experience was instrumental in bringing forth the notion of “top-down” therapy to improve overall clinical response while reducing the risk of complications resulting from long-standing active disease. Infliximab has proven efficacy in the induction and maintenance of disease remission in children and adolescents with CD. In an open-labeled study of 112 pediatric patients with moderate to severe CD, 58% achieved clinical remission on induction of infliximab (5 mg/kg therapy. Among those patients who achieved disease remission, 56% maintained disease remission on maintenance (5 mg/kg every 8 weeks therapy. Longitudinal follow-up studies have also shown that responsiveness to infliximab therapy also correlates well with reduced rates of hospitalization, and surgery for complication of long-standing active disease, including stricture and fistulae formation. Moreover, these children have also been shown to improve overall growth while maintaining an effective disease remission. The pediatric experience has been instructive in suggesting that the early introduction of anti-TNF-α therapy may perhaps alter the natural history of CD in children, an observation that has stimulated a great deal of interest among gastroenterologists who care for adult patients with CD.Keywords: Crohn’s disease

  20. Behandling af defaekationsblokade som følge af dyb fossa recto-genitalis med total baekkenbundsrekonstruktion med Prolene-net

    DEFF Research Database (Denmark)

    Møller, P; Monrad, H; Kehlet, H

    1992-01-01

    The causes of severe defaecation blockage resulting from compression of the rectum and deep recto-genital fossa are reviewed and are illustrated by three patients who had previously undergone hysterectomy and who had incapacitating defaecation blockage and abdominal pain requiring morphine in two...... of the patients. The condition had not been diagnosed despite previous hospital contact for many years in two of the patients. Complete reconstruction of the pelvic floor with prolene net was performed. Subsequent defaecography showed normalization of defaecation without rectal compression and with relief...... of the abdominal pain and dependence on morphine in two of the patients. Rectal compression resulting from an abnormally deep recto-genital fossa should be included in the differential diagnostic deliberations in patients with severe constipation and defaecation blockage. Complete reconstruction of the pelvic...

  1. Het ontstaan van immuuncomplexen van infliximab en anti-infliximab als een verklaring voor het falen van infliximabtherapie bij reumatoïde artritis: observationeel onderzoek bij 4 patiënten

    NARCIS (Netherlands)

    van der Laken, C. J.; Voskuyl, A. E.; Roos, J. C.; Stigter van Walsum, M.; de Groot, E. R.; Wolbink, G. J.; Dijkmans, B. A. C.; Aarden, L. A.

    2008-01-01

    OBJECTIVE: To investigate the in vivo mechanism of non-responding to infliximab treatment of patients with rheumatoid arthritis (RA) and the role of anti-infliximab antibodies by using radiolabeled infliximab. DESIGN: Descriptive and comparative study. METHOD: Two responding and two non-responding

  2. Infliximab for treating sarcoidosis patients, Portuguese experience

    Directory of Open Access Journals (Sweden)

    M. Aguiar

    2011-03-01

    Full Text Available Despite aggressive treatment, sarcoidosis may be debilitating and progressive. The role of tumor necrosis factor (TNF ap in the genesis of granulomas is ambiguous. It has proved to be critical in the formation and maintenance of granulomatous inflammation and its antagonist, Infl iximab, has therefore been used with success in the treatment of patients with sarcoidosis. There are, however, reports of onset of sarcoidosis in patients treated for other conditions and where there had been no outbursts before submission to this therapy. We used Infl iximab in the treatment of patients with sarcoidosis who either had not responded to corticosteroids and other conventional drugs or had developed unacceptable side effects to these drugs. The initial dose was 5 mg/kg body weight and subsequent doses were given at weeks 2, 4 and then every other 8 weeks for a total period of one year. We treated ten patients with biopsy proven sarcoidosis, five men and five women, with a mean age of 47.1 years ranging from 28 to 63 years of age. Three patients had severe neurological symptoms, two had hepatic cirrhosis, one had granulomatous inflammation of the lachrymal gland and had already undergone repeated surgery, one had extensive pulmonary involvement (stage III, one had disfiguring lupus pernio and two presented disabling cutaneous nodules. Eight patients had more than one organ with evidence of disease. All patients were submitted to at least seven infusions of Infliximab. In four patients the dosage of corticosteroids or other immunosuppressive drugs was suspended, in three the dosage was reduced and in one, corticosteroids were added to the Infl iximab therapy. In five of the patients there was an important improvement. One of the patients with neurological symptoms displayed a complete recovery, while another had significant improvement of vision deficit enabling her to read again. Two patients withdrew from therapy, one due to lack of improvement of

  3. Inflammatory Bowel Disease Patients Are Frequently Nonadherent to Scheduled Induction and Maintenance Infliximab Therapy: A Canadian Cohort Study

    Directory of Open Access Journals (Sweden)

    Christopher Ma

    2015-01-01

    Full Text Available BACKGROUND: Adherence to maintenance medication regimens in inflammatory bowel disease patients has traditionally been poor. Although infliximab has demonstrated efficacy in inducing and maintaining disease remission, adherence to regularly scheduled infliximab infusions is required to maintain therapeutic trough drug levels and prevent the development of anti-infliximab antibodies.

  4. Tolerability of Shortened Infliximab Infusion Times in Patients With Inflammatory Bowel Diseases : A Single-Center Cohort Study

    NARCIS (Netherlands)

    Breynaert, Christine; Ferrante, Marc; Fidder, Herma; Van Steen, Kristel; Noman, Maja; Ballet, Vera; Vermeire, Severine; Rutgeerts, Paul; Van Assche, Gert

    OBJECTIVES: Scheduled maintenance therapy with infliximab decreases the risk of infusion reactions. Many centers have accelerated infusion times to 1 h in selected patients who tolerate 5 mg/kg infliximab infusions. The aim of this study was to compare the tolerability of 1-h and 2-h infliximab

  5. Sustained effect after lowering high-dose infliximab in patients with rheumatoid arthritis: a prospective dose titration study.

    NARCIS (Netherlands)

    Bemt, B.J.F van den; Broeder, A. den; Snijders, G.F.; Hekster, Y.A.; Riel, P.L.C.M. van; Benraad, B.; Wolbink, G.J.; Hoogen, F.H.J. van den

    2008-01-01

    OBJECTIVES: In clinical trials only a small subset of patients with rheumatoid arthritis (RA) benefits from higher than standard dose of infliximab (>3 mg/kg/8 weeks). However, dose escalation of infliximab is frequently applied in clinical practice. Individual adjustment of infliximab treatment

  6. Stjerneroller med stort K

    DEFF Research Database (Denmark)

    Redvall, Eva Novrup

    2017-01-01

    Der er langt mellem de spændende roller til kvinder over 40 i amerikansk film og tv. Det har flere kvindelige filmstjerner før og nu arbejdet aktivt på at ændre ved at søsætte egne projekter. To vellykkede eksempler på det kan for tiden ses på HBO i 'Big Little Lies' med Reese Witherspoon og Nico...

  7. Farlig sex med engle

    DEFF Research Database (Denmark)

    Mejrup, Kristian

    2013-01-01

    De fleste af os tænker ikke på engle som kønnede væsner med en seksualitet, og selv om vi er i stand til at acceptere engle i alle mulige afskygninger, fra juletræets tyksakker i glitrende guld til frygtindgydende skikkelser i de bibelske skrifter, så er vi tilbøjelig til at ignorere spørgsmålet ...

  8. At lede med latter

    DEFF Research Database (Denmark)

    Møller, Mette

    2014-01-01

    "Det sagde hun også i går!" Platte vitser, der lægger op til den karakteristiske 'bodom-tchi'-trommelyd, behøver ikke være lederens eneste forsøg på at udvise humoristisk sans på talerstolen. For humor kan være meget andet og gøre meget mere for lederen end at score billige point med en spontan s...

  9. A double-blind, placebo-controlled, randomized study of infliximab in primary sclerosing cholangitis

    NARCIS (Netherlands)

    Hommes, Daan W.; Erkelens, Willemien; Ponsioen, Cyriel; Stokkers, Pieter; Rauws, Erik; van der Spek, Mirjam; ten Kate, Fiebo; van Deventer, Sander J.

    2008-01-01

    GOALS: To evaluate the safety and efficacy of infliximab in patients with primary sclerosing cholangitis. STUDY: In this double-blind, placebo-controlled study, 24 patients with primary sclerosing cholangitis were screened and randomly assigned in a 2:1 ratio to receive infliximab (5 mg/kg) or

  10. The Immunogenicity of Branded and Biosimilar Infliximab in Rheumatoid Arthritis According to Th9-Related Responses

    Directory of Open Access Journals (Sweden)

    Rossella Talotta

    2017-10-01

    Full Text Available Our objective was to evaluate the immunogenicity of branded and biosimilar infliximab by detecting changes in T-helper-9 (Th9 percentages induced by an in vitro stimulation test. Methods: Peripheral blood mononuclear cells collected from 55 consecutive rheumatoid arthritis (RA outpatients (15 drug free, 20 successfully treated with branded infliximab, 20 branded infliximab inadequate responders and 10 healthy controls were cultured, with or without 50 μg/mL of infliximab originator (Remicade® or 50 μg/mL of infliximab biosimilar (Remsima® for 18 h. Th9 lymphocytes were identified by means of flow cytometry as PU.1 and IRF4-expressing, IL-9-secreting CD4+ T cells. Furthermore, the markers CCR7 and CD45RA were used to distinguish naïve from memory IL-9 producer cells. Results: Under unstimulated conditions, the drug-free RA patients had the highest percentages of Th9 lymphocytes. Following stimulation with branded infliximab, the percentages of PU.1 and IRF4-expressing Th9 cells, CCR7+, CD45RA− (central memory and CCR7−, CD45RA− (effector memory cells significantly increased in the group of inadequate responders, but no significant variation was observed after exposure to the biosimilar of infliximab. Conclusions: Th9 cells seem to be involved in the immune response to the epitopes of branded, but not biosimilar, infliximab, and this may depend on the recall and stimulation of both central and effector memory cells.

  11. As Infliximab Use for Ulcerative Colitis Has Increased, so Has the Rate of Surgical Resection.

    Science.gov (United States)

    Kin, Cindy; Kate Bundorf, M

    2017-07-01

    Infliximab was approved for ulcerative colitis in 2005 after randomized trials showed it reduced the risk of colectomy. Its effect on population-level surgery rates is unknown. Our aim is to assess the impact of infliximab approval for ulcerative colitis on surgical intervention. Retrospective review of a private insurance claims database (2002 to 2013) was performed of patients aged 18-64 diagnosed with ulcerative colitis and with 2 years of follow-up. Outcome measures were infliximab treatment and surgical resection. Multivariable logistic regression used independent variables of time period of diagnosis, age, gender, comorbidities, and insurance type. The cohort included 58,681 patients. Age, gender, and comorbidities were comparable across time periods. Patients diagnosed in the post-infliximab period had greater odds of undergoing infliximab treatment within the first year of diagnosis than those in the pre-infliximab era (OR = 2.88, p infliximab period (OR 1.5, p infliximab for ulcerative colitis has, as expected, increased since its approval, but so has the risk of surgery. Thus, the introduction of biologic therapy has not decreased the risk for surgery for this patient population.

  12. The duration of effect of infliximab maintenance treatment in paediatric Crohn's disease is limited

    NARCIS (Netherlands)

    de Bie, C. I.; Kindermann, A.; Kokke, F. T. M.; Damen, G. M.; Kneepkens, C. M. F.; van Rheenen, P. F.; Schweizer, J. J.; Hoekstra, J. H.; Norbruis, O. F.; Ten, W. E. Tjon A.; Vreugdenhil, A. C.; Deckers-Kocken, J. M.; Gijsbers, C. F. M.; Escher, J. C.; de Ridder, L.; Hummel, T.

    2011-01-01

    P>Background Infliximab is effective for induction and maintenance of remission in children with moderately to severely active Crohn's disease (CD). Aim To evaluate the long-term efficacy of infliximab treatment in paediatric CD. Methods In this observational, multicentre study, all paediatric CD

  13. Re-activation of bovine tuberculosis in a patient treated with infliximab

    DEFF Research Database (Denmark)

    Larsen, Mette Vang; Thomsen, V Ø; Sørensen, Inge Juul

    2008-01-01

    before initiation of treatment with infliximab. The tuberculin skin test (TST) was negative, chest radiography was normal and she had no known risk factors for TB. After 4 months of treatment with infliximab, the patient developed ascites caused by Mycobacterium bovis. The TST was repeatedly negative...

  14. Influence of methotrexate on infliximab pharmacokinetics and pharmacodynamics in ankylosing spondylitis

    Science.gov (United States)

    Ternant, David; Mulleman, Denis; Lauféron, Francine; Vignault, Céline; Ducourau, Emilie; Wendling, Daniel; Goupille, Philippe; Paintaud, Gilles

    2012-01-01

    AIMS Infliximab, an anti-tumour necrosis factor α monoclonal antibody, has profoundly modified the treatment of several inflammatory diseases. The objective was to assess the influence of methotrexate on the variability of infliximab pharmacokinetics and concentration–effect relationship in axial ankylosing spondylitis (AAS) patients. METHODS Twenty-six patients with AAS were included in a prospective study. They were treated by infliximab 5 mg kg−1 infusions at weeks 0, 2, 6, 12 and 18. Infliximab concentrations were measured before, and 2 and 4 h after each infusion, and at each intermediate visit (weeks 1, 3, 4, 5, 8, 10 and 14). Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was measured at each visit. Infliximab pharmacokinetics was described using a two-compartment model with first-order distribution and elimination constants. A population approach was used. Infliximab pharmacodynamics was described using the area under the BASDAI curve. RESULTS A total of 507 blood samples and 329 BASDAI measurements were collected. The following pharmacokinetic parameters were obtained (interindividual coefficient of variation): volumes of distribution for the central compartment = 2.4 l (9.6%) and peripheral compartment = 1.8 l (26%), systemic clearance = 0.23 l day−1 (22%) and intercompartment clearance = 2.3 l day−1. Methotrexate influenced neither pharmacokinetic nor BASDAI variability. CONCLUSIONS Using the present dosage, the clinical efficacy of infliximab is only weakly influenced by its serum concentrations. The results do not support the combination of methotrexate with infliximab in ankylosing spondylitis. PMID:21692827

  15. Infliximab and adalimumab drug levels in Crohn's disease: contrasting associations with disease activity and influencing factors.

    Science.gov (United States)

    Ward, M G; Warner, B; Unsworth, N; Chuah, S-W; Brownclarke, C; Shieh, S; Parkes, M; Sanderson, J D; Arkir, Z; Reynolds, J; Gibson, P R; Irving, P M

    2017-07-01

    Discriminative drug level thresholds for disease activity endpoints in patients with Crohn's disease. have been consistently demonstrated with infliximab, but not adalimumab. To identify threshold concentrations for infliximab and adalimumab in Crohn's disease according to different disease endpoints, and factors that influence drug levels. We performed a cross-sectional service evaluation of patients receiving maintenance infliximab or adalimumab for Crohn's disease. Serum drug levels were at trough for infliximab and at any time point for adalimumab. Endpoints included Harvey-Bradshaw index, C-reactive protein and faecal calprotectin. 6-tioguanine nucleotide (TGN) concentrations were measured in patients treated with thiopurines. A total of 191 patients (96 infliximab, 95 adalimumab) were included. Differences in infliximab levels were observed for clinical (P=.081) and biochemical remission (P=.003) and faecal calprotectin normalisation (Pinfliximab dose, body mass index and colonic disease independently accounted for 31% of the variation in infliximab levels, and weekly dosing, albumin and weight accounted for 23% of variation in adalimumab levels. TGN levels did not correlate with drug levels. Infliximab drug levels are associated with the depth of response/remission in patients with Crohn's disease, but no such relationship was observed for adalimumab. More data are needed to explain the variation in drug levels. © 2017 John Wiley & Sons Ltd.

  16. Non-invasiv behandling af slid og erosion

    DEFF Research Database (Denmark)

    Pallesen, Ulla; van Dijken, Jan WV

    2011-01-01

    Slid og erosion af tænder synes i dag at være et voksende problem for mange patienter. I de fleste tilfælde kan tandlægens tidlige diagnostik føre til, at forebyggende tiltag iværksættes i tide, så fortsatte skader ophører eller progressionen begrænses. Desværre er det ikke altid muligt og hvis...... restaureret med fuldkroner på alle tænder. Hvis behandlingen udføres med direkte plast, kan det også betyde, at omkostningerne bliver mindre, så flere får mulighed for at få udført en nødvendig rekonstruktion af tandsættet. I det følgende vil forskellige faktorer i forbindelse med tandslid og erosion blive...

  17. Anti-infliximab antibodies are already detectable in most patients with rheumatoid arthritis halfway through an infusioncycle: an open-label pharmacokinetic cohort study

    NARCIS (Netherlands)

    Bemt, B.J.F van den; Broeder, A. den; Wolbink, G.J.; Hekster, Y.A.; Riel, P.L. van; Benraad, B.; Hoogen, F.H.J. van den

    2011-01-01

    BACKGROUND: This study in patients with rheumatoid arthritis (RA) treated with infliximab describes prospectively the course of (anti)infliximab levels within an infusioncycle to assess at what moment patients develop low/no infliximab trough levels and/or detectable anti-infliximab levels. METHODS:

  18. Knowledge of Fecal Calprotectin and Infliximab Trough Levels Alters Clinical Decision-making for IBD Outpatients on Maintenance Infliximab Therapy

    Science.gov (United States)

    Prosser, Connie; Kroeker, Karen I.; Wang, Haili; Shalapay, Carol; Dhami, Neil; Fedorak, Darryl K.; Halloran, Brendan; Dieleman, Levinus A.; Goodman, Karen J.; Fedorak, Richard N.

    2015-01-01

    Background: Infliximab is an effective therapy for inflammatory bowel disease (IBD). However, more than 50% of patients lose response. Empiric dose intensification is not effective for all patients because not all patients have objective disease activity or subtherapeutic drug level. The aim was to determine how an objective marker of disease activity or therapeutic drug monitoring affects clinical decisions regarding maintenance infliximab therapy in outpatients with IBD. Methods: Consecutive patients with IBD on maintenance infliximab therapy were invited to participate by providing preinfusion stool and blood samples. Fecal calprotectin (FCP) and infliximab trough levels (ITLs) were measured by enzyme linked immunosorbent assay. Three decisions were compared: (1) actual clinical decision, (2) algorithmic FCP or ITL decisions, and (3) expert panel decision based on (a) clinical data, (b) clinical data plus FCP, and (c) clinical data plus FCP plus ITL. In secondary analysis, Receiver-operating curves were used to assess the ability of FCP and ITL in predicting clinical disease activity or remission. Results: A total of 36 sets of blood and stool were available for analysis; median FCP 191.5 μg/g, median ITLs 7.3 μg/mL. The actual clinical decision differed from the hypothetical decision in 47.2% (FCP algorithm); 69.4% (ITL algorithm); 25.0% (expert panel clinical decision); 44.4% (expert panel clinical plus FCP); 58.3% (expert panel clinical plus FCP plus ITL) cases. FCP predicted clinical relapse (area under the curve [AUC] = 0.417; 95% confidence interval [CI], 0.197–0.641) and subtherapeutic ITL (AUC = 0.774; 95% CI, 0.536–1.000). ITL predicted clinical remission (AUC = 0.498; 95% CI, 0.254–0.742) and objective remission (AUC = 0.773; 95% CI, 0.622–0.924). Conclusions: Using FCP and ITLs in addition to clinical data results in an increased number of decisions to optimize management in outpatients with IBD on stable maintenance infliximab therapy. PMID

  19. Antibodies to Infliximab and Adalimumab in Patients with Rheumatoid Arthritis in Clinical Remission

    DEFF Research Database (Denmark)

    Eng, Grith P; Bendtzen, Klaus; Bliddal, Henning

    2015-01-01

    Objective. To investigate if antibodies towards biological TNF-α inhibitors (anti-TNFi Abs) are present in patients with rheumatoid arthritis (RA) in clinical remission and to relate any anti-TNFi Abs to circulating level of TNF-α inhibitor (TNFi). Methods. Patients with RA, treated with infliximab....../44 patients (18%) treated with infliximab and 1/49 patients (2%) treated with adalimumab (p = 0.012). In the former group, anti-TNFi Abs corresponded with low levels of TNFi (p = 0.048). Anti-TNFi Ab-positive patients had shorter disease duration at initiation of TNFi therapy (p = 0.023) but were similar...... for the rest of the compared parameters. Conclusions. In RA patients in clinical remission, anti-TNFi Abs occur frequently in patients treated with infliximab, while they occur rarely in patients treated with adalimumab. Presence of anti-infliximab Abs is accompanied by low or undetectable levels of infliximab...

  20. ALKOHOL MED MLADOSTNIKI

    OpenAIRE

    Blazinšek, Valentina

    2011-01-01

    Uporaba alkohola je ena od oblik tveganega vedenja, s katero mladostnik išče razumevanje in odobravanje predvsem v družbi lastne generacije. Uporablja jo zlasti pod vplivom pritiskov z dveh strani: sveta odraslih in sveta vrstnikov, v katerem pogosto veljajo drugačna pravila, vrednote, oblike vedenja in komuniciranja, kot jih zapovedujejo odrasli. Zato je poseganje po alkoholu problem, ki mu veliko držav posveča posebno pozornost. Med številnimi zdravstvenimi problemi, ki tako ali drugače pri...

  1. Outcome Following Infliximab Therapy for Pediatric Patients Hospitalized with Refractory Colitis-Predominant Inflammatory Bowel Disease

    Science.gov (United States)

    Falaiye, Tolulope O.; Mitchell, Keisha R.; Lu, Zengqi; Saville, Benjamin R.; Horst, Sara N.; Moulton, Dedrick E.; Schwartz, David A.; Wilson, Keith T.; Rosen, Michael J.

    2013-01-01

    Objectives While randomized trials demonstrated efficacy of infliximab for both pediatric Crohn’s disease (CD) and ulcerative colitis (UC), few patients in these studies exhibited colitis requiring hospitalization. The aims of this study were to determine the rate of subsequent infliximab failure and dose escalation in pediatric patients started on infliximab during hospitalization for colitis-predominant IBD, and to identify potential predictors of these endpoints. Methods Single center retrospective cohort study of patients admitted from 2005 to 2010 with Crohn’s colitis, UC, or IBD-unspecified (IBD-U) and initiated on infliximab. Results We identified 29 patients (12 Crohn’s colitis, 15 UC, and 2 IBD-U; median age 14 years) with a median follow-up of 923 days. 18 patients (62%) required infliximab dose escalation (increased dose or decreased infusion interval). Infliximab failure occurred in 18 patients (62%), due to ineffectiveness in 12 (67%) and adverse reactions in 6 (33%). 12 patients (41%) underwent colectomy. Subsequent need for infliximab dose escalation was associated with lower body mass index (BMI) z-score (P=0.01), lower serum albumin (P=0.03), and higher ESR (P=0.002) at baseline. ESR predicted subsequent infliximab dose escalation with an area under the curve of 0.89 (95% CI 0.72–1.00) and a sensitivity and specificity at a cutoff of 38 mm/hr of 0.79 (95% CI 0.49–0.95) and 0.88 (95% CI 0.47–0.99), respectively. Conclusions Most hospitalized pediatric patients with colitis treated with infliximab require early dose escalation and fail the drug long term. Low BMI and albumin, and high ESR may identify patients who would benefit from a higher infliximab starting dose. PMID:24048170

  2. Clinical relevance and inter-test reliability of anti-infliximab antibodies and infliximab trough levels in patients with inflammatory bowel disease.

    Science.gov (United States)

    Guiotto, Cristina; Daperno, Marco; Frigerio, Francesco; Vizzini, Margherita; Cerruti, Roberta; Ercole, Elena; Cosimato, Maurizio; Lavagna, Alessandro; Germano, Laura; Migliardi, Marco; Rocca, Rodolfo

    2016-02-01

    Treatment with infliximab is a common option for inflammatory bowel disease (IBD) patients. Therapeutic drug monitoring could improve treatment management. To test inter-test reliability of two commercially available diagnostic kits for infliximab trough levels and infliximab antibodies, and their association with treatment outcomes. 86 IBD outpatients on infliximab maintenance treatment were enrolled in a prospective cross-sectional study, 115 samples were available for inter-test reliability. Inter-test agreement was good both for trough levels (concordance correlation coefficient 0.78, weighted κ 0.60, Sperman's ρ 0.937) and for infliximab antibodies (weighted κ 0.79) measurement, when comparing Promonitor and ImmunDiagnostik kits. According to manufacturers' cut-off values, trough levels were classified as undetectable (17%), low (21%) or in range (63%). The only significant associations were: mucosal healing (p=0.026; OR 6.50), infliximab antibody status (p=0.0015; OR 0.031) and adverse events (p=0.009; OR 0.115). Higher trough levels were observed among patients on concomitant steroid/immunosuppressive therapy and among patients with dose-intensification. Infliximab antibodies were significantly associated to treatment-related adverse events (p=0.0003, OR 30.42), and to lower trough levels, but not to other clinical variables. The two tests performed equally well. Infliximab antibodies were associated to adverse events, while trough levels were not associated to treatment outcomes. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. Momsmæssig behandling af porteføljeforvaltning

    DEFF Research Database (Denmark)

    Thygesen, Jette

    2015-01-01

    I 2012 kom EU-domstolens afgørelse i Deutsche Bank sagen. Med Deutsche Bank afgørelsen kom der en ny udvikling i fortolkningen af sammensatte ydelsers momsmæssige status. Således afgjorde EU-domstolen, at når en sammensat ydelse ikke kan opdeles, uden dette virker kunstigt, da ydelsen bestå af...

  4. MedPAC Data Book

    Data.gov (United States)

    U.S. Department of Health & Human Services — MedPACs Data Book is the result of discussions with congressional staff members regarding ways that MedPAC can better support them. Some of the information it...

  5. Inflammatory bowel disease patients are frequently nonadherent to scheduled induction and maintenance infliximab therapy: A Canadian cohort study.

    Science.gov (United States)

    Ma, Christopher; Evaschesen, Chad J; Gracias, Grenvil; Huang, Vivian W; Fedorak, Darryl K; Kroeker, Karen I; Dieleman, Levinus A; Halloran, Brendan P; Fedorak, Richard N

    2015-01-01

    Adherence to maintenance medication regimens in inflammatory bowel disease patients has traditionally been poor. Although infliximab has demonstrated efficacy in inducing and maintaining disease remission, adherence to regularly scheduled infliximab infusions is required to maintain therapeutic trough drug levels and prevent the development of anti-infliximab antibodies. To characterize patient adherence to regularly scheduled induction and maintenance infliximab infusions. A retrospective cohort study was conducted evaluating adult outpatients with Crohn disease or ulcerative colitis on an induction or maintenance regimen of regularly scheduled infliximab from 2008 to 2010 at the University of Alberta (Edmonton, Alberta). Nonadherence was defined by a discrepancy of >72 h between the scheduled date of infusion and the actual date of administration. Patients were defined as nonadherent if they received 1 week late. While three-quarters of patients are adherent to infliximab induction therapy, fewer than one-third remained adherent to their scheduled maintenance infliximab regimen.

  6. Pharmacokinetic Effects of Antidrug Antibodies Occurring in Healthy Subjects After a Single Dose of Intravenous Infliximab.

    Science.gov (United States)

    Ehrenpreis, Eli D

    2017-12-01

    Infliximab pharmacokinetic studies have been performed in patients receiving chronic infliximab therapy. In these patients, infliximab antidrug antibodies (ADAs) increase infliximab clearance and decrease serum levels and drug efficacy. This study analyzed the pharmacokinetic effect of infliximab ADAs in healthy subjects receiving a single dose of intravenous infliximab. Data were obtained from a single-blind, parallel-group, single-dose study of healthy subjects receiving 5 mg/kg of intravenous SB2 (infliximab biosimilar), EU-sourced Remicade (EU-IFX) or US-sourced Remicade (US-IFX). Serum infliximab was measured at 1, 2, 3, 6, 12, 24, 48, and 72 h and at 5, 7, 14, 21, 28, 42, 56, and 70 days after administration. ADAs were measured pre-dose and at 29 and 71 days. Data from the first ten subjects randomized to each treatment arm were utilized for this study. A two-compartment model of the serum infliximab vs. time curve was developed using nonlinear regression. At 10 weeks, 11 subjects (37%) developed ADAs. ADAs were detected in four subjects after SB2, one subject after EU-IFX, and six subjects after US-IFX infusion. Of these, neutralizing antibodies occurred in one subject after SB2, in no subjects after EU-IFX, and in three subjects after US-IFX infusion. Infliximab clearance was increased in subjects with ADAs vs. those without ADAs (12.89 ± 2.69 vs. 9.90 ± 1.74 ml/h; p ADAs (282.4 ± 56.4 vs. 343.3 ± 61.9 h; p ADAs are common in healthy subjects after a single intravenous dose of infliximab and result in faster infliximab clearance, shorter elimination time, and lower serum infliximab levels. These data confirm that ADAs are common with biologic therapy and significantly impact the efficacy of these drugs.

  7. Development of Eosinophilic Fasciitis during Infliximab Therapy for Psoriatic Arthritis

    Directory of Open Access Journals (Sweden)

    Richard Hariman

    2016-01-01

    Full Text Available Eosinophilic fasciitis (EF is a rare disorder involving chronic inflammation of the fascia and connective tissue surrounding muscles, nerves, and blood vessels. While its pathogenesis is not entirely understood, this disorder is thought to be autoimmune or allergic in nature. We present here a case of a 59-year-old male who developed peripheral eosinophilia and subsequent eosinophilic fasciitis during treatment with infliximab. To our knowledge, eosinophilic fasciitis has not been previously described in patients during treatment with an inhibitor of tumor necrosis factor α.

  8. Infliximab en pacientes con enfermedad ocular inflamatoria, refractarios a DARMES

    OpenAIRE

    Elmer R. García-Salazar; Henry Terrazas; Javier Gonzales; Miguel Fernández

    2013-01-01

    Se describe la experiencia con infliximab (anticuerpo monoclonal con una potente acción antiinflamatoria) en el tratamiento de enfermedades oculares inflamatorias secundarias a patologías reumáticas y refractarias a drogas antirreumáticas modificadoras de la enfermedad (DARMES). Se evaluó el caso de una paciente de 50 años con artritis reumatoide (AR) de fondo activo y una paciente de 37 años con vasculitis anticuerpos anticitoplasma de neutrófilos especifico para mieloperoxidasa (ANCA MPO) s...

  9. Management of inflammatory bowel disease in poor responders to infliximab

    Science.gov (United States)

    Guerra, Iván; Bermejo, Fernando

    2014-01-01

    Infliximab (IFX) is an effective treatment for inducing and maintaining response in Crohn’s disease and ulcerative colitis patients. Some patients present lack of response or loss of response to IFX during maintenance therapy. Empirical management with combination therapy with an immunomodulator, IFX dose escalation, or switching IFX for another antitumor necrosis factor-α drug, mainly adalimumab, is common in clinical practice. Selecting the best choice with the help of serum drug concentrations and trough IFX antibody concentrations could be a very interesting approach. In addition to surgery, a broad spectrum of new drugs has been tested and could expand treatment options in the near future. PMID:25258548

  10. Long-term safety and efficacy of infliximab for the treatment of ankylosing spondylitis

    Science.gov (United States)

    Elalouf, Ofir; Elkayam, Ori

    2015-01-01

    The introduction of TNFα blockers has revolutionized the treatment of ankylosing spondylitis (AS). The objectives of this review are to summarize the most up-to-date data on long-term efficacy and safety of infliximab in AS, with special emphasis on axial and extra-articular disease, predictors of response, and radiological response. The general consensus of this literature search was that infliximab is highly efficacious in the treatment of AS. Most studies have demonstrated good clinical outcomes after 3 years of treatment, as measured by Spondyloarthritis International Society response in 75%–85% of treated AS patients. Reports on the long-term effects of infliximab as documented by radiological findings, however, are controversial. While some studies reported a similar progression rate as that of the historical OASIS cohort, others have suggested that infliximab may halt new bone formation. The long-term safety of infliximab is well known, mainly from data stored in national registries. While it has been suggested that side effects of infliximab may be fewer in AS compared to rheumatoid arthritis, data on this issue are sparse, with most of the information on long-term safety pertaining to rheumatoid arthritis. It can however be concluded that the long-term efficacy of infliximab is apparently maintained in AS and with an acceptable safety profile. PMID:26640380

  11. Higher order structures of Adalimumab, Infliximab and their complexes with TNFα revealed by electron microscopy.

    Science.gov (United States)

    Tran, Bich Ngoc; Chan, Siew Leong; Ng, Chloe; Shi, Jian; Correia, Ivan; Radziejewski, Czeslaw; Matsudaira, Paul

    2017-12-01

    Adalimumab and Infliximab are recombinant IgG1 monoclonal antibodies (mAbs) that bind and neutralize human tumor necrosis factor alpha (TNFα). TNFα forms a stable homotrimer with unique surface-exposed sites for Adalimumab, Infliximab, and TNF receptor binding. Here, we report the structures of Adalimumab-TNFα and Infliximab-TNFα complexes modeled from negative stain EM and cryo-EM images. EM images reveal complex structures consisting of 1:1, 1:2, 2:2, and 3:2 complexes of Adalimumab-TNFα and Infliximab-TNFα. The 2:2 complex structures of Adalimumab-TNFα and Infliximab-TNFα show diamond-shaped profiles and the 2D class averages reveal distinct orientations of the Fab domains, indicating different binding modes by Adalimumab and Infliximab to TNFα. After separation by size exclusion chromatography and analysis by negative stain EM, the 3:2 complexes of Adalimumab-TNFα or Infliximab-TNFα complexes are more complicated but retain features recognized in the 2:2 complexes. Preliminary cryo-EM analysis of 3:2 Adalimumab-TNFα complex generated a low-resolution density consistent with a TNFα trimer bound with three Fab domains from three individual antibody molecules, while each antibody molecule binds to two molecules of TNFα trimer. The Fc domains are not visible in the reconstruction. These results show the two mAbs form structurally distinct complexes with TNFα. © 2017 The Protein Society.

  12. Use of Electronic Health Record Tools to Facilitate and Audit Infliximab Prescribing.

    Science.gov (United States)

    Sharpless, Bethany R; Del Rosario, Fernando; Molle-Rios, Zarela; Hilmas, Elora

    2018-01-01

    The objective of this project was to assess a pediatric institution's use of infliximab and develop and evaluate electronic health record tools to improve safety and efficiency of infliximab ordering through auditing and improved communication. Best use of infliximab was defined through a literature review, analysis of baseline use of infliximab at our institution, and distribution and analysis of a national survey. Auditing and order communication were optimized through implementation of mandatory indications in the infliximab orderable and creation of an interactive flowsheet that collects discrete and free-text data. The value of the implemented electronic health record tools was assessed at the conclusion of the project. Baseline analysis determined that 93.8% of orders were dosed appropriately according to the findings of a literature review. After implementation of the flowsheet and indications, the time to perform an audit of use was reduced from 60 minutes to 5 minutes per month. Four months post implementation, data were entered by 60% of the pediatric gastroenterologists at our institution on 15.3% of all encounters for infliximab. Users were surveyed on the value of the tools, with 100% planning to continue using the workflow, and 82% stating the tools frequently improve the efficiency and safety of infliximab prescribing. Creation of a standard workflow by using an interactive flowsheet has improved auditing ability and facilitated the communication of important order information surrounding infliximab. Providers and pharmacists feel these tools improve the safety and efficiency of infliximab ordering, and auditing data reveal that the tools are being used.

  13. Long-Term Outcome of Patients with Ulcerative Colitis and Primary Non-response to Infliximab.

    Science.gov (United States)

    Papamichael, Konstantinos; Rivals-Lerebours, Oliviane; Billiet, Thomas; Vande Casteele, Niels; Gils, Ann; Ferrante, Marc; Van Assche, Gert; Rutgeerts, Paul J; Mantzaris, Gerassimos J; Peyrin-Biroulet, Laurent; Vermeire, Severine

    2016-09-01

    We studied the long-term outcome of patients with ulcerative colitis [UC] and primary non response [PNR] to infliximab and searched for predictors of colectomy in these patients. This retrospective, multi-centre study included UC patients from three European referral centres, with PNR to infliximab defined as a lack of clinical improvement after the induction therapy, leading to drug discontinuation. Relapse, for patients who continued on biologicals after PNR to infliximab, was defined as drug discontinuation for PNR, loss of response, or serious adverse event. Serum infliximab concentrations at Weeks 2 and 6 were evaluated using an enzyme-linked immunosorbent assay [ELISA] developed in house. The study population consisted of 99 anti-tumour necrosis factor [TNF]-naïve patients with UC and PNR to infliximab. At the end of follow-up (median: 3.2 [interquartile range 1-6.3] years), 55 [55.6%] of these patients underwent colectomy. Multiple Cox regression analysis identified acute severe UC (hazard ratio [HR]: 24; 95% confidence interval [CI]: 2.5-231; p = 0.006], baseline C-reactive protein [CRP] > 5mg/l [HR: 11; 95% CI: 2.1-58.8; p = 0.005], baseline albumin infliximab concentration at Week 2 infliximab, there was a marginally higher cumulative probability for relapse in patients switching to another anti-TNF agent compared with those swapping to vedolizumab [p logrank = 0.08]. About half of UC patients with PNR to infliximab will undergo colectomy. Patients with severe inflammation and low serum infliximab concetrations during the induction phase are at greatest risk. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  14. IMPORTANCE OF MEASURING LEVELS OF INFLIXIMAB IN PATIENTS TREATING INFLAMMATORY BOWEL DISEASE IN A BRAZILIAN COHORT.

    Science.gov (United States)

    Kampa, Katia Cristina; Morsoletto, Daphne Benatti Gonçalves; Loures, Marcela Rocha; Pissaia, Alcindo; Nones, Rodrigo Bremer; Ivantes, Cláudia Alexandra Pontes

    2017-12-01

    Crohn's disease and ulcerative colitis are chronic inflammatory bowel diseases. In such pathologies, there is an increased production of alpha tumor necrosis factor (TNF-α). Patients, in whom the conventional immunosuppressant treatment fails, require the use of immunobiological therapy, such as anti-TNF-α, a monoclonal antibody. Infliximab is an anti-TNF-α drug, a chimerical immunoglobulin, with a murine component, which is responsible for the generation of immunogenicity against the drug and formation of anti-TNF-α antibodies. The presence of anti-drug antibodies may be responsible for adverse events and reduction of the drug's effectiveness. Patients with inflammatory bowel diseases undergoing therapy with biological medication, such as infliximab, can relapse overtime and this may not be translated into clinical symptoms. Thus, there is a need for a method to evaluate the efficacy of the drug, through the measurement of serum infliximab levels, as well as antibodies research. This study aimed to measure serum infliximab levels and anti-infliximab antibodies in patients with inflammatory bowel diseases post-induction phase and during maintenance therapy, and describe the therapeutic modifications that took place based on the serum levels results. It was a retrospective study, that included forty-five patients, with a total of 63 samples of infliximab measurement. Twenty-one patients had an adequate infliximab serum level, 31 had subtherapeutic levels and 11 had supratherapeutic levels. Seven patients had their medication suspended due to therapeutic failure or high levels of antibodies to infliximab. In conclusion, only a third of the patients had adequate infliximab levels and 36% presented with subtherapeutic levels at the end of the induction phase. Therapy optimization occurred based in about 46% of the samples results, demonstrating the importance of having this tool to help the clinical handling of patients with inflammatory bowel diseases ongoing

  15. Infliximab for ipilimumab-induced colitis: A series of 13 patients.

    Science.gov (United States)

    Hillock, Nadine T; Heard, Sharryn; Kichenadasse, Ganessan; Hill, Catherine L; Andrews, Jane

    2017-10-01

    To review the outcomes of metastatic melanoma patients treated with infliximab for severe steroid-refractory colitis secondary to ipilimumab therapy. Immune-related colitis is a known potential adverse effect of ipilimumab, that causes significant morbidity and extended hospital stays. There are limited outcome data for patients treated with infliximab for ipilimumab-induced colitis refractory to corticosteroids. Management guidelines have been developed based on case study evidence only. A retrospective review of all patients administered infliximab for ipilimumab-induced colitis at South Australian public hospitals between October 2011 and April 2015. Resolution of colitis/diarrhea, duration of hospital stay, dosage regimen of infliximab used (single dose vs multiple dose) and surgical intervention if required. Between October 2011 and April 2015, 106 patients were dispensed ipilimumab from South Australian public hospitals for the treatment of metastatic melanoma. Thirteen were administered infliximab for severe, steroid-refractory colitis secondary to ipilimumab. Sixty-two percent received a single dose of infliximab only. Four patients achieved resolution of colitis symptoms at 1 month postinfliximab. Thirty-three percent required surgical intervention despite treatment with infliximab. One patient declined surgery and subsequently died due to bowel perforation. The average number of overnight bed days due to colitis was 27. This series of patients with severe ipilimumab-induced colitis suggests that despite treatment with infliximab a high proportion of patients do not achieve resolution of symptoms. Review of these cases has highlighted the absence of evidence-based guidelines to treat severe, steroid refractory colitis secondary to ipilimumab. Further prospective studies may clarify the role of infliximab for the treatment of ipilimumab-induced colitis. © 2016 John Wiley & Sons Australia, Ltd.

  16. The effects of pregnancy on the pharmacokinetics of infliximab and adalimumab in inflammatory bowel disease.

    Science.gov (United States)

    Seow, C H; Leung, Y; Vande Casteele, N; Ehteshami Afshar, E; Tanyingoh, D; Bindra, G; Stewart, M J; Beck, P L; Kaplan, G G; Ghosh, S; Panaccione, R

    2017-05-01

    Transplacental transfer of infliximab and adalimumab results in detectable drug levels in the cord blood and infant. To determine if pregnancy influenced the pharmacokinetics of anti-TNF agents in women with inflammatory bowel disease. Twenty-five women from the University of Calgary inflammatory bowel disease(IBD) pregnancy clinic on maintenance infliximab or adalimumab were recruited prospectively with serum bio-banking performed each trimester. Infliximab trough and adalimumab steady-state levels were the outcomes of interest and were analysed using the ANSER infliximab and adalimumab assays. Multivariate linear mixed-effects models were constructed to assess infliximab and adalimumab drug levels during pregnancy adjusting for the clinical covariates of albumin, BMI and CRP. Fifteen women (eight Crohn's disease, seven ulcerative colitis) received infliximab and 10 women with 11 pregnancies were treated with adalimumab. Median age was 29.6 years (IQR: 27.6-31.2 years). Median disease duration was 9.2 years (IQR: 3.16-15.0 years). Median trough infliximab concentrations were 8.50 μg/mL (IQR: 7.23-10.07 μg/mL), 10.31 μg/mL (IQR: 7.66-15.63 μg/mL) and 21.02 μg/mL (IQR: 16.01-26.70 μg/mL) at trimesters 1, 2 and 3 respectively. Significant changes in albumin and BMI (P 0.05) were documented throughout pregnancy. After adjusting for albumin, BMI and CRP, infliximab trough levels increased during pregnancy, by 4.2 μg/mL per trimester (P = 0.02), while adalimumab drug levels remained stable (P > 0.05). Infliximab levels rise during pregnancy, whereas adalimumab levels remain stable after accounting for changes in albumin, BMI and CRP. Therapeutic drug monitoring in the second trimester may be useful in guiding dosing in the third trimester. © 2017 John Wiley & Sons Ltd.

  17. Successful treatment of PASH syndrome with infliximab, cyclosporine and dapsone.

    Science.gov (United States)

    Staub, J; Pfannschmidt, N; Strohal, R; Braun-Falco, M; Lohse, P; Goerdt, S; Leverkus, M

    2015-11-01

    The group of autoinflammatory syndromes associated with Pyoderma gangrenosum, Acne, and Suppurative Hidradenitis are poorly defined and difficult to control with currently available treatment modalities. We describe a patient with PASH syndrome and report about the successful multimodal treatment with infliximab, cyclosporine, and dapsone. A review of the available literature to date about this group of autoinflammatory diseases was performed. We performed genetic analysis for PSTPIP1 mutations associated with PAPA syndrome. A 22-year-old woman presented to our department with pyoderma gangrenosum, concomitant acne, and suppurative hidradenitis. She had previously been treated unsuccessfully with etanercept, adalimumab, fumaric acid and the IL-1 receptor antagonist (IL-1RA) anakinra without prolonged remission. Treatment with intravenous infliximab in combination with cyclosporine and dapsone lead to sudden and prolonged improvement of the clinical symptoms that we classified as PASH syndrome. We review the literature about this group of diseases and report the third case of PASH syndrome to date. PASH syndrome and associated diseases should be considered whenever hidradenitis suppurativa is found in association with pyoderma gangrenosum. We provide a systematic overview about PASH syndrome and suggest a novel multimodal therapeutic regimen beyond isolated inhibition of TNF or IL-1. © 2014 European Academy of Dermatology and Venereology.

  18. Infliximab therapy for Crohn’s disease in the presence of chronic hepatitis C infection - Reply

    Directory of Open Access Journals (Sweden)

    M. Galeazzi

    2011-09-01

    Full Text Available Il trattamento del morbo di Crohn con infliximab rappresenta una importante terapia nei pazienti con la forma fistolizzata della malattia, refrattaria al trattamento con farmaci convenzionali. Tuttavia esistono preoccupazioni nell’usare questo farmaco in pazienti con concomitante infezione cronica da HCV. Tali preoccupazioni sono determinate dal rischio teorico di un accelerato scompenso epatico dovuto all’effetto immunomodulante dell’Infliximab. Noi descriviamo il caso di un paziente affetto da morbo di Crohn e concomitante infezione attiva da epatite C sottoposto a terapia con Infliximab che non ha mostrato alcun peggioramento della funzionalità epatica e dei livelli di carica virale testati con PCR.

  19. A Case Report of Successful Treatment of Recalcitrant Childhood Localized Scleroderma with Infliximab and Leflunomide.

    Science.gov (United States)

    Ferguson, Ian D; Weiser, Peter; Torok, Kathryn S

    2015-01-01

    Herein we report successful treatment of an adolescent Caucasian female with severe progressive localized scleroderma (mixed subtype, including generalized morphea and linear scleroderma of the trunk/limb) using infliximab and leflunomide. The patient demonstrated improvement after the first 9 months of therapy based on her clinical examination, objective measures, and patient and parent global assessments. Infliximab is a potential treatment option for pediatric localized scleroderma patients who have progression of disease or who are unable to tolerate the side effect profile of more standard systemic therapy. Larger longitudinal studies or case series are needed to confirm and further investigate infliximab's role in localized scleroderma.

  20. Infliximab dependency is related to decreased surgical rates in adult Crohn's disease patients

    DEFF Research Database (Denmark)

    Pedersen, N.; Duricova, D.; Lenicek, M.

    2010-01-01

    last intended infusion: prolonged response (maintenance of complete/partial response), infliximab dependency (relapse requiring repeated infusions to regain complete/partial response or need of infliximab > 12 months to sustain response). Results Forty-seven percent obtained prolonged response, 29...... on maintenance versus on demand regime was 33 and 31%, respectively (P = 0.63). No relevant clinical or genetic predictors were identified. Conclusion The infliximab dependency response seems to be equivalent to the prolonged response in adult CD patients when comparing surgery rates. Eur J Gastroenterol Hepatol...

  1. Baseline tumour necrosis factor alpha levels predict the necessity for dose escalation of infliximab therapy in patients with rheumatoid arthritis

    Science.gov (United States)

    Takeuchi, Tsutomu; Miyasaka, Nobuyuki; Tatsuki, Yoshihiko; Yano, Toshiro; Yoshinari, Toru; Abe, Tohru; Koike, Takao

    2011-01-01

    Objectives To investigate the possible role of baseline plasma tumour necrosis factor alpha levels (baseline-TNF) on the clinical response to infliximab in patients with rheumatoid arthritis (RA). Methods Patients with RA refractory to methotrexate received 3, 6, or 10 mg/kg of infliximab every 8 weeks, in a randomised, double-blind manner: the RISING study. Clinical response (disease activity score in 28 joints based on C-reactive protein or American College of Rheumatology core set) at week 54 and serum infliximab levels were compared in three patient groups with low, intermediate, or high baseline-TNF (TNF-low, TNF-int, or TNF-high). Results In TNF-low patients, the clinical response to different doses of infliximab was comparable, whereas TNF-int patients exhibited a dose-dependent trend. In contrast, TNF-high patients (approximately 13% of the total patients) had a clinical response to 10 mg/kg significantly better than the response to 3 and 6 mg/kg of infliximab. In TNF-high patients, the median trough serum levels of infliximab were below the detection limit (infliximab in patients with a high baseline-TNF. A higher dose of infliximab may be necessary in these patients, whereas lower doses of infliximab are sufficient for those with a low baseline-TNF. Baseline-TNF may be a useful measure for personalising the treatment of RA using infliximab. PMID:21478189

  2. Inflammatory bowel disease patients are frequently nonadherent to scheduled induction and maintenance infliximab therapy: A Canadian cohort study

    Science.gov (United States)

    Ma, Christopher; Evaschesen, Chad J; Gracias, Grenvil; Huang, Vivian W; Fedorak, Darryl K; Kroeker, Karen I; Dieleman, Levinus A; Halloran, Brendan P; Fedorak, Richard N

    2015-01-01

    BACKGROUND: Adherence to maintenance medication regimens in inflammatory bowel disease patients has traditionally been poor. Although infliximab has demonstrated efficacy in inducing and maintaining disease remission, adherence to regularly scheduled infliximab infusions is required to maintain therapeutic trough drug levels and prevent the development of anti-infliximab antibodies. OBJECTIVES: To characterize patient adherence to regularly scheduled induction and maintenance infliximab infusions. METHODS: A retrospective cohort study was conducted evaluating adult outpatients with Crohn disease or ulcerative colitis on an induction or maintenance regimen of regularly scheduled infliximab from 2008 to 2010 at the University of Alberta (Edmonton, Alberta). Nonadherence was defined by a discrepancy of >72 h between the scheduled date of infusion and the actual date of administration. Patients were defined as nonadherent if they received infliximab infusions per schedule. RESULTS: A total of 215 patients (173 Crohn disease, 42 ulcerative colitis) met the inclusion criteria. Patients received a median of 12.0 infliximab infusions (interquartile range 7.0 to 13.0) during the study period; 412 induction and 1837 maintenance infliximab infusions were administered. Of 140 patients, 109 (77.9%) were adherent to their infliximab induction regimen, while 68 of 215 (31.6%) were adherent to their infliximab maintenance regimen. One hundred ninety-eight of 215 (92.1%) patients received at least one delayed maintenance infliximab infusion and 20 (10.1%) received maintenance infusions, on average, >1 week late. CONCLUSIONS: While three-quarters of patients are adherent to infliximab induction therapy, fewer than one-third remained adherent to their scheduled maintenance infliximab regimen. PMID:26069894

  3. Prognostic factors for long-term infliximab treatment in Crohn's disease patients: a 20-year single centre experience.

    Science.gov (United States)

    Billiet, T; Cleynen, I; Ballet, V; Ferrante, M; Van Assche, G; Gils, A; Vermeire, S

    2016-10-01

    The long-term efficacy of infliximab in patients with Crohn's disease is suboptimal. To study prognostic factors for real-life long-term effcacy of infliximab in Crohn's disease. All consecutive Crohn's disease patients treated with infliximab at a tertiary centre were retrospectively analysed. Only patients who received scheduled infliximab maintenance treatment were considered. Patient- and disease-related factors were used to identify independent predictors of infliximab failure-free survival using Cox proportional hazards regression. Of 1031 patients with Crohn's disease, 261 were eligible for inclusion. Median time on infliximab was 2.4 [IQR 1.4-4.7] years, and 65 (24.9%) patients experienced infliximab failure. Estimated 5-year infliximab failure-free survival was 65.9% (95% CI 58.3-73.5). Multivariate Cox regression identified disease duration ≥1 year (HR 2.5 (95% CI 1.2-5.2), P = 0.02), L1 disease location [HR 2.0 (1.1-3.5), P = 0.02], prior anti-TNF use [HR 2.3 (1.1-4.8), P = 0.03], haemoglobin infliximab failure-free survival. Stratifying patients into risk groups resulted in estimated 3-year infliximab failure-free survival rates ranging from 95.3% (94.2-96.4) to 26.3% (8.6-44.0) depending on the number of risk factors (P = 8 × 10(-13) ). This study identified several easy to obtain predictors of infliximab failure in patients with Crohn's disease, and these are in line with previous reports. Those with a high-risk profile for infliximab failure in whom infliximab initiation is considered, should be treated as early as possible making use of therapeutic drug monitoring. © 2016 John Wiley & Sons Ltd.

  4. Predictors of response to infliximab in patients with fistulizing Crohn's disease Factores predictivos de respuesta a infliximab en pacientes con enfermedad de Crohn fistulizante

    Directory of Open Access Journals (Sweden)

    M. Luna-Chadid

    2004-06-01

    Full Text Available Objective: to evaluate the efficacy and toxicity of infliximab for the treatment of fistulizing Crohn's disease. Methods: consecutive patients with fistulizing Crohn's disease receiving infliximab were prospectively enrolled. Partial response was defined as a reduction of 50% or more from base-line in the number of draining fistulae. Complete response was defined as the closure of all fistulae. The influence of different variables on the efficacy of infliximab was evaluated. Results: 108 patients were included. The disease was inflammatory plus fistulizing in 18% and only fistulizing in 82%. After the third infusion of infliximab the response was partial in 26% and complete in 57%. Response (% rates (partial/complete depending on fistula location were: enterocutaneous (25/68%, perianal (35/60%, rectovaginal (36/64%, and enterovesical (20/40%. None of the studied variables (including concomitant immunosuppressive therapy correlated with efficacy of infliximab in the multivariate analysis. Incidence of adverse effects (21% depending on the dose of infliximab was: first dose (5.6%, second (7.4%, and third (11.1%. Conclusions: infliximab is an efficacious treatment for fistulizing Crohn's disease. Partial response was achieved in approximately one third of the patients, and complete response in more than half. No studied variable was predictive of response. Adverse effects were relatively infrequent and mild.Objetivo: evaluar la eficacia e identificar los factores predictivos de respuesta al tratamiento con infliximab en la enfermedad de Crohn fistulizante. Métodos: se realizó un estudio prospectivo en pacientes con enfermedad de Crohn fistulizante que recibían tratamiento con infliximab. La respuesta parcial se definió como una reducción del 50% o más de la línea base en el número de fístulas que drenan. La respuesta completa se definió como el cierre de todas las fístulas. Se evaluó la influencia de diferentes variables sobre la

  5. Infliximab's influence on anastomotic strength and degree of inflammation in intestinal surgery in a rabbit model

    DEFF Research Database (Denmark)

    Frostberg, Erik; Ström, Petter; Gerke, Oke

    2014-01-01

    BACKGROUND: Infliximab, a TNF-alpha inhibitor, is a potent anti-inflammatory drug in the treatment of inflammatory bowel diseases. Recent studies have investigated the effect of infliximab treatment on postoperative complications such as anastomotic leakage, however, with conflicting results...... and conclusions. The purpose of this study was to investigate whether a single dose infliximab has an adverse effect on the anastomotic healing process, observed as reduced anastomotic breaking strength and histopathologically verified lower grade of inflammatory response, in the small intestine of a rabbit....... METHODS: Thirty New Zealand rabbits (median weight 2.5 kg) were allocated to treatment with an intravenous bolus of either 10 mg/kg infliximab (n = 15) or placebo (n = 15). One week later all rabbits underwent two separate end-to-end anastomoses in the jejunum under general anesthesia. At postoperative...

  6. Health Care Resource Use and Costs for Crohn’s Disease before and after Infliximab Therapy

    Directory of Open Access Journals (Sweden)

    Dustin E Loomes

    2011-01-01

    Full Text Available BACKGROUND: Infliximab therapy in patients with Crohn’s disease decreases resource use; however, the overall impact on health-related expenditures is unclear, especially beyond one year of study.

  7. Clinical Experience with Infliximab for Crohn’s Disease: The First 100 Patients in Edmonton, Alberta

    Directory of Open Access Journals (Sweden)

    Clifford Sample

    2002-01-01

    Full Text Available OBJECTIVE: To determine whether the clinical efficacy and safety of infliximab in diverse clinical referral practices was similar to that seen in the randomized, controlled clinical trials.

  8. Infliximab or cyclosporine as rescue therapy in hospitalized patients with steroid-refractory ulcerative colitis

    DEFF Research Database (Denmark)

    Sjöberg, Mats; Walch, Andrea; Meshkat, Mina

    2012-01-01

    Cyclosporine (CsA) or infliximab (IFX) are used as rescue therapies in steroid-refractory, severe attacks of ulcerative colitis (UC). There are no data comparing the efficacy of these two alternatives.......Cyclosporine (CsA) or infliximab (IFX) are used as rescue therapies in steroid-refractory, severe attacks of ulcerative colitis (UC). There are no data comparing the efficacy of these two alternatives....

  9. Efficacy of treatment intensification with adalimumab, etanercept and infliximab in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Eng, Grith; Stoltenberg, Michael B; Szkudlarek, Marcin

    2013-01-01

    To summarize the empirical evidence regarding the effect of treatment intensification on clinical outcomes in patients with rheumatoid arthritis treated with one of the TNF-α-inhibitors, adalimumab, etanercept or infliximab.......To summarize the empirical evidence regarding the effect of treatment intensification on clinical outcomes in patients with rheumatoid arthritis treated with one of the TNF-α-inhibitors, adalimumab, etanercept or infliximab....

  10. Real-life treatment paradigms show infliximab is cost-effective for management of ulcerative colitis.

    Science.gov (United States)

    Ung, Victoria; Thanh, Nguyen Xuan; Wong, Karen; Kroeker, Karen I; Lee, Thomas; Wang, Haili; Ohinmaa, Arto; Jacobs, Philip; Fedorak, Richard N

    2014-11-01

    Infliximab is effective for induction and maintenance of response in patients with moderate to moderately severe ulcerative colitis. Previous cost analyses of infliximab treatment for ulcerative colitis used models of colectomy vs infliximab and response rates derived from early clinical trials. In real life, therapeutic options are more complex; patients frequently choose to remain in an unwell state rather than undergo colectomy, and rates of response to infliximab are generally higher than those reported from clinical trials. We evaluate the real-life cost-effectiveness of infliximab for treatment of ulcerative colitis where infliximab was readily available compared with not available, causing patients to remain in unwell states. We constructed a Markov model to simulate disease progression of patients with moderate or moderately severe ulcerative colitis who depended on corticosteroids and/or did not respond to thiopurine therapy. Utility scores and transition probabilities between health states were determined by using data from randomized controlled trials and real-life rates published by expert inflammatory bowel disease centers. Health care costs were obtained from the Ontario Case Costing Initiative and the Alberta Health Schedule of Medical Benefits documents. The incremental cost-effectiveness ratios for infliximab treatment of ulcerative colitis were $79,000 and $64,000 per quality-adjusted life year, compared with ongoing medical therapy, at 5-year and 10-year treatment time horizons, respectively. By using real-life response rates and patients' preference to avoid colectomy, infliximab therapy is a cost-effective strategy at a willingness-to-pay threshold of $80,000 for treatment of ulcerative colitis. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  11. Health care resource use and costs in Crohn's disease before and after infliximab therapy.

    Science.gov (United States)

    Loomes, Dustin E; Teshima, Christopher; Jacobs, Philip; Fedorak, Richard N

    2011-09-01

    Infliximab therapy in patients with Crohn's disease decreases resource use; however, the overall impact on health-related expenditures is unclear, especially beyond one year of study. A retrospective analysis of economic data one and two years before and after infliximab therapy was performed using patients who served as their own controls. Total health care resource use and direct health care costs were compared for patients with or without fistulae. Patients with one (n=66) and two (n=39) years of economic data before and after infliximab treatment had their resource use and direct health care costs estimated. In the year following initiation of infliximab therapy, there were significant decreases in health care use, reflected in total hospital days (495 to 155 [P<0.05]), inpatient colonoscopies (46 to 24 [P<0.05]), outpatient colonoscopies (58 to 33 [P<0.05]) and major surgeries (10 to 2 [P<0.05]). Direct health care costs of inpatient costs for luminal (-$1,747 [P<0.05]) and fistulizing disease (-$2,530 [P<0.05]), major surgeries (-$1240 [P<0.05]) and outpatient colonoscopies (-$184 [P<0.05]) were also significantly reduced before and after infliximab therapy. Total direct health care costs, including the drug cost of infliximab, increased ($21,416 [P<0.05]). In general, the trends in health care costs analyzed over four consecutive years paralleled the two consecutive-year analysis.  Infliximab therapy in patients with Crohn's disease resulted in a significant decrease in both resource use and health care costs, but an increase in total direct health care costs once the cost of infliximab was added.

  12. Prediction of Individual Serum Infliximab Concentrations in Inflammatory Bowel Disease by a Bayesian Dashboard System.

    Science.gov (United States)

    Eser, Alexander; Primas, Christian; Reinisch, Sieglinde; Vogelsang, Harald; Novacek, Gottfried; Mould, Diane R; Reinisch, Walter

    2018-01-30

    Despite a robust exposure-response relationship of infliximab in inflammatory bowel disease (IBD), attempts to adjust dosing to individually predicted serum concentrations of infliximab (SICs) are lacking. Compared with labor-intensive conventional software for pharmacokinetic (PK) modeling (eg, NONMEM) dashboards are easy-to-use programs incorporating complex Bayesian statistics to determine individual pharmacokinetics. We evaluated various infliximab detection assays and the number of samples needed to precisely forecast individual SICs using a Bayesian dashboard. We assessed long-term infliximab retention in patients being dosed concordantly versus discordantly with Bayesian dashboard recommendations. Three hundred eighty-two serum samples from 117 adult IBD patients on infliximab maintenance therapy were analyzed by 3 commercially available assays. Data from each assay was modeled using NONMEM and a Bayesian dashboard. PK parameter precision and residual variability were assessed. Forecast concentrations from both systems were compared with observed concentrations. Infliximab retention was assessed by prediction for dose intensification via Bayesian dashboard versus real-life practice. Forecast precision of SICs varied between detection assays. At least 3 SICs from a reliable assay are needed for an accurate forecast. The Bayesian dashboard performed similarly to NONMEM to predict SICs. Patients dosed concordantly with Bayesian dashboard recommendations had a significantly longer median drug survival than those dosed discordantly (51.5 versus 4.6 months, P dashboard helps to assess the diagnostic performance of infliximab detection assays. Three, not single, SICs provide sufficient information for individualized dose adjustment when incorporated into the Bayesian dashboard. Treatment adjusted to forecasted SICs is associated with longer drug retention of infliximab. © 2018, The American College of Clinical Pharmacology.

  13. Infliximab for the treatment of CNS sarcoidosis: A multi-institutional series.

    Science.gov (United States)

    Gelfand, Jeffrey M; Bradshaw, Michael J; Stern, Barney J; Clifford, David B; Wang, Yunxia; Cho, Tracey A; Koth, Laura L; Hauser, Stephen L; Dierkhising, Jason; Vu, NgocHanh; Sriram, Subramaniam; Moses, Harold; Bagnato, Francesca; Kaufmann, Jeffrey A; Ammah, Deidre J; Yohannes, Tsion H; Hamblin, Mark J; Venna, Nagagopal; Green, Ari J; Pawate, Siddharama

    2017-11-14

    To describe clinical and imaging responses in neurosarcoidosis to infliximab, a monoclonal antibody against tumor necrosis factor-α. Investigators at 6 US centers retrospectively identified patients with CNS sarcoidosis treated with infliximab, including only patients with definite or probable neurosarcoidosis following rigorous exclusion of other causes. Of 66 patients with CNS sarcoidosis (27 definite, 39 probable) treated with infliximab for a median of 1.5 years, the mean age was 47.5 years at infliximab initiation (SD 11.7, range 24-71 years); 56.1% were female; 62.1% were white, 37.0% African American, and 3% Hispanic. Sarcoidosis was isolated to the CNS in 19.7%. Using infliximab doses ranging from 3 to 7 mg/kg every 4-8 weeks, MRI evidence of a favorable treatment response was observed in 82.1% of patients with imaging follow-up (n = 56), with complete remission of active disease in 51.8% and partial MRI improvement in 30.1%; MRI worsened in 1 patient (1.8%). There was clinical improvement in 77.3% of patients, with complete neurologic recovery in 28.8%, partial improvement in 48.5%, clinical stability in 18.2%, worsening in 3%, and 1 lost to follow-up. In 16 patients in remission when infliximab was discontinued, the disease recurred in 9 (56%), typically in the same neuroanatomic location. Most patients with CNS sarcoidosis treated with infliximab exhibit favorable imaging and clinical treatment responses, including some previously refractory to other immunosuppressive treatments. This study provides Class IV evidence that for patients with CNS sarcoidosis infliximab is associated with favorable imaging and clinical responses. © 2017 American Academy of Neurology.

  14. Appropriate infliximab infusion dosage and monitoring: results of a panel meeting of rheumatologists, dermatologists and gastroenterologists

    Science.gov (United States)

    de Vries, Hilbert S; van Oijen, Martijn G H; Driessen, Rieke J B; de Jong, Elke M G J; Creemers, Marjonne C W; Kievit, Wietske; de Jong, Dirk J

    2011-01-01

    AIMS Infliximab, an anti-TNF biologic agent, is currently indicated and reimbursed for rheumatoid arthritis, ankylosing spondylitis, Crohn's disease (both adult and paediatric), ulcerative colitis, psoriatic arthritis and plaque psoriasis. Development of national and international guidelines for rheumatology, gastroenterology and dermatology, was mostly based on clinical studies and expert opinion. The aim of this study was to compare available guidelines and local protocols for rheumatology, dermatology and gastroenterology, regarding dosage of infliximab, synergy of infliximab with concomitant medication and monitoring of vital signs during infliximab administration, for achieving optimal care. METHODS Current international, national and local guidelines on the use of infliximab were reviewed and compared, differences and shortcomings were identified, and optimal treatment schedules discussed during a meeting (July 2008) of clinical experts and researchers from three departments of a Dutch university hospital. RESULTS Recommended dosages of infliximab are not equal for different indications. Loss of response to infliximab is a common problem encountered within the three medical specialties, but indications for adjustments in treatment schedules are lacking in all of the guidelines. Monitoring of vital signs (blood pressure, pulse, temperature) during infusion with infliximab is common practice and recommended by some guidelines. Routine measurement of vital signs is not of any value in predicting or recognizing acute infusion reactions, in our experience, and this is confirmed by literature on inflammatory bowel disease. CONCLUSION Different indications encompass different dosing schedules. National and internal guidelines do not provide advice regarding loss of response. Routine measurement of vital signs during infusion is not valuable in detecting acute infusion reactions and should only be performed in case of an acute infusion reaction. These topics need to

  15. Circulating Biomarkers for Predicting Infliximab Response in Rheumatoid Arthritis: A Systematic Bioinformatics Analysis.

    Science.gov (United States)

    Huang, Qiu-Lan; Zhou, Fu-Jiang; Wu, Cheng-Bin; Xu, Chao; Qian, Wen-Ying; Fan, De-Ping; Cai, Xu-Shan

    2017-04-17

    BACKGROUND Infliximab shows good efficacy in treating refractory rheumatoid arthritis (RA). However, many patients responded poorly and related studies were inconsistent in predictive biomarkers. This study aimed to identify circulating biomarkers for predicting infliximab response in RA. MATERIAL AND METHODS Public databases of Gene Expression Omnibus (GEO) and ArrayExpress were searched for related microarray datasets, focused on the response to infliximab in RA. All peripheral blood samples were collected before infliximab treatment and gene expression profiles were measured using microarray. Differential genes associated with infliximab efficacy were analyzed. The genes recognized by half of the datasets were regarded as candidate biomarkers and validated by prospective datasets. RESULTS Eight microarray datasets were identified with 374 blood samples of RA patients, among which 191 (51.1%) were diagnosed as non-responders in the subsequent infliximab treatment. Five genes (FKBP1A, FGF12, ANO1, LRRC31, and AKR1D1) were associated with the efficacy and recognized by half of the datasets. The 5-gene model showed a good predictive power in random- and prospective-designed studies, with AUC (area under receiver operating characteristic [ROC] curve)=0.963 and 1.000, and it was also applicable at the early phase of treatment (at week 2) for predicting the response at week 14 (AUC=1.000). In the placebo group, the model failed to predict the response (AUC=0.697), indicating the model's specificity in infliximab treatment. CONCLUSIONS The model of FKBP1A, FGF12, ANO1, LRRC31, and AKR1D1 in peripheral blood is useful for efficiently predicting the response to infliximab treatment in rheumatoid arthritis.

  16. EFFECTIVENESS OF INFLIXIMAB IN PATIENT WITH SYSTEMIC TYPE OF JUVENILE RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    E.S. Zholobova

    2011-01-01

    Full Text Available The article presents the case report of a child with juvenile rheumatoid arthritis, systemic type. The efficacy of infliximab (Remicade in treatment of systemic types of juvenile rheumatoid arthritis (JRA is analyzed. Treatment of JRA with high doses of prednisolone is inacceptable due to the risk of severe adverse events.Key words: juvenile rheumatoid arthritis, systemic type, infliximab, prednisolone, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2: 201–204

  17. Need for infliximab dose intensification in Crohn’s disease and ulcerative colitis

    Science.gov (United States)

    Taxonera, Carlos; Olivares, David; Mendoza, Juan L; Díaz-Rubio, Manuel; Rey, Enrique

    2014-01-01

    AIM: To compare the need for infliximab dose intensification in two cohorts of patients with Crohn’s disease (CD) or ulcerative colitis (UC). METHODS: Single centre, uncontrolled, observational study. Consecutive patients with CD and UC who responded to infliximab induction doses were included. Data collected in a prospectively maintained database were retrospectively analysed. Differences in the rates of dose intensification per patient-month and the intensification-free survival time were compared. We also evaluated the interval between the first infliximab induction dose and the first infliximab escalated dose. The weight-adjusted infliximab administration costs were also calculated. RESULTS: Fifty nine patients with CD and 38 patients with UC were enrolled. The rate of intensification per patient-month was 3.9% for UC and 1.4% for CD (P = 0.005). The median time from baseline to intensification was significantly shorter in UC compared to CD [6.6 mo (IQR: 4.2-9.5 mo) vs 10.7 mo (IQR: 8.9-11.7 mo), P = 0.005]. In the survival analysis, the cumulative probability of avoiding infliximab dose intensification was significantly higher in CD (P = 0.002). In the multivariate analysis, disease (UC vs CD) was the only factor significantly associated with dose intensification. The infiximab administration costs during the first year were significantly higher for UC compared to CD (mean ± SD 234.9 ± 53.3 Euros/kg vs 212.3 ± 15.1 Euros/kg, P = 0.03). CONCLUSION: The rate of infliximab dose intensification per patient-month is significantly higher in UC patients. The infliximab administration costs are also significantly higher in patients with UC. PMID:25083091

  18. A budget impact model for biosimilar infliximab in Crohn's disease in Bulgaria, the Czech Republic, Hungary, Poland, Romania, and Slovakia.

    Science.gov (United States)

    Brodszky, Valentin; Rencz, Fanni; Péntek, Márta; Baji, Petra; Lakatos, Péter L; Gulácsi, László

    2016-01-01

    To estimate the budget impact of the introduction of biosimilar infliximab for the treatment of Crohn's disease (CD) in Bulgaria, the Czech Republic, Hungary, Poland, Romania and Slovakia. A 3-year, prevalence-based budget impact analysis for biosimilar infliximab to treat CD was developed from third-party payers' perspective. The model included various scenarios depending on whether interchanging originator infliximab with biosimilar infliximab was allowed or not. Total cost savings achieved in biosimilar scenario 1 (interchanging not allowed) and BSc2 (interchanging allowed in 80% of the patients) were estimated to €8.0 million and €16.9 million in the six countries. Budget savings may cover the biosimilar infliximab therapy for 722-1530 additional CD patients. Introduction of biosimilar infliximab to treat CD may offset the inequity in access to biological therapy for CD between Central and Eastern European countries.

  19. Risk factors for surgical site infection and association with infliximab administration during surgery for Crohn's disease.

    Science.gov (United States)

    Uchino, Motoi; Ikeuchi, Hiroki; Matsuoka, Hiroki; Bando, Toshihiro; Ichiki, Kaoru; Nakajima, Kazuhiko; Tomita, Naohiro; Takesue, Yoshio

    2013-10-01

    Preoperative infliximab treatment may influence postoperative infectious complications in patients with Crohn's disease. The aim of this study was to identify predictors of surgical site infection after surgery for Crohn's disease and evaluate the effects of preoperative infliximab administration. We performed a prospective surveillance and review of surgical site infections. This study was conducted in the Surgical Department of Hyogo College of Medicine. A total of 405 consecutive patients with Crohn's disease who underwent abdominal surgery between January 2008 and December 2011 were included. Infection was diagnosed by the infection control team. The possible risk factors were analyzed by using logistic regression analyses to determine their predictive significance. Within the patient population, 20% of patients received infliximab, and 60% had penetrating disease. The median duration from the last infliximab infusion to surgery was 43 days (range, 4-80). The overall incidence of surgical site infection was 27%. The incidence of incisional surgical site infection was 18%, and the organ/space surgical site infection rate was 8%. In the multivariate analysis, proctectomy was the highest risk factor for all surgical site infection (OR, 3.4-11.8; p risk factor for surgical site infection. By contrast, there was a significantly reduced risk of incisional surgical site infection in patients with penetrating disease who received infliximab (OR, 0.1; p risk factor for surgical site infection in patients with Crohn's disease. The administration of preoperative infliximab was not a risk factor for surgical site infection.

  20. Perioperative Timing of Infliximab and the Risk of Serious Infection After Elective Hip and Knee Arthroplasty.

    Science.gov (United States)

    George, Michael D; Baker, Joshua F; Hsu, Jesse Yenchih; Wu, Qufei; Xie, Fenglong; Chen, Lang; Yun, Huifeng; Curtis, Jeffrey R

    2017-12-01

    The optimal timing of tumor necrosis factor antagonists before elective surgery is unknown. This study evaluated the association between infliximab timing and serious infection after elective hip or knee arthroplasty. A retrospective cohort study evaluated US Medicare patients with rheumatoid arthritis, inflammatory bowel disease, psoriasis, psoriatic arthritis, or ankylosing spondylitis who received infliximab within 6 months of elective knee or hip arthroplasty from 2007 to 2013. Propensity-adjusted analyses examined whether infliximab stop timing (time between the most recent infusion and surgery) was associated with hospitalized infection within 30 days or prosthetic joint infection (PJI) within 1 year. Hospitalized infection within 30 days occurred after 270 of 4,288 surgeries (6.3%). Infliximab stop timing 10 mg/day was associated with increased risk of 30-day infection (OR 2.11 [95% CI 1.30-3.40]) and PJI (HR 2.70 [95% CI 1.30-5.60]). Other risk factors for infection included elderly age, comorbidities, revision surgery, and previous hospitalized infection. Administering infliximab within 4 weeks of elective knee or hip arthroplasty was not associated with a higher risk of short- or long-term serious infection compared to withholding infliximab for longer time periods. Glucocorticoid use, especially >10 mg/day, was associated with an increased infection risk. © 2017, American College of Rheumatology.

  1. Adalimumab administration after infliximab therapy is a successful treatment strategy for generalized pustular psoriasis.

    Science.gov (United States)

    Matsumoto, Ai; Komine, Mayumi; Karakawa, Masaru; Kishimoto, Megumi; Ohtsuki, Mamitaro

    2017-02-01

    We report a case of a 70-year-old woman with generalized pustular psoriasis (GPP) who responded well to infliximab therapy and adalimumab therapy after secondary failure of infliximab therapy, but did not respond to ustekinumab therapy. We speculate that the pathogenic factor in this case favored anti-tumor necrosis factor (TNF)-α therapy to anti-interleukin-12/23 therapy. Herein, we also briefly present three additional cases of treatment with adalimumab after secondary failure of infliximab. GPP is often difficult to treat, and no placebo-controlled trials have been conducted to guide the use of biologics against it because of a paucity of cases. Infliximab and adalimumab are anti-TNF-α antibodies that specifically block the interaction of TNF-α with its receptors. Infliximab has been reported to be effective, with a rapid clearance of symptoms, even in cases of severe GPP. Adalimumab could be a good biologic candidate that can be administrated after secondary failure of infliximab therapy. © 2016 Japanese Dermatological Association.

  2. Værdier med mening

    DEFF Research Database (Denmark)

    Gørtz, Kim

    Bogen handler om at frigøre arbejdet med værdier fra tekniske og pragmatiske operationer - og tilsigter herved at øge forståelsen for hvilke grundlæggende fejl, udfordringer og faldgruber, der typisk forekommer i forbindelse med værdiarbejdet, personligt såvel som organisatorisk....

  3. Hodgkin's Lymphoma in Crohn's Disease Treated with Infliximab

    Directory of Open Access Journals (Sweden)

    Diana Carvalho

    2017-09-01

    Full Text Available Introduction: Lymphoproliferative disorders, particularly non-Hodgkin's and Hodgkin's lymphomas, are rare in patients with inflammatory bowel diseases. The use of thiopurines and infection by Epstein-Barr virus are well-known cofactors that can raise its prevalence. Other risk factors such as disease activity and biological treatment are the subject of discussion, without enough data in the literature to confirm a potential association. Methods: We report a case of Hodgkin's lymphoma in a patient who had been treated with azathioprine and was on long-term monotherapy with infliximab. Conclusions: We stress the importance of recognizing the possible occurrence of a lymphoproliferative disorder in association with anti-tumor necrosis factor-α therapy

  4. [Legionella pneumonia after infliximab in a patient with rheumatoid arthritis].

    Science.gov (United States)

    Giassi, Karina de Souza; Furlanetto, Vilson; Fialho, Sonia; Gomes Ribeiro, Giovana; Pereira, Ivânio Alves

    2014-01-01

    The antagonists of tumour necrosis factor (anti-TNF) have been successfully used in several chronic inflammatory diseases such as Rheumatoid Arthritis (RA), but some studies have observed the development of infections by intracellular pathogens in patients using anti-TNF. We report a case of a female patient with previous diagnosis of RA for 16 years that used several disease-modifying anti-rheumatic drugs (DMARDs) that resulted in treatment failure, and then was treated with infliximab. After fifteen days of the second dose, the patient developed ventilatory-dependent chest pain, dry cough and dyspnea. She was hospitalized, and the diagnosis of pneumonia by Legionella pneumophila was confirmed by the presence of Legionella antigen in an urine test. TNF is an inflammatory cytokine that also acts inhibiting the bacterial growth of intracellular pathogens, and its inhibition seems to increase susceptibility to these infections in some patients. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  5. Role of scintigraphy with {sup 99m}Tc-infliximab in predicting the response of intraarticular infliximab treatment in patients with refractory monoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Conti, F.; Ceccarelli, F.; Priori, R.; Iagnocco, A.; Valesini, G. [University of Rome, Rheumatology Unit, Faculty of Medicine and Dentistry, Rome (Italy); Malviya, G.; Signore, A. [University of Rome, Nuclear Medicine Unit, Faculty of Medicine and Psychology, Rome (Italy)

    2012-08-15

    The rationale for the present study was to evaluate the predictive role of {sup 99m}Tc-infliximab scintigraphy in therapy decision-making in patients with refractory monoarthritis and also candidates for intraarticular (IA) infliximab treatment. We studied 12 patients (5 with rheumatoid arthritis and 7 with spondyloarthropathy) with active monoarthritis (11 knees and 1 ankle) that had lasted for at least 3 months. Patients were evaluated clinically and ultrasonographically at baseline and 12 weeks after IA administration of infliximab. At the same time-points, {sup 99m}Tc-infliximab scintigraphy was performed: planar anterior and posterior images of arthritic joints were acquired at 6 and 20 h after injection and target-to-background (T/B) ratios were calculated. After treatment, a significant improvement in clinical and ultrasonographic parameters was recorded in six patients. Three patients had a partial response and three did not respond. Regarding scintigraphic evaluation, the T/B ratio analysis showed a significantly higher uptake in affected than in nonaffected joints before therapy (1.78 {+-} 0.46 vs. 1.29 {+-} 0.27, p = 0.006 at 6 h; 2.05 {+-} 0.50 vs. 1.41 {+-} 0.36 at 20 h, p = 0.002), and mean uptake at 20 h was also significantly higher than at 6 h (p = 0.0004). Scintigraphy showed a significant decrease in posttherapy T/B ratios of the affected joints (p = 0.0001 at 6 h and p = 0.0001 at 20 h), indicating a reduction in TNF into the affected joints. Most importantly, responders showed a significantly higher percentage increase in pretherapy uptake from 6 h to 20 h in the affected joints than nonresponders (p = 0.00001). The results of the present investigation suggest that {sup 99m}Tc-infliximab scintigraphy could be a useful tool to predict the clinical response to IA infliximab treatment in patients with refractory monoarthritis. (orig.)

  6. Infliximab versus Cyclosporine Treatment for Severe Corticosteroid-Refractory Ulcerative Colitis: A Korean, Retrospective, Single Center Study

    Science.gov (United States)

    Kim, Eun Hye; Kim, Duk Hwan; Park, Soo Jung; Hong, Sung Pil; Kim, Tae Il; Kim, Won Ho; Cheon, Jae Hee

    2015-01-01

    Background/Aims In patients with corticosteroid-refractory ulcerative colitis (UC), cyclosporine or infliximab may be added to the treatment regimen to induce remission. Here, we aimed to compare the efficacy of cyclosporine and infliximab. Methods Between January 1995 and May 2012, the medical records of 43 patients with corticosteroid-refractory UC who received either infliximab or cyclosporine as a rescue therapy at a tertiary care hospital in Korea were reviewed. Results Among the 43 patients, 10 underwent rescue therapy with cyclosporine and the remaining 33 patients received infliximab. A follow-up of 12 months was completed for all patients. The colectomy rate at 12 months was 30% and 3% in the cyclosporine and the infliximab groups, respectively (p=0.034). However, the Cox proportional hazard model indicated that the treatment of rescue therapy was not an independent associate factor for preventing colectomy (p=0.164). In the subgroup analysis, infliximab with azathioprine was superior to cyclosporine for preventing colectomy (hazard ratio of infliximab with azathioprine compared with cyclosporine only, 0.073; 95% confidence interval, 0.008 to 0.629). Conclusions No difference between infliximab and cyclosporine with respect to preventing colectomy was noted. However, infliximab with azathioprine may be more effective than cyclosporine alone for preventing colectomy. PMID:25473080

  7. Combination of infliximab with thiopurines significantly reduces white cell and neutrophil counts in inflammatory bowel disease patients.

    Science.gov (United States)

    Parihar, V; Maceneaney, O; Maguire, S; Garry, C; O'Sullivan, M; Kennedy, M; Safaya, K; Smyth, C; Farrell, R

    2017-05-01

    The effects of thiopurines on white cell count are well documented. We compared the effects of infliximab 5 mg/kg monotherapy and combination of infliximab with thiopurines on the total and differential white cell count (WBC). 13 IBD patients treated with infliximab monotherapy and 18 IBD patients treated with a combination of infliximab and thiopurines were included in the study. Using retrospective data, cell counts were examined prior to induction of infliximab, and at 6 weeks and 1 year post-induction. The patients on combination therapy had an absolute WBC at 52 weeks of 5.7 whereas that of patients on Infliximab monotherapy at the same time point was 8.3 with comparable neutrophil count of 3.4 and 5.4. The results showed a significant reduction in white cell count and neutrophils at 6 weeks which persisted at 52 weeks in both groups (p infliximab and thiopurine (p Infliximab monotherapy. There was no significant change in the lymphocyte count. Full blood counts should be closely monitored in all patients starting infliximab therapy, in particular patients receiving concomitant thiopurines.

  8. Low infliximab serum trough levels and anti-infliximab antibodies are prevalent in rheumatoid arthritis patients treated with infliximab in daily clinical practice: results of an observational cohort study

    NARCIS (Netherlands)

    van der Maas, A.; van den Bemt, B.J.; Wolbink, G.; Hoogen, F.H.J. van den; van Riel, P.L.; Broeder, A. den

    2012-01-01

    ABSTRACT: BACKGROUND: To get insight in the prevalence of high, or low/no serum infliximab trough levels in patients with low disease activity and if serum trough levels are stable and reliable longitudinally we conducted a prospective cohort study METHODS: In a longitudinal, observational cohort of

  9. Clinical Use of Infliximab Trough Levels and Antibodies to Infliximab in Pediatric Patients With Inflammatory Bowel Disease.

    Science.gov (United States)

    Merras-Salmio, Laura; Kolho, Kaija-Leena

    2017-02-01

    Optimizing infliximab (IFX) treatment in pediatric patients with inflammatory bowel disease (IBD) by using serum infliximab (S-IFX) trough levels and antibodies to IFX is recommended. There is need for studies assessing this strategy in clinical practice. We retrospectively identified all pediatric patients with IBD (n = 146, median age 14.8 years) treated with IFX at our tertiary referral center from 2003 to 2014. All were analyzed for IFX trough levels (S-IFX, n = 475), and IFX antibody (IFX-Ab, n = 219) titers were included. Both were analyzed using enzyme-linked immunosorbent assay. We correlated these parameters with concurrently analyzed fecal calprotectin levels and the treatment outcome. If IFX had no efficacy, or a loss of response occurred, 40 of 64 (63%) had trough levels <2.0 mg/L, with negative IFX-Ab in 37 of 59 (63%). If the S-IFX was very low (<0.2 mg/L), 4 of 36 still had negative IFX-Ab. Concurrent azathioprine therapy did not relate to IFX-Ab. Fecal calprotectin was significantly lower in patients with clinical remission or ongoing therapy compared with those with subsequent loss of efficacy: medians 95 μg/g (33-308) and 670 μg/g (264-1473), P < 0.0001. The S-IFX median was substantially higher in patients with either remission or ongoing therapy, compared with those with no or loss of efficacy: 3.7 mg/L (1.8-5.4) and 1.2 mg/L (0.03-4.4, P = 0.01), respectively. Measuring IFX trough levels and fecal calprotectin has a potential impact on the treatment strategies and should be included in clinical routine. Low IFX trough levels associate with increased antibodies to IFX in most, but not in all cases.

  10. Clinical correlations of infliximab trough levels and antibodies to infliximab in South Korean patients with Crohn's disease.

    Science.gov (United States)

    Oh, Eun Hye; Ko, Dae-Hyun; Seo, Hyungil; Chang, Kiju; Kim, Gwang-Un; Song, Eun Mi; Seo, Myeongsook; Lee, Ho-Su; Hwang, Sung Wook; Yang, Dong-Hoon; Ye, Byong Duk; Byeon, Jeong-Sik; Myung, Seung-Jae; Yang, Suk-Kyun; Park, Sang Hyoung

    2017-02-28

    To investigate the clinical implications of infliximab trough levels (IFX-TLs) and antibodies to infliximab (ATI) levels in Crohn's disease (CD) patients in Asian countries. IFX-TL and ATI level were measured using prospectively collected samples obtained with informed consent from CD patients being treated at Asan Medical Center, South Korea. We analyzed the correlations between IFX-TLs/ATI levels and the clinical activity of CD (quiescent vs active disease) based on the CD activity index, C-reactive protein level, and physician's judgment of patients' clinical status at enrollment. The impact of concomitant immunomodulators was also investigated. This study enrolled 138 patients with CD (84 with quiescent and 54 with active disease). In patients with quiescent and active diseases, the median IFX-TLs were 1.423 μg/mL and 0.163 μg/mL, respectively ( P < 0.001) and the median ATI levels were 8.064 AU/mL and 11.209 AU/mL, respectively ( P < 0.001). In the ATI-negative and -positive groups, the median IFX-TLs were 1.415 μg/mL and 0.141 μg/mL, respectively ( P < 0.001). In patients with and without concomitant immunomodulator use, there were no differences in IFX-TLs (0.632 μg/mL and 1.150 μg/mL, respectively; P = 0.274) or ATI levels (8.655 AU/mL and 9.017 AU/mL, respectively; P = 0.083). IFX-TL/ATI levels were well correlated with the clinical activity in South Korean CD patients. Our findings support the usefulness of IFX-TLs/ATI levels in treating CD patients receiving IFX in clinical practice.

  11. Crohn's disease genotypes of patients in remission vs relapses after infliximab discontinuation.

    Science.gov (United States)

    Lu, Cathy; Waugh, Alistair; Bailey, Robert J; Cherry, Raeleen; Dieleman, Levinus A; Gramlich, Leah; Matic, Kata; Millan, Mario; Kroeker, Karen I; Sadowski, Daniel; Teshima, Christopher W; Todoruk, Dennis; Wong, Clarence; Wong, Karen; Fedorak, Richard N

    2012-09-28

    To investigate genetic differences between Crohn's disease (CD) patients with a sustained remission vs relapsers after discontinuing infliximab while in corticosteroid-free remission. Forty-eight CD patients received infliximab and were in full corticosteroid-free clinical remission but then discontinued infliximab for reasons other than a loss of response, were identified by review of an electronic database and charts. Infliximab-associated remission was defined as corticosteroid-free plus normalization of clinical disease activity [CD activity index (CDAI) 220) and a therapeutic intervention with CD medication(s), or a hospitalization with complications related to active CD. Genetic analyses were performed on samples from 14 patients (n = 6 who had a sustained long term remission after stopping infliximab, n = 8 who rapidly relapsed after stopping infliximab). Nucleotide-binding oligomerization domain 2 (NOD2)/caspase activation recruitment domain 15 (CARD15) polymorphisms (R702W, G908R and L1007fs) and the inflammatory bowel disease 5 (IBD5) polymorphisms (IGR2060a1 and IGR3081a1) were analyzed in each group. Five single nucleotide polymorphisms of IBD5 and NOD2/CARD15 genes were successfully analyzed for all 14 subjects. There was no significant increase in frequency of the NOD2/CARD15 polymorphisms (R702W, G908R and L1007fs) and the IBD5 polymorphisms (IGR2060a1 and IGR3081a1) in either group of patients; those whose disease relapsed rapidly or those who remained in sustained long term remission following the discontinuation of infliximab. Nearly a third of patients in full clinical remission who stopped infliximab for reasons other than loss of response remained in sustained clinical remission, while two-thirds relapsed rapidly. There was a marked difference in the duration of clinical remission following discontinuance of infliximab between the two groups. The patients who lost remission did so after 1.0 years ± 0.6 years, while those still in remission

  12. Crohn’s disease genotypes of patients in remission vs relapses after infliximab discontinuation

    Science.gov (United States)

    Lu, Cathy; Waugh, Alistair; Bailey, Robert J; Cherry, Raeleen; Dieleman, Levinus A; Gramlich, Leah; Matic, Kata; Millan, Mario; Kroeker, Karen I; Sadowski, Daniel; Teshima, Christopher W; Todoruk, Dennis; Wong, Clarence; Wong, Karen; Fedorak, Richard N

    2012-01-01

    AIM: To investigate genetic differences between Crohn’s disease (CD) patients with a sustained remission vs relapsers after discontinuing infliximab while in corticosteroid-free remission. METHODS: Forty-eight CD patients received infliximab and were in full corticosteroid-free clinical remission but then discontinued infliximab for reasons other than a loss of response, were identified by review of an electronic database and charts. Infliximab-associated remission was defined as corticosteroid-free plus normalization of clinical disease activity [CD activity index (CDAI) 220) and a therapeutic intervention with CD medication(s), or a hospitalization with complications related to active CD. Genetic analyses were performed on samples from 14 patients (n = 6 who had a sustained long term remission after stopping infliximab, n = 8 who rapidly relapsed after stopping infliximab). Nucleotide-binding oligomerization domain 2 (NOD2)/caspase activation recruitment domain 15 (CARD15) polymorphisms (R702W, G908R and L1007fs) and the inflammatory bowel disease 5 (IBD5) polymorphisms (IGR2060a1 and IGR3081a1) were analyzed in each group. RESULTS: Five single nucleotide polymorphisms of IBD5 and NOD2/CARD15 genes were successfully analyzed for all 14 subjects. There was no significant increase in frequency of the NOD2/CARD15 polymorphisms (R702W, G908R and L1007fs) and the IBD5 polymorphisms (IGR2060a1 and IGR3081a1) in either group of patients; those whose disease relapsed rapidly or those who remained in sustained long term remission following the discontinuation of infliximab. Nearly a third of patients in full clinical remission who stopped infliximab for reasons other than loss of response remained in sustained clinical remission, while two-thirds relapsed rapidly. There was a marked difference in the duration of clinical remission following discontinuance of infliximab between the two groups. The patients who lost remission did so after 1.0 years ± 0.6 years, while

  13. Stability of infliximab dosing in inflammatory bowel disease: results from a multicenter US chart review.

    Science.gov (United States)

    Waters, Heidi; Vanderpoel, Julie; McKenzie, Scott; Lunacsek, Orsolya; Franklin, Meg; Lennert, Barbara; Goff, John; Augustyn, Damian H

    2011-01-01

    Infliximab dosing for inflammatory bowel disease (IBD) is based on patient weight and treatment response. Understanding dosing patterns may provide insight into treatment response and predictability of treatment cost. The purpose of this medical record review was to assess dose and dose frequency of infliximab maintenance treatment in patients with IBD using patient chart data. A retrospective chart review was conducted at 14 community gastroenterology clinics (GI clinics). Patients were aged ≥18 years, diagnosed with Crohn's disease (CD) or ulcerative colitis (UC), and had a first infliximab administration (index date) between January 1, 2005 and September 30, 2007. At least 24 months of continuous data availability were required with dosing data collected for 12 months after initiation of infliximab therapy. Patients with biologic use and/or participation in an IBD clinical trial within 12 months before the index date were excluded. Charts from 182 CD patients and 86 UC patients were analyzed. About half of the patients were female. Over 90% of patients initiated treatment with infliximab 5 mg/kg. Among CD patients and UC patients, respectively, 79% and 61% continued receiving this dose for maintenance therapy at stable intervals. This retrospective descriptive study is limited by the type and quantity of information available in patient charts from 14 GI clinics during the first year of infliximab treatment. Further, non-anti-tumor necrosis factor medication data were intermittently collected in some charts and, therefore, did not allow for analysis. Weight-based dosing and, presumably, patient response enabled providers to find the effective infliximab dose for IBD patients. The maintenance dose and administration frequency remained stable during the initial year.

  14. Efficacy of adalimumab in sarcoidosis patients who developed intolerance to infliximab.

    Science.gov (United States)

    Crommelin, Heleen A; van der Burg, Leone M; Vorselaars, Adriane D M; Drent, Marjolein; van Moorsel, Coline H M; Rijkers, Ger T; Deneer, Vera H M; Grutters, Jan C

    2016-06-01

    Tumor necrosis factor-alpha (TNF-α) inhibitors are regarded as the third-line therapy in sarcoidosis, the first choice generally being infliximab. To date, data regarding response to adalimumab in sarcoidosis patients intolerant to infliximab are lacking. The objective of this retrospective observational study was to establish if adalimumab could achieve stabilization or improvement of the disease in refractory sarcoidosis patients who developed intolerance to infliximab. Sarcoidosis patients referred to St Antonius Interstitial Lung Diseases Center of Excellence, Nieuwegein, The Netherlands, between January 2008 and April 2015 who switched from infliximab to adalimumab were included. Changes in organ function, inflammatory biomarker levels, and adverse events were retrieved from medical records. Out of 142 infliximab treated patients, 18 (13%) had to discontinue treatment due to antibody formation or severe adverse events and switched to adalimumab therapy. Organ function improved in 7 patients (39%), was stable in 6 patients (33%), and worsened in 5 patients (28%) after 12 months of treatment or after 6 months if evaluation after 12 months was not available (n = 4). In none of the patients biomarker levels of soluble interleukin-2 receptor (sIL-2R) deteriorated. Median decrease in sIL-2R was 3614 pg/mL. Most reported adverse event was infection (n = 10). Adalimumab is an effective alternative for patients intolerant to infliximab. The switch to adalimumab achieved clinical improvement in 39% and stabilization in 33% of patients intolerant to infliximab. Further research is needed to develop guidelines on how to use adalimumab for sarcoidosis in terms of dosing regimen. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Predictors of long-term drug survival for infliximab in psoriasis.

    Science.gov (United States)

    Magis, Q; Jullien, D; Gaudy-Marqueste, C; Baumstark, K; Viguier, M; Bachelez, H; Guibal, F; Delaporte, E; Karimova, E; Montaudié, H; Boye, T; Aubin, F; Beylot-Barry, M; Richard, M-A

    2017-01-01

    Limited information is available regarding factors associated with long-term drug survival of infliximab for psoriasis in real life. The main aim pf this study was to identify predictors of long-term (>12 months) drug survival among patients treated with infliximab for psoriasis in a real-world clinical setting. Retrospectively collected data, relating to disease, patient characteristics and treatment procedures, in a multicentre observational cohort of patients with moderate-to-severe plaque psoriasis treated with infliximab at eight university hospitals, 120 of whom maintained a response to infliximab for more than 12 months, were compared with prospectively collected data in the same centres from 54 patients who experienced secondary loss of response within a 12-month period. Mean duration of drug survival of infliximab in patients with long-term drug survival was 41.12 months ± 20.64 SD vs. 8.5 months ± 2.43 SD in patients with a secondary loss of response. Multivariate analysis identified greater disease severity at treatment onset (PASI score >12) (OR = 5.18, 95% CI: 1.60-16.77, P = 0.006), high levels of initial psoriasis clearance (PASI-90 reduction or equivalent) (OR = 18.50, 95% CI: 4.56-74.45, P = 0.0001) and combination with methotrexate (OR = 13.15, 95% CI: 1.46-118.79, P = 0.022) as independent predictors of long-term drug survival and sustained efficacy of infliximab. Positive predictors for long-term drug survival of infliximab in real life were identified. Their impact on treatment management should be addressed in further prospective trials. © 2016 European Academy of Dermatology and Venereology.

  16. CAM on PubMed

    Science.gov (United States)

    ... PubMed provides access to citations from the MEDLINE database and additional life science journals. It also includes links to many full-text articles at journal Web sites and other related Web resources. Sample Searches ...

  17. Long-term safety and efficacy of biosimilar infliximab among patients with inflammatory arthritis switched from reference product

    Directory of Open Access Journals (Sweden)

    Abdalla A

    2017-03-01

    Full Text Available Abuelmagd Abdalla, Niamh Byrne, Richard Conway, Thomas Walsh, Geraldine Mannion, Michael Hanly, Miriam O’Sullivan, Ann Maria Curran, John J Carey Department of Rheumatology, Galway University Hospitals, Galway, Ireland Purpose: To evaluate the efficacy and safety of the biosimilar infliximab in adult patients with inflammatory arthritis switched from reference product in our center. Patients and methods: In April 2014, patients attending our rheumatology service for infliximab infusions were switched from reference product to the biosimilar infliximab following consent and hospital approval. Results: Around 34 patients with inflammatory arthritis were switched from reference product to biosimilar infliximab in 2014: 50% female, mean age 55 years (standard deviation=12.9, mean disease duration 14.79 years (9.7, median duration on infliximab 57 months, and two-thirds on oral disease-modifying antirheumatic drugs. There was no difference in efficacy or safety in the first 6 months of therapy. By the end of 2015, the mean follow-up on biosimilar infliximab was 15.8 (standard deviation=6.3 months. Our results showed no significant difference in Health Assessment Questionnaire score, patient global assessment of disease activity, number of disease flares, or the medication dose between the originator and the biosimilar infliximab. However, reported pain and C-reactive protein values were significantly higher during the longer follow-up period (p=0.043, 0.001 respectively. There was no significant difference in the number of adverse events or infusion reactions during follow-up periods. Only five (14.7% patients discontinued the biosimilar infliximab. Conclusion: Our patients experienced similar efficacy and safety for managing their arthritis with the biosimilar infliximab as the reference product infliximab, but at a much lower cost. Keywords: biologic therapy, rheumatic diseases, biosimilar exchange, infliximab, adult

  18. Unges friluftsliv set med integrationsbriller

    DEFF Research Database (Denmark)

    Gentin, Sandra

    2010-01-01

    Det er almindelig kendt, at indvandrere ikke deltager i foreningsliv i samme omfang som etniske danskere. Det er der forsøgt rådet bod på ved at invitere unge med anden etnisk baggrund end dansk til at dyrke spejdersport i henholdsvis Varde og København NV. Tilgangen til at integrere de unge var ...... friluftsliv blandt unge etniske danskere og unge med anden etnisk baggrund....

  19. Privat voldgift med offentligretlige delspørgsmål

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2008-01-01

    Artiklen behandler de offentligretlige delspørgsmål, der kan opstå under en voldgiftssag, fx vedrørende el-, varme-, naturgas- og anden forsyningslovgivning, national eller fællesskabsretlig konkurrencelovgivning, forskrifter om statsforvaltningens godkendelse af vilkårene for udtræden af fællesk...

  20. Infliximab en pacientes con espondilitis anquilosante activa: experiencia en el Hospital Nacional Edgardo Rebagliati Martins

    Directory of Open Access Journals (Sweden)

    Manuel Montero

    2007-06-01

    Full Text Available Infliximab es un medicamento efectivo en el tratamiento de pacientes con espondilitis anquilosante (EA activa. Sin embargo, debido a su alto costo, su uso indiscriminado es prohibitivo. Objetivo: Evaluar si un régimen de inducción con infliximab es efectivo en pacientes con EA activa. Diseño: Sólo expuestos. Lugar: Servicio de Reumatología del Hospital Nacional Edgardo Rebagliati. Participantes: Pacientes con espondilitis anquilosante activa refractaria. Intervenciones: infliximab a las 0, 2 y 6 semanas. Un paciente recibió dosis de 3 mg/kg y los restantes 5 mg/kg de infliximab. Todos los pacientes continuaron recibiendo sulfasalazina. Principales medidas de resultados: Se determinó la proporción de pacientes que alcanzaron mejoría de acuerdo a los criterios ASAS 20, ASAS 40 y BASDAI 50, en la última evaluación (mediana de 55 semanas. Resultados: En la última evaluación, cinco pacientes (71,4% presentaban respuesta ASAS 20 sostenida. Cuatro (57% y tres (43% de los pacientes alcanzaron BASDAI 50 y ASAS 40, respectivamente. Tres pacientes (43% recayeron en un tiempo promedio de 26,6 semanas. No se observó efectos adversos serios. Conclusiones: La infusión de tres dosis de infliximab es efectiva para controlar la actividad de la enfermedad de los pacientes con EA refractaria a AINEs y en algunos pacientes controla la enfermedad por periodos prolongados de tiempo.

  1. QUALITY OF LIFE IN CHILDREN WITH JUVENILE RHEUMATOID ARTHRITIS TREATED WITH INFLIXIMAB

    Directory of Open Access Journals (Sweden)

    R.V. Denisova

    2008-01-01

    Full Text Available Juvenile rheumatoid arthritis (JRA is chronic disease, leading to early incapacitating injury in patients. Treatment of JRA with new expensive biological agents allows obtaining long term remission of disease and improving its prognosis. Estimation of quality of life is one of the main effectiveness criteria of treatment. A quality of life in children who were 2–4 years old treated with infliximab was estimated. 43 patients with different types of JRA were examined. A quality of life was estimated with the help of questionnaire PEDSQL generic core scale, PEDSQL rheumatology module. Index of functional disability was estimated by childhood health assessment questionnaire (CHAQ. Significant increase of quality of life rates and decrease of index of functional disability was registered in 6 weeks of therapy with infliximab. The rates of quality of life in patients with JRA treated with infliximab were significantly equal to that in healthy children in the same age in 6, 12 and 24 months of treatment. Thus, treatment with infliximab significantly increases quality of life in children in 2–4 years old with JRA and their families, decreases negative influence of disease on child's living, improves physical activity and emotional state of patients, and allows improving contact between patients and healthy children in the same age.Key words: children, juvenile rheumatoid arthritis, quality of life, infliximab.

  2. Infliximab after Boston Keratoprosthesis in Stevens-Johnson Syndrome: An Update.

    Science.gov (United States)

    Robert, Marie-Claude; Črnej, Alja; Shen, Lucy Q; Papaliodis, George N; Dana, Reza; Foster, C Stephen; Chodosh, James; Dohlman, Claes H

    2017-06-01

    To report our experience using intravenous infliximab for the treatment of tissue melt after Boston keratoprosthesis (B-KPro) types I and II in patients with autoimmune disease. Case series. We identified four patients who were treated with intravenous infliximab in the context of tissue melt after B-KPro. Stevens-Johnson syndrome-associated corneal blindness was the primary surgical indication for B-KPro implantation in all patients. Two patients received a B-KPro type I and two patients received a B-KPro type II. The patients received intravenous infliximab for skin retraction around B-KPro type II, melting of the carrier graft or leak. Treatment resulted in a dramatic decrease in inflammation and, in some cases, arrest of the melting process. Cost and patient adherence were limiting factors to pursuing infliximab therapy. In addition, one patient developed infusion reactions. Intravenous infliximab may be considered as globe- and sight-saving therapy for tissue melt after B-KPro.

  3. Effect of Systemic Infliximab Therapy in Patients with Sjögren’s Syndrome

    Directory of Open Access Journals (Sweden)

    Elif Betül Türkoğlu

    2015-08-01

    Full Text Available Objectives: To investigate the effect of systemic infliximab therapy on tear function tests and the ocular surface in patients with Sjögren’s syndrome secondary to various autoimmune diseases. Materials and Methods: This prospective study included 22 eyes of 22 patients with Sjögren’s syndrome who began treatment with systemic infliximab. Tear film break-up time (TBUT, anesthetized Schirmer’s 1 test, fluorescein staining test, and Ocular Surface Disease Index (OSDI scores were recorded before treatment and in the 3rd and 6th months of treatment. Results: In the 3rd month of infliximab therapy, no significant changes were observed in Schirmer’s values, TBUT, fluorescein staining, or OSDI scores (p=0.260, p=0.357, p=0.190 and p=0.07, respectively. In the 6th month of infliximab therapy, no significant changes were observed in TBUT, fluorescein staining, Schirmer’s value or OSDI scores (p=0.510, p=0.320, p=0.220 and p=0.344, respectively. Conclusion: Infliximab therapy, which is commonly used in systemic autoimmune diseases such as rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and ankylosing spondylitis, did not show a positive effect on ocular surface and tear function tests. (Turk J Ophthalmol 2015; 45: 138-141

  4. [Acute severe ulcerative colitis treated with accelerated infliximab induction. Case report].

    Science.gov (United States)

    Fluxá, Daniela; Flores, Lilian; Kronberg, Udo; Moreno, Mauricio; Figueroa, Carolina; Ibáñez, Patricio; Lubascher, Jaime; Simian, Daniela; Quera, Rodrigo

    2017-08-01

    Acute severe ulcerative colitis (ASUC) is a potentially life-threatening condition that requires early recognition, hospitalization and adequate treatment. Currently, the use of infliximab in ulcerative colitis (UC) is recommended in the case of severe disease refractory to corticosteroids, once that superimposed bacterial or viral infections (such as cytomegalovirus or Clostridium difficile) have been excluded. However, conventional weight-based regimens of infliximab might be insufficient for patients with ASUC. Accelerated infliximab induction regimen may increase its serum concentration levels and efficacy by reducing early colectomy rates in these patients. We report a 34 year old female presenting with an ASUC. She was initially treated with hydrocortisone 300 mg/day and mesalazine enemas 4 g/day with an unfavorable clinical response. At the fifth day of therapy, an accelerated induction therapy with infliximab was started in doses of 10 mg/kg at weeks 0, 1 and 4. After the second dose, there was a favorable response with reduction of abdominal pain, stool frequency and hematochezia. She was discharged with prednisone and azathioprine. After a year of starting infliximab, the patient remains in clinical remission.

  5. Inpatient infliximab is ineffective at preventing colectomy for steroid refractory extensive colitis.

    Science.gov (United States)

    Andrew, Rachel E; Lauria, Alexis; Puleo, Frances J; Berg, Arthur; Stewart, David B

    2017-11-01

    Despite data suggesting safety and efficacy in ulcerative colitis patients treated with inpatient infliximab, prior studies did not focus on patients with extensive colitis, the group at highest risk for requiring surgery. This was a single center, retrospective study (2008-2015) of consecutive patients who required admission because of severe extensive ulcerative colitis defined by preoperative symptoms and computed tomography scans and postoperative histology. Patients admitted for high-dose steroids were compared with steroid refractory inpatients provided with one or two infusions of infliximab. The primary study outcome was colectomy rates; secondary outcomes included mean length of stay and 60-d complication rates. A total of 174 patients required admission with steroids for extensive ulcerative colitis. Of these, 19 (10%) also received infliximab. Among the subjects treated with infliximab, 15 (78%) required total colectomy during that admission versus 81 (52%) who received steroids alone (P = 0.03). Postoperative readmission rates, surgical-site infections, return to the operating room, and all-complication rates were similar between the cohorts (P > 0.05). For steroid refractory extensive ulcerative colitis, inpatient infliximab did not lower colectomy rates or increase postoperative complications compared with patients treated with steroids alone. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Incidence and management of infusion reactions to infliximab in 186 italian patient’s with rheumatoid arthritis: the Padua experience

    Directory of Open Access Journals (Sweden)

    S. Todesco

    2011-09-01

    Full Text Available Objective: We report the incidence and treatment of infusion reactions to infliximab, a chimeric monoclonal IgG1 antibody against tumor necrosis factor a, in a large cohort of patients with rheumatoid arthritis. Patients and methods: One hundred eighty six patients with rheumatoid arthritis treated with infliximab for a total of 216.6 patient years were retrospectively evaluated. Patients received 2160 infliximab infusions at the Division of Rheumatology at the University Hospital of Padua from May, 2000 to April, 2004. Specific treatment protocols for initial and subsequent acute infusion reactions were followed and the outcomes documented. Results: The overall incidence of infusion reactions to infliximab was 0.8% (19 out of 2160 of infusions, affecting 10.2% of patients (19 out of 186. Mild, moderate, or severe acute reactions occurred in 0.1% (3 of 2160, 0.6% (13 of 2160, and 0.04% (1 of 2160 of infliximab infusions, respectively. Delayed infusion reactions occurred in 0.09% (2 of 2160 of infusions. Use of specific treatment protocols resulted in rapid resolution of all acute reactions to infliximab. With a prophylaxis protocol, all patients who experienced an initial mild acute reaction were able to receive additional infusions. Conclusions: Using appropriate treatment protocols, infliximab infusion reactions were effectively treated and prevented in patients with mild acute reactions upon retreatment. In the case of moderate to severe infusion reactions, the risks and the benefits of the continuation of infliximab therapy need to be carefully considered.

  7. Efficacy and safety of retreatment with anti-tumor necrosis factor antibody (infliximab) to maintain remission in Crohn's disease

    NARCIS (Netherlands)

    Rutgeerts, P.; D'Haens, G.; Targan, S.; Vasiliauskas, E.; Hanauer, S. B.; Present, D. H.; Mayer, L.; van Hogezand, R. A.; Braakman, T.; DeWoody, K. L.; Schaible, T. F.; van Deventer, S. J.

    1999-01-01

    Infliximab, an anti-tumor necrosis factor monoclonal antibody, rapidly reduces signs and symptoms of active Crohn's disease. The aim of this study was to determine whether repeated infusions of infliximab would effectively and safely maintain the remitting benefit. The efficacy, safety,

  8. Induction and Maintenance Infliximab Therapy for the Treatment of Moderat-to Severe Crohns Disease in Children

    DEFF Research Database (Denmark)

    Pærregaard, Anders; NN, NN

    2007-01-01

    BACKGROUND AND AIMS: The REACH study evaluated the safety and efficacy of infliximab in children with moderately to severely active Crohn's disease. METHODS: Patients (n = 112) with a Pediatric Crohn's Disease Activity Index (PCDAI) score >30 received infliximab 5 mg/kg at weeks 0, 2, and 6...

  9. Body mass index influences infliximab post-infusion levels and correlates with prospective loss of response to the drug in a cohort of inflammatory bowel disease patients under maintenance therapy with Infliximab.

    Directory of Open Access Journals (Sweden)

    Franco Scaldaferri

    Full Text Available Infliximab is an effective treatment for inflammatory bowel disease (IBD. Studies differ regarding the influence of body mass index (BMI on the response to infliximab, with the majority of studies indicating that increased BMI may be associated with a poorer response to Infliximab. However, the pharmacokinetic mechanisms causing this have not yet been reported.Examine the correlation between BMI/immunosuppressant use with clinical response, trough and post-infusion levels of infliximab, tumour necrosis factor-α(TNF-α and anti-drug antibodies(ATI, and determine if these factors can predict future response.We collected serum from 24 patients receiving Infliximab before and 30 minutes following infusion. Clinical parameters were collected retrospectively and prospectively. ELISA measurements of infliximab, TNF-α and ATI were performed.We confirmed that patients with higher infliximab trough levels have a better response rate and that patients with an elevated BMI display a higher rate of loss of response (20%. Patients with a higher BMI had elevated post-infusion levels of infliximab. Additionally, the ratio of IFX/TNF-α trough levels correlated with clinical response to the following infusion.This study confirms that an elevated BMI is associated with a poorer response to infliximab. For the first time, we describe that a higher BMI correlates with higher post-infusion levels, however this does not correlate with a higher rate of response to the drug, suggesting that circulating drug levels do not correlate with tissue levels. Furthermore, in our small cohort of patients, we identified a possible predictive marker of future response to treatment which may be used to guide dose escalation and predict non-response to infliximab.

  10. A prospective randomized controlled trial comparing infliximab and etanercept in patients with moderate-to-severe chronic plaque-type psoriasis: the Psoriasis Infliximab vs. Etanercept Comparison Evaluation (PIECE) study.

    Science.gov (United States)

    de Vries, A C Q; Thio, H B; de Kort, W J A; Opmeer, B C; van der Stok, H M; de Jong, E M G J; Horvath, B; Busschbach, J J V; Nijsten, T E C; Spuls, Ph I

    2017-03-01

    There are currently no independent data available comparing infliximab and etanercept for the treatment of psoriasis. To compare these biologics without funding from pharmaceutical companies. Overall, 50 patients were randomized to etanercept (n = 23) 50 mg subcutaneously twice weekly or infliximab (n = 25) 5 mg kg -1 intravenously at week 0, 2, 6, 14 and 22. After 24 weeks, 19 patients stopped and 22 continued treatment and were followed up to week 48. The primary outcome was ≥ 75% improvement of Psoriasis Area and Severity Index (PASI 75) at week 24. The secondary outcomes included PASI 75 at week 6 (onset of action) and week 12, Investigator's Global Assessment (IGA), Patient Global Assessment, impact on quality of life (Skindex-17 and SF-36), Treatment Satisfaction Questionnaire of Medication, duration of remission, maintenance treatment and safety. At week 24, PASI 75 was achieved in 72% (infliximab) vs. 35% (etanercept) (P = 0·01). The onset of action was achieved in 52% (infliximab) and 4% (etanercept). At week 12, 76% (infliximab) and 22% (etanercept) achieved PASI 75 (P infliximab) and 30% (etanercept) (P = 0·01). Skindex-17 symptom score was significantly better for infliximab. Maintenance treatment achieved PASI 75 for 67% (n = 6) infliximab vs. 50% (n = 5) etanercept, at week 48 (P = 0·65). Mild adverse events were reported in 76% (infliximab) vs. 66% (etanercept). Infliximab showed a rapid and significant higher level of efficacy until week 24 compared with etanercept. Long-term data showed no significant differences between both groups at week 48. Safety parameters were comparable. © 2016 British Association of Dermatologists.

  11. Body mass index influences infliximab post-infusion levels and correlates with prospective loss of response to the drug in a cohort of inflammatory bowel disease patients under maintenance therapy with Infliximab.

    Science.gov (United States)

    Scaldaferri, Franco; D'Ambrosio, Daria; Holleran, Grainne; Poscia, Andrea; Petito, Valentina; Lopetuso, Loris; Graziani, Cristina; Laterza, Lucrezia; Pistone, Maria Teresa; Pecere, Silvia; Currò, Diego; Gaetani, Eleonora; Armuzzi, Alessandro; Papa, Alfredo; Cammarota, Giovanni; Gasbarrini, Antonio

    2017-01-01

    Infliximab is an effective treatment for inflammatory bowel disease (IBD). Studies differ regarding the influence of body mass index (BMI) on the response to infliximab, with the majority of studies indicating that increased BMI may be associated with a poorer response to Infliximab. However, the pharmacokinetic mechanisms causing this have not yet been reported. Examine the correlation between BMI/immunosuppressant use with clinical response, trough and post-infusion levels of infliximab, tumour necrosis factor-α(TNF-α) and anti-drug antibodies(ATI), and determine if these factors can predict future response. We collected serum from 24 patients receiving Infliximab before and 30 minutes following infusion. Clinical parameters were collected retrospectively and prospectively. ELISA measurements of infliximab, TNF-α and ATI were performed. We confirmed that patients with higher infliximab trough levels have a better response rate and that patients with an elevated BMI display a higher rate of loss of response (20%). Patients with a higher BMI had elevated post-infusion levels of infliximab. Additionally, the ratio of IFX/TNF-α trough levels correlated with clinical response to the following infusion. This study confirms that an elevated BMI is associated with a poorer response to infliximab. For the first time, we describe that a higher BMI correlates with higher post-infusion levels, however this does not correlate with a higher rate of response to the drug, suggesting that circulating drug levels do not correlate with tissue levels. Furthermore, in our small cohort of patients, we identified a possible predictive marker of future response to treatment which may be used to guide dose escalation and predict non-response to infliximab.

  12. Toxic hepatitis induced by infliximab in a patient with rheumatoid arthritis with no relapse after switching to etanercept

    DEFF Research Database (Denmark)

    Carlsen, K M; Riis, L; Madsen, O R

    2009-01-01

    We present a case of toxic hepatitis related to infliximab treatment in a 38-year-old woman with rheumatoid arthritis (RA). The patient had previously been treated with different disease-modifying drugs (DMARDs) alone or in combination but had never revealed signs of liver dysfunction. Due to high...... elevations of the transaminases up to five times the upper normal limit were noted and treatment with infliximab was terminated. Serological tests for viral and autoimmune hepatitis and for ANA and anti-dsDNA were all negative. Specific infliximab antibodies could not be detected. Ultrasound of the liver...... was normal. Liver biopsy showed late signs of acute toxic hepatitis without MTX-related fibrosis. This is one the first cases that convincingly demonstrates that infliximab treatment may cause toxic hepatitis. Moreover, the case suggests a lack of hepatic cross-toxicity between infliximab and etanercept...

  13. Med det sociale som designmateriale

    DEFF Research Database (Denmark)

    Brandt, Eva; Binder, Thomas

    2016-01-01

    Samarbejde, samskabelse og social nysgerrighed er i dag en præmis for den nyskabende designer. Det sociale er det nye designmateriale som unge designere giver sig i kast med når f.eks. Emmy Linde samarbejder med plejehjemsbeboere, deres pårørende, plejepersonale og fysioterapeuter for at designe...... inviterer til aktivitet og ’wayfinding’ gradvist tog form gennem afprøvning og dialog. Denne designpraksis kaldes ’kollaborativ design’ eller i kort form ’codesign’. Men hvad er godt design med ’det sociale’ som designmateriale? Og hvad er vedkommende samtidsdesign når designere og designstuderende slipper...... de faste holdepunkter i studiokulturen og den kanon for dansk design som mange ser det som en vigtig opgave at være kurator for? Det er nogle af de spørgsmål som kapitlet kredse om....

  14. Profile of infliximab in the treatment of pediatric Crohn’s disease

    Directory of Open Access Journals (Sweden)

    Kierus J

    2015-06-01

    Full Text Available Jaroslaw Kierkus,1 Edyta Szymanska,2 Grzegorz Oracz,1 Anna Wiernicka,1 Maciej Dadalski1 1Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, 2Department of Pediatrics, Nutrition and Metabolic Disorders, The Children’s Memorial Health Institute, Warsaw, Poland Abstract: In recent years, a novel biologic therapy with monoclonal antibodies against tumor necrosis factor-alpha has revolutionized the treatment of Crohn’s disease. Infliximab, the first biologic agent, has been demonstrated to considerably improve both clinical and endoscopic outcomes. In view of the growing popularity of infliximab in the management of Crohn’s disease, we review the profile of the agent in the treatment of this disease in a pediatric setting. Keywords: infliximab, Crohn’s disease, children, biologic therapy, anti-TNF-agents

  15. The use of infliximab in a patient with idiopathic granulomatous hepatitis

    Science.gov (United States)

    Kapoor, Sabrina Reenu; Snowden, Neil

    2009-01-01

    We report a therapeutic response to infliximab in a patient with idiopathic granulomatous hepatitis resistant to treatment with methotrexate and corticosteroids. A 41-year-old woman presented with a 12-month history of fever, night sweat, gross hepatomegaly and 13 kg weight loss. Infection and malignancy were carefully excluded and a liver biopsy showed changes consistent with idiopathic granulomatous hepatitis. The patient was treated with high dose steroids and methotrexate, but her clinical symptoms and biochemical and radiological signs did not settle. Introduction of infliximab led to rapid and sustained resolution of symptoms, hepatomegaly and liver function tests (LFTs) after 1 year of follow-up. To our knowledge this is the first successful use of infliximab in idiopathic granulomatous hepatitis. PMID:21686858

  16. Review and Clinical Perspectives for the Use of Infliximab in Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Remo Panaccione

    2008-01-01

    Full Text Available Infliximab is a chimeric, monoclonal anti-tumour necrosis factor-alpha antibody. It has been previously demonstrated to be an effective treatment for patients with Crohn’s disease who do not achieve the desired response with conventional treatments. Although the etiology of ulcerative colitis (UC differs from that of Crohn’s disease, randomized controlled trials have demonstrated that infliximab is also beneficial for the treatment of moderate to severe UC in patients who are either intolerant of or refractory to immunosuppressant agents or steroids, or those who are steroid-dependent. A review of the literature is followed by practical recommendations regarding infliximab that address the needs of clinicians and UC patients. Where there is a lack of evidence-based information, the expert panel provides its combined opinion derived from the members’ clinical experiences.

  17. Review and clinical perspectives for the use of infliximab in ulcerative colitis

    Science.gov (United States)

    Panaccione, Remo; Fedorak, Richard N; Aumais, Guy; Bernard, Edmond-Jean; Bernstein, Charles N; Bitton, Alain; Croitoru, Ken; Dieleman, Levinus A; Enns, Robert; Feagan, Brian G; Franchimont, Denis; Greenberg, Gordon R; Griffiths, Anne-Marie; Marshall, John K; Pare, Pierre; Patel, Sunil; Penner, Robert; Render, Craig; Seidman, Ernest; Steinhart, A Hillary

    2008-01-01

    Infliximab is a chimeric, monoclonal anti-tumour necrosis factor-alpha antibody. It has been previously demonstrated to be an effective treatment for patients with Crohn’s disease who do not achieve the desired response with conventional treatments. Although the etiology of ulcerative colitis (UC) differs from that of Crohn’s disease, randomized controlled trials have demonstrated that infliximab is also beneficial for the treatment of moderate to severe UC in patients who are either intolerant of or refractory to immunosuppressant agents or steroids, or those who are steroid-dependent. A review of the literature is followed by practical recommendations regarding infliximab that address the needs of clinicians and UC patients. Where there is a lack of evidence-based information, the expert panel provides its combined opinion derived from the members’ clinical experiences. PMID:18354755

  18. An open-label pilot study of infliximab therapy in diffuse cutaneous systemic sclerosis

    DEFF Research Database (Denmark)

    Denton, C P; Engelhart, M; Tvede, N

    2008-01-01

    /kg). Clinical assessment included skin sclerosis score, scleroderma health assessment questionnaire, self-reported functional score and physician global visual analogue scale. Collagen turnover, skin biopsy analysis and full safety evaluation were performed. RESULTS: There was no significant change in skin......AIM: The safety and potential efficacy of a chimaeric anti-tumour necrosis factor alpha monoclonal antibody (infliximab) were examined in diffuse cutaneous systemic sclerosis (dcSSc). METHODS: A 26-week open-label pilot study in which 16 cases of dcSSc received five infusions of infliximab (5 mg.......025). CONCLUSION: In dcSSc infliximab did not show clear benefit at 26 weeks but was associated with clinical stabilisation and a fall in two laboratory markers of collagen synthesis. The frequency of suspected infusion reactions may warrant additional immunosuppression in any future studies in systemic sclerosis....

  19. Complement activation in plasma before and after infliximab treatment in Crohn disease

    DEFF Research Database (Denmark)

    Zimmermann-Nielsen, E; Agnholt, J; Thorlacius-Ussing, O

    2003-01-01

    complicated by fistulizing ano-rectal disease was collected before and after three Infliximab infusions (5 mg kg(-1)). RESULTS: Before treatment, the C3-activation capacities (C3-AC) in plasma from patients with Crohn disease were comparable with values obtained from healthy controls. The classical C pathway......-mediated C3-AC, mannan-binding lectin C4-AC, leucocyte count, C-reactive protein concentration and Crohn Disease Activity Index decreased significantly 8 weeks after the first infusion of Infliximab (P ... in plasma from patients with Crohn disease; the decrease observed in the classical pathway-mediated C3-AC after treatment with Infliximab reflects a general down-regulation in immune activation....

  20. TREATMENT WITH INFLIXIMAB IN PATIENT WITH EARLY POLYARTICULAR JUVENILE RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    T.V. Sleptsova

    2010-01-01

    Full Text Available The article presents a case report of severe polyarticular juvenile rheumatoid arthritis (JRA resistant to treatment with corticosteroids and classic immunosuppressive agents. Authors describe successful treatment with genetically engineered biological agent — infliximab in patient with early arthritis (duration of disease in less than two years: at 1st week of treatment pain and morning stiffness were stopped, and exudative lesions of joint significantly decreased. Inactive phase of disease was reached in 6 weeks, and movements in 8 of 9 joints were restored. Oral prednisolone was stopped. This case report shows high effectiveness of infliximab in patient with early JRA. Therapeutic treatment of early stages of disease before development of irreversible osteocartilaginous destruction with blocker of tumor necrotizing factor is very perspective. Key words: children, early juvenile rheumatoid arthritis, treatment, infliximab.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(5:127-132

  1. Infliximab inhibits DNA repair in ultraviolet B-irradiated premalignant keratinocytes

    DEFF Research Database (Denmark)

    Faurschou, A.; Gniadecki, R.; Wulf, Hans Chr.

    2008-01-01

    Anti-tumor necrosis factor-alpha (TNF alpha) approaches are increasingly used in the therapy of autoimmune diseases. One of the safety concerns is the potential enhancement of skin carcinogenesis. The aim of this study was to investigate if the TNF alpha neutralizing antibody, infliximab, directly...... affects the cell cycle and DNA repair in premalignant human keratinocytes after ultraviolet-B (UVB) irradiation. We found that infliximab-treated cells exhibited an enhanced G2/M cell cycle arrest and increased apoptosis after 10-20 mJ/cm(2) UVB. In spite of this, the level of cyclobutane pyrimidine...... dimers (CPD) in infliximab-treated cells was significantly increased at both 24 and 48 h after irradiation with 10 mJ/cm(2) UVB. As we have recently shown that protein kinase B/Akt is involved in the TNF alpha signalling pathway and promotes cell survival and skin carcinogenesis, we measured activatory...

  2. Ud at se med Erasmus

    DEFF Research Database (Denmark)

    Frandsen, Pernille

    2009-01-01

    Få lidt luft under vingerne, kom ud at møde udenlandske kolleger og se, hvordan man også kan lave uddannelsesbibliotek. Med begejstring fortæller tre bibliotekarer om deres oplevelser i det store udland – alt sammen finansieret af Erasmus.......Få lidt luft under vingerne, kom ud at møde udenlandske kolleger og se, hvordan man også kan lave uddannelsesbibliotek. Med begejstring fortæller tre bibliotekarer om deres oplevelser i det store udland – alt sammen finansieret af Erasmus....

  3. The incidence and management of infusion reactions to infliximab: a large center experience.

    Science.gov (United States)

    Cheifetz, Adam; Smedley, Michelle; Martin, Sara; Reiter, Monica; Leone, Grace; Mayer, Lloyd; Plevy, Scott

    2003-06-01

    To assess the incidence and management of infusion reactions to infliximab, a chimeric monoclonal antibody that targets human tumor necrosis factor-alpha, in patients with Crohn's disease treated at a large infusion center. A total of 165 consecutive patients who received 479 infliximab infusions in the Division of Clinical Immunology Infusion Center at Mount Sinai Medical Center from July, 1998 to January, 2001 were evaluated. Specific treatment protocols for initial and subsequent acute infusion reactions were followed and the outcomes documented. The overall incidence of infusion reactions to infliximab was 6.1% (29 of 479) of infusions, affecting 9.7% (16 of 165) of patients. Mild, moderate, or severe acute reactions occurred in 3.1% (15 of 479), 1.2% (six of 479), and 1.0% (five of 479) of infliximab infusions, respectively. Use of treatment protocols resulted in rapid resolution of all acute reactions to infliximab. With the prophylaxis protocol, all patients who experienced an initial mild or moderate acute reaction were able to receive additional infusions. Four patients experienced a total of five severe acute reactions. Three patients were retreated: two patients had no further problems, whereas one patient had a second severe acute reaction that rapidly resolved with treatment. Suggesting that acute infusion reactions are not type I hypersensitivity reactions, in 11 patients who experienced 14 acute infusion reactions, serum tryptase levels were normal. Delayed infusion reactions occurred in 0.6% (three of 479) of infusions. Infliximab infusions were accompanied by acute reactions in approximately 5% of infusions. These reactions did not seem to be true IgE-mediated type I hypersensitivity events. Using appropriate treatment protocols, these reactions were effectively treated and prevented upon retreatment in nearly all patients. Delayed reactions were rare, occurring in <1% of infusions.

  4. Long-term response rates to infliximab therapy for Crohn's disease in an outpatient cohort.

    Science.gov (United States)

    Teshima, Christopher W; Thompson, Adrienne; Dhanoa, LeRose; Dieleman, Levinus A; Fedorak, Richard N

    2009-05-01

    Infliximab's efficacy in the induction and maintenance of remission in luminal Crohn's disease has been confirmed by randomized, controlled trials. Less clearly described are long-term outcomes in the clinical practice setting since the establishment of regularly scheduled, every eight-week maintenance infliximab infusions. Existing reports describing clinical practice outcomes are limited by short durations of follow-up or by the use of episodic dosing, or focus on safety data rather than clinical outcomes. To examine induction and maintenance responses to infliximab in an outpatient inflammatory bowel disease clinic. A retrospective chart review was performed. Clinical outcomes were infliximab induction and maintenance responses, defined as the ability to stop and remain off corticosteroids while not requiring additional therapy for active disease. One hundred thirty-three patients were identified with records sufficiently detailed to be analyzed. Of these, 117 patients (88%) demonstrated a clinical response to induction; 104 of 117 (89%) were on concomitant immunosuppressive therapy; 80 of 104 on azathioprine/6-mercaptopurine (77%); and 24 of 104 on methotrexate (23%). The mean duration of clinical response was 94 weeks (95% CI 78.8 to 109.2). The proportion of patients who maintained response at 30 weeks was 83.2%, at 54 weeks was 63.6% and at 108 weeks was 44.9%. Adverse events occurred for 15 of 117 patients (12.8%), consisting of nine infusion reactions, four serum sickness-like reactions, one rash and one infection. Patients treated with infliximab therapy for luminal Crohn's disease in our outpatient clinic achieved excellent induction and maintenance of response rates, confirming the real-life efficacy of maintenance infliximab established in clinical trials.

  5. Infliximab Dosing Strategies and Predicted Trough Exposure in Children with Crohn’s Disease

    Science.gov (United States)

    Frymoyer, Adam; Piester, Travis L; Park, KT

    2016-01-01

    Objectives Standard infliximab maintenance dosing of 5 mg/kg every 8 weeks may be inadequate to consistently achieve sufficient drug exposure to minimize loss of response or treatment failure in pediatric Crohn’s disease (CD). We aimed to determine the predicted infliximab trough concentrations in children with CD during maintenance therapy and the percentage of patients achieving target trough concentration >3 μg/ml. Methods A Monte Carlo simulation analysis was constructed using a published population pharmacokinetic model based on data from 112 children in the REACH trial. We assessed maintenance dosing strategies of 5, 7.5, and 10 mg/kg at dosing intervals of every 4, 6, and 8 weeks for children that differed by age, weight, albumin level, and concomitant immunomodulator therapy. Results Based on the index case of a 10 year old with CD receiving standard infliximab dosing with concomitant immunomodulator therapy, the median (IQR) simulated infliximab trough concentration at week 14 was 1.3 (0.5–2.7) μg/ml, and 2.4 (1.0–4.8) μg/ml for albumin levels of 3 and 4 g/dl, respectively. Among 1000 simulated children in the model, trough concentration >3 μg/ml at week 14 was achieved 21% and 41% of the time for albumin levels of 3 and 4 g/dl, respectively. Conclusions Standard infliximab maintenance dosing in children with CD is predicted to frequently result in inadequate exposure, especially when albumin levels are low. Optimized dosing strategies for individual patients are needed to achieve sufficient drug exposure during infliximab maintenance therapy. PMID:26890885

  6. Switching Between Infliximab Originator and Biosimilar in Paediatric Patients with Inflammatory Bowel Disease. Preliminary Observations.

    Science.gov (United States)

    Sieczkowska, J; Jarzębicka, D; Banaszkiewicz, A; Plocek, A; Gawronska, A; Toporowska-Kowalska, E; Oracz, G; Meglicka, M; Kierkus, J

    2016-02-01

    The growing incidence of inflammatory bowel disease (IBD) in children necessitates the use of biological treatments. Recently, an infliximab biosimilar was authorized in the European Union, which may result in switching patients. We present our preliminary experiences with such switches. The prospective study included 32 paediatric patients diagnosed with Crohn's disease (CD) and 7 children with ulcerative colitis (UC) at 3 academic hospitals, who were switched from infliximab originator to its biosimilar (Remsima). Patient characteristics, disease severity, laboratory parameters and adverse events were recorded. Means, medians and ranges were calculated. Mean age at diagnosis of CD and UC was 11.1 (2.7-15.3) and 12.3 years (8.5-14.8), respectively. Mean number of infliximab originator infusions before switching to the biosimilar was 9.9 (median 8, range 4-29) and 5.1 (5, 1-12) for the CD and UC group, respectively. Evaluation efficacy of last biosimilar doses of all patients revealed rates of clinical remission of 88 and 57% for CD and UC patients, respectively. Last follow-up assessment of patients who continued with biosimilar therapy showed that 16/20 (80%) CD patients and all 4 UC individuals were in remission. One infusion reaction to infliximab biosimilar was observed in a CD patient, which led to treatment discontinuation. The incidence of sporadic mild adverse events prior to and after switching did not differ significantly and was consistent with the safety profile of the infliximab molecule. Switching from infliximab originator to its biosimilar seems to be a safe option in children with CD. After the switch the biosimilar was just as effective as the originator. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  7. Nonclinical Evaluation of PF-06438179: A Potential Biosimilar to Remicade®(Infliximab).

    Science.gov (United States)

    Derzi, Mazin; Johnson, Theodore R; Shoieb, Ahmed M; Conlon, Hugh D; Sharpe, Penny; Saati, Andrew; Koob, Sarah; Bolt, Michael W; Lorello, Leslie G; McNally, Jim; Kirchhoff, Carol F; Smolarek, Teresa A; Leach, Michael W

    2016-11-01

    PF-06438179, a potential biosimilar to Remicade ® (infliximab, Janssen Biotech, Inc.), is a chimeric mouse-human monoclonal antibody targeting human tumor necrosis factor alpha (TNF). Analytical (small subset reported here) and nonclinical studies compared the structural, functional, and in vivo nonclinical similarity of PF-06438179 with Remicade sourced from the United States (infliximab-US) and/or European Union (infliximab-EU). The peptide map profiles were superimposable, and peptide masses were the same, indicating identical amino acid sequences. Data on post-translational modifications, biochemical properties, and biological function provided strong support for analytical similarity. Administration of a single intravenous (IV) dose (10 or 50 mg/kg) of PF-06438179 or infliximab-EU to male rats was well tolerated. There were no test article-related clinical signs or effects on body weight or food consumption. Systemic exposures [maximum drug concentration (C max ) and area under the concentration-time curve (AUC)] in rats administered PF-06438179 or infliximab-EU were similar, with mean exposure ratio of PF-06438179 relative to infliximab-EU ranging from 0.88 to 1.16. No rats developed anti-drug antibodies. A 2-week IV toxicity study was conducted with once-weekly administration of 10 or 50 mg/kg of PF-06438179 to male and female rats. PF-06438179-related hyperplasia of sinusoidal cells occurred in the liver in rats administered 50 mg/kg, but was not adverse based on its minimal to mild severity. The no-observed adverse-effect level for PF-06438179 was 50 mg/kg. At this dose, C max was 1360 µg/mL and AUC at 168 h was 115,000 µg h/mL on day 8. The analytical and nonclinical studies have supported advancement of PF-06438179 into global comparative clinical trials. Pfizer Inc.

  8. [Efficacy of infliximab in the treatment of korean patients with crohns disease].

    Science.gov (United States)

    Kim, Sai Hui; Yang, Suk; Kim, Kyung Jo; Kim, Eun Hee; Yoon, Soon Man; Ye, Byong Duk; Byeon, Jeong Sik; Myung, Seung Jae; Kim, Jin Ho

    2009-08-01

    Infliximab has been proven to be effective for refractory luminal and fistulizing Crohns disease (CD). We performed this study to demonstrate the efficacy of infliximab in Korean CD patients. Medical records of 40 CD patients who had been treated with infliximab were reviewed retrospectively. Among 40 patients, 11 (27.5%) patients were treated for refractory luminal disease, 14 (35%) for fistulizing disease, and 15 (37.5%) for both types. Clinical response rate was higher in 26 patients with refractory luminal disease (Complete response (CR), 73.1%; Partial response (PR), 23.1%) than in 29 patients with fistulizing disease (CR, 41.4%; PR, 31%) (p=0.024). The clinical response rate tended to be higher in 28 patients with external fistulas (CR, 46.4%; PR, 32.2%) than 4 patients with internal fistulas (PR, 25%; NR, 75%) (p=0.064). Among patients with external fistulas, the response rate of 8 patients with enterocutaneous fistulas (CR, 50%; PR, 12.5%) was not different from 20 patients with perianal fistulas (CR, 45%; PR, 40%). Among 20 patients with perianal fistulas, the response rate of 6 patients with perianal fistulas without a history of operation (CR, 83.3%; PR, 0%) was higher than 14 patients with perianal fistulas resistant to previous surgical treatment (CR, 28.6%; PR, 57.1%) (p=0.044). As for adverse reaction, 7 patients experienced mild infusion reaction, and 2 patients developed serious infection. Infliximab is more effective for refractory luminal disease than for fistulizing disease. In addition, clinical responses to infliximab are different according to subtypes of fistulas. These findings should be considered for the proper use of infliximab.

  9. Disseminated nocardiosis in a patient on infliximab and methylprednisolone for treatment-resistant Sweet's syndrome.

    Science.gov (United States)

    Drone, Elizabeth R; McCrory, Allison L; Lane, Natalie; Fiala, Katherine

    2014-07-01

    A 62-year-old white man with a 10-year history of treatment-refractory Sweet's syndrome was admitted to the hospital with the onset of purpuric lesions. Methylprednisolone and infliximab were administered. Our patient developed disseminated Nocardia infection and eventually succumbed. Opportunistic infections such as Nocardia have been associated with infliximab and other tumour necrosis factor (TNF)-α inhibitors. The astute clinician should be aware of the risk of rare opportunistic infections, particularly in patients on TNF-α inhibitors and systemic corticosteroids.

  10. Canadian Association of Gastroenterology Clinical Practice Guidelines: The Use of Infliximab in Crohn's Disease

    Directory of Open Access Journals (Sweden)

    Remo Panaccione

    2004-01-01

    Full Text Available These guidelines are presented as a follow-up to the original Canadian Association of Gastroenterology Clinical Practice Guidelines: The use of infliximab in Crohn's disease, published in the Canadian Journal of Gastroenterology (1. The original guidelines represented publications between 1998 and 2000. The current guidelines have been updated to reflect knowledge gained from two pivotal randomized clinical trails, with the use of infliximab in the maintenance of inflammatory Crohn's disease in remission (2 and in the maintenance of fistulous Crohn's disease in remission (3.

  11. Concentrations of Adalimumab and Infliximab in Mothers and Newborns, and Effects on Infection

    DEFF Research Database (Denmark)

    Julsgaard, Mette; Christensen, Lisbet Ambrosius; Gibson, Peter R.

    2016-01-01

    and in umbilical cords, and in infants for every 3 months until the drug was no longer detected.  Results  The time from last exposure to anti-TNF agent during pregnancy correlated inversely with the concentration of the drugs in the umbilical cord (adalimumab: r = -0.64, P =.0003; infliximab: r = -0.77, P ... the drugs until 12 months of age. There was an inverse correlation between the time from last exposure during pregnancy and drug concentration in the umbilical cord. Infliximab was cleared more slowly than adalimumab from the infants. The combination of an anti-TNF agent and thiopurine therapy during...

  12. Infliximab dosing patterns in a sample of patients with Crohn's disease: results from a medical chart review.

    Science.gov (United States)

    Tkacz, Joseph; Lofland, Jennifer H; Vanderpoel, Julie; Ruetsch, Charles

    2014-04-01

    Infliximab, a monoclonal antibody tumor necrosis factor-alpha inhibitor, is an effective therapy that is indicated for the treatment of patients with Crohn's disease. Although dose escalation from 5 mg/kg to 10 mg/kg is allowed according to the prescribing label of infliximab, conflicting results exist regarding the rate at which this escalation may occur, which may affect payers and providers. The goal of this exploratory study was to characterize and quantify the rate of infliximab dose escalation in a sample of patients with Crohn's disease. Administrative claims data from patients with Crohn's disease in a large mid-Atlantic managed care organization were collected and used to target and recruit providers into a chart review study of infliximab dosing. Data from the charts of 161 patients with Crohn's disease who were receiving infliximab between 2006 and 2010 were extracted. Patients were grouped into an infliximab dose-escalation group or a dose-stable group based on these data. The evidence of any infliximab dose ≥7.5 mg/kg or evidence of a mean maintenance interval of 42 days or less resulted in the placement of a patient in the dose-escalation group, with the balance of patients comprising the stable-dose group. A total of 925 infliximab infusions were captured from 161 patients. Of the 161 patients identified, 110 had at least 4 infusions, and 4 had missing data; therefore, only 106 (66%) patients were qualified for the final infliximab dosing analysis. A total of 18 (17%) of these patients had evidence of infliximab dose escalation (dose-escalation group), and the remaining 88 (83%) patients had a consistent 5-mg/kg dose and schedule (stable-dose group). Of the 18 patients in the dose-escalation group, 9 (50%) had a decrease in maintenance interval, whereas 12 (66.7%) patients had an increase in their dosage. A total of 3 (16.7%) patients had both an increase in dose and a reduction in maintenance interval. Infliximab has been shown to be a cost

  13. Informationsledelse med mindset-map

    DEFF Research Database (Denmark)

    Brodersen, Lars

    i ring og skaber splid frem for samarbejde, og om indholdet er opstået på tilfældigheder. Med informationsledelse får du kompetencer til at skabe meningsfuld information ved at holde brugerfokus hele vejen gennem projektet og reducere kompleksiteten, hvad enten du skal bage kage, bygge motorveje...

  14. Fotofilm om musikterapi med flygtninge

    DEFF Research Database (Denmark)

    Lindvang, Charlotte

    2016-01-01

    mennesker fra andre kulturer. Musikken er et universelt sprog og musik kan derfor være et mødested. Musikterapi i forbindelse med voksne traumatiserede flygtninge giver god mening, fordi musikken giver mulighed for at regulere den stress som sidder i krop og sind. Flygtningebørn kan have svært ved at udtale...

  15. Induction and Maintenance Infliximab Therapy for the Treatment of Crohn's Disease with Perianal Fistulas in Children: Retrospective, Multicenter Study.

    Science.gov (United States)

    Iwańczak, Barbara M; Ryżko, Józef; Jankowski, Piotr; Sładek, Małgorzata; Wasilewska, Agata; Szczepanik, Mariusz; Sienkiewicz, Edyta; Szaflarska-Popławska, Anna; Więcek, Sabina; Kwiecień, Jarosław; Korczowski, Bartosz; Maślana, Jolanta

    2016-01-01

    Infliximab is a biological drug used for the treatment of Crohn's disease in children. The aim of this retrospective study was the estimation of effectiveness and safety of infliximab in the treatment of Crohn's disease with perianal fistulas in children. Analysis comprised 50 children with Crohn's disease with perianal fistulas aged 9 to 18 years (16 girls and 34 boys) who failed to respond to conventional therapy. The children were divided into two groups: the first group contained 23 children with simple fistulas and the second - 27 children with complex fistulas. All children were treated with infliximab, administered in the dose of 5 mg per kilogram of the body mass. In the induction phase infliximab was administered at weeks 0, 2 and 6 and after clinical response in maintenance phase the drug was administered every 8 weeks; together for 12 months. In 76% of children after induction therapy with infliximab and in 71.87% after maintenance therapy the complete closure of fistula occurred. During the first year after the treatment a recurrence of a fistula was observed in 30.43% of the children. In two children anaphylactic shock was observed during injection of infliximab. The remaining children tolerated the drug well. The treatment with infliximab was effective in the majority of fistulazing Crohn's disease and caused the closure of perianal fistula which improved quality of life.

  16. Prospective comparison of preference and efficacy of adalimumab and infliximab for treating ulcerative colitis naive to antitumor necrosis factor therapy.

    Science.gov (United States)

    Mizoshita, Tsutomu; Katano, Takahito; Tanida, Satoshi; Hirano, Atsuyuki; Miyaki, Tomokatsu; Ozeki, Keiji; Suzuki, Yuka; Sugimura, Naomi; Kataoka, Hiromi; Joh, Takashi

    2017-08-01

    There have been few reports on 2 tumor necrosis factor alpha inhibitors, infliximab and adalimumab, with respect to patient preference and efficacy in ulcerative colitis (UC).We used questionnaires to evaluate the preference and reasons for drug choice between infliximab and adalimumab in UC patients naive to antitumor necrosis factor alpha therapy. We also analyzed the efficacy of infliximab and adalimumab prospectively and endoscopically before treatment and at 14 and 54 weeks.Of the 25 UC patients, infliximab and adalimumab were chosen by 10 (40%) and 15 (60%), respectively. Patients who favored infliximab considered "fear of syringes" (7/10, 70%) as the most important influencing factor, whereas patients who favored adalimumab considered "ease of administration" (10/15, 66.7%) and "time required for therapy" (10/15, 66.7%) as the most important factors. There were no statistical differences in remission induction and maintenance between the infliximab and adalimumab groups with regard to response, remission, mucosal healing, steroid-free, and steroid-free remission rates at weeks 14 and 54.The efficacy of adalimumab in remission induction and maintenance was equivalent to that of infliximab in UC patients naive to antitumor necrosis factor alpha therapy in this prospective study, but more patients preferred adalimumab.

  17. Med Kingo på dybt vand

    DEFF Research Database (Denmark)

    Arndal, Lars Stubbe

    2014-01-01

    Tag med digteren Thomas Kingo ud på dybt vand i selskab med lektor og mag.art. Lars Arndal, der kaster nye perspektiver på Kingos forlisdigt Hierte-Suk. Arndal kommer hermed også med et bud på, hvordan man som lærer kan invitere eleverne med på opdagelse i digtet...

  18. Postinduction serum infliximab trough level and decrease of C-reactive protein level are associated with durable sustained response to infliximab: a retrospective analysis of the ACCENT I trial

    Science.gov (United States)

    Cornillie, Freddy; Hanauer, Stephen B; Diamond, Robert H; Wang, Jianping; Tang, Kezhen L; Xu, Zhenhua; Rutgeerts, Paul; Vermeire, Séverine

    2014-01-01

    Background Serum infliximab trough levels correlate with efficacy; dose escalation is often beneficial in patients with Crohn's disease who stop responding to infliximab treatment. Objective To carry out a post hoc analysis of A Crohn's Disease Clinical Trial Evaluating Infliximab in a New Long-term Treatment Regimen I (ACCENT I) to evaluate the association between serum infliximab trough levels and C-reactive protein (CRP) after 14 weeks of induction treatment with durable sustained long-term response (Crohn's Disease Activity Index decrease ≥70 points and reduction ≥25% from baseline). Design ACCENT I was a multicentre, randomised, placebo-controlled study. Week 14 trough levels and CRP percentage decrease from baseline to week 14 were compared between patients with and without durable sustained response through week 54. Sensitivity and specificity were determined to predict durable sustained response. Receiver operating characteristic (ROC) curves identified optimal cut-off points; logistic regression determined ORs. Results After induction with 5 mg/kg infliximab, 25% (37/147) and 33% (47/144) of patients sustained week 14 response to infliximab 5 or 10 mg/kg, respectively, administered every 8 weeks without dose escalation, through week 54. Median week 14 trough levels of patients with and without durable sustained response to infliximab 5 mg/kg were 4.0 and 1.9 μg/mL, respectively (p=0.0331). Optimal predictors of durable sustained response to maintenance infliximab 5 mg/kg were week 14 trough level ≥3.5 µg/mL and ≥60% CRP decrease (ORs (95% CI), 3.5 (1.1 to 11.4) and 7.3 (1.4 to 36.7)), respectively, in patients with raised baseline CRP (>8.0 mg/L); area under the ROC curve was 0.75 for both predictors. A ≥3.5 µg/mL week 14 infliximab serum level did not predict durable sustained response to 10 mg/kg maintenance infliximab. Conclusions Patients with durable sustained response to maintenance infliximab 5 mg/kg had higher

  19. Effect of infliximab dose increase in rheumatoid arthritis at different trough concentrations: a cohort study in clinical practice conditions

    Directory of Open Access Journals (Sweden)

    Chamaida ePlasencia

    2015-10-01

    Full Text Available BackgroundEvidence supporting treatment intensification in rheumatoid arthritis is limited and controversial. We explored outcomes of infliximab dose increases and accounted for pre-existing trough levels in patients with active rheumatoid arthritis (RA.MethodsThis study was a retrospective study of 42 RA patients who received increased infliximab following an insufficient response (DAS28 > 3.2. Serum concentrations of infliximab and antibodies to infliximab (ATI and DAS28 and EULAR clinical response parameters were recorded for one year. Analyses were performed in three patient groups that were defined by infliximab serum concentration prior to treatment enhancement: No detectable, Low (< 1.1 µg/mL or High (≥ 1.1 µg/mL drug levels. Results No circulating infliximab was detected in 20 patients (47.6 %, but 13 (30.9 % and 9 (21.4 % patients exhibited Low and High levels, respectively. ATI were only detected in patients with No detectable drug levels because the drug interferes with ELISA. DAS28 disease activity globally showed a modest improvement after dose escalation, but this improvement did not persist after 6 and 12 months. Infliximab serum levels increased significantly in the High group (p=0.016, but no increase was achieved in the Low and No detectable groups. The three study groups exhibited similar disease activity over time, and no improvement was observed in the non-responder EULAR rates. ConclusionsThese results suggest that the efficacy of an infliximab dose increase is limited, and the response is independent of the infliximab trough serum concentration that is achieved prior to escalation.

  20. Comparable Immune Function Inhibition by the Infliximab Biosimilar CT-P13: Implications for Treatment of Inflammatory Bowel Disease.

    Science.gov (United States)

    Lim, Ki Jung; Lee, So Jung; Kim, Sunghwan; Lee, Su Yeon; Lee, Min Seob; Park, Yoon A; Choi, Eun Jin; Lee, Eun Beom; Jun, Hwang Keun; Cho, Jong Moon; Lee, SooYoung; Kwon, Ki Sung; Lim, Byung Pil; Jeon, Myung-Shin; Shin, Eui Cheol; Choi, Yong Sung; Fudim, Ella; Picard, Orit; Yavzori, Miri; Ben-Horin, Shomron; Chang, Shin Jae

    2017-05-01

    CT-P13 is the first biosimilar monoclonal antibody to infliximab, and was recently approved in the European Union, Japan, Korea, and USA for all six indications of infliximab. However, studies directly assessing the biologic activity of CT-P13 versus inflximab in the context of inflammatory bowel disease [IBD] are still scanty. In the present study, we aimed to compare the biological activities of CT-P13 and infliximab with specific focus on intestinal cells so as to gain insight into the potential biosimilarity of these two agents for treatment of IBD. CT-P13 and infliximab were investigated and compared by in vitro experiments for their neutralisation ability of soluble tumour necrosis factor alpha [sTNFα] and membrane-bound tumour necrosis factor alpha [mTNFα], suppression of cytokine release by reverse signalling, induction of regulatory macrophages and wound healing, and antibody-dependent cell cytotoxicity [ADCC]. CT-P13 showed similar biological activities to infliximab as gauged by neutralisation of soluble TNFα, as well as blockade of apoptosis and suppression of pro-inflammatory cytokines in intestinal Caco-2 cells. Infliximab and CT-P13 equally induced apoptosis and outside-to-inside signals through transmembrane TNFα [tmTNFα]. Moreover, regulatory macrophage induction and ensuing wound healing were similarly exerted by CT-P13 and infliximab. However, neither CT-P13 nor infliximab exerted any significant ADCC of ex vivo-stimulated peripheral blood monocytes or lamina propria mononuclear cells from IBD patients. These findings indicate that CT-P13 and infliximab exert highly similar biological activities in intestinal cells, and further support a mechanistic comparability of these two drugs in the treatment of IBD. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

  1. Infliximab Concentration Thresholds During Induction Therapy Are Associated With Short-term Mucosal Healing in Patients With Ulcerative Colitis.

    Science.gov (United States)

    Papamichael, Konstantinos; Van Stappen, Thomas; Vande Casteele, Niels; Gils, Ann; Billiet, Thomas; Tops, Sophie; Claes, Karolien; Van Assche, Gert; Rutgeerts, Paul; Vermeire, Severine; Ferrante, Marc

    2016-04-01

    Mucosal healing is an independent predictor of sustained clinical remission in patients with ulcerative colitis (UC) treated with infliximab. We investigated whether infliximab concentrations during induction therapy are associated with short-term mucosal healing (STMH) in patients with UC. We performed a retrospective, single-center analysis of data collected from a tertiary referral center from 101 patients with UC who received scheduled induction therapy with infliximab at weeks 0, 2, and 6 and had an endoscopic evaluation at baseline and after induction therapy. STMH was defined as Mayo endoscopic sub-score ≤1, assessed at weeks 10-14, with baseline sub-score ≥2. Infliximab concentrations were evaluated in serum samples collected at weeks 0, 2, 6, and 14 of infliximab therapy by using an enzyme-linked immunosorbent assay we developed. Fifty-four patients (53.4%) achieved STMH. Patients with STMH had a higher median infliximab concentration at weeks 2, 6, and 14 than patients without STMH. A receiver operating characteristic (ROC) analysis identified infliximab concentration thresholds of 28.3 (area under the ROC curve [AUROC], 0.638), 15 (AUROC, 0.688), and 2.1 μg/mL (AUROC, 0.781) that associated with STMH at weeks 2, 6, and 14, respectively. Multiple logistic regression analysis identified infliximab concentration ≥15 at week 6 (P = .025; odds ratio, 4.6; 95% confidence interval, 1.2-17.1) and ≥2.1 μg/mL at week 14 (P = .004; odds ratio, 5.6; 95% confidence interval, 1.7-18) as independent factors associated with STMH. In an analysis of data from real-life clinical practice, we associated infliximab concentrations during the induction therapy with STMH in patients with UC. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  2. Fang CO2 med Aminosyrer

    DEFF Research Database (Denmark)

    Lerche, Benedicte Mai

    2010-01-01

    Med såkaldte “carbon capture-teknikker” er det muligt at rense røgen fra kulfyrede kraftværker, således at den er næsten helt fri for drivhusgassen CO2. Kunsten er at gøre processen tilstrækkeligt billig. Et lovende fangstredskab i denne proces er aminosyrer.......Med såkaldte “carbon capture-teknikker” er det muligt at rense røgen fra kulfyrede kraftværker, således at den er næsten helt fri for drivhusgassen CO2. Kunsten er at gøre processen tilstrækkeligt billig. Et lovende fangstredskab i denne proces er aminosyrer....

  3. Magnitude of Increased Infliximab Clearance Imposed by Anti-infliximab Antibodies in Crohn's Disease Is Determined by Their Concentration.

    Science.gov (United States)

    Edlund, Helena; Steenholdt, Casper; Ainsworth, Mark A; Goebgen, Eva; Brynskov, Jørn; Thomsen, Ole Ø; Huisinga, Wilhelm; Kloft, Charlotte

    2017-01-01

    Antibodies (Abs) against infliximab (IFX) increase IFX clearance and can result in treatment failure and acute hypersensitivity reactions. However, interpretation of their clinical value is complicated by individual differences in Ab responses and methods used for quantification. The increase in IFX clearance imposed by anti-IFX Abs has generally been evaluated using a binary classification, i.e., positive or negative. This analysis aimed to investigate if anti-IFX Ab concentrations provide a more adequate prediction of alterations in clearance. Data originated from a clinical trial on Crohn's disease patients with IFX treatment failure. The trial was not originally designed for pharmacokinetic analysis. Therefore, published pharmacokinetic models were utilized as priors to enable covariate investigation. The impact of anti-IFX Abs on clearance was assessed using different mathematical relationships and exploiting information from two different quantification assays, measuring semi-quantitative "total" or "unbound neutralizing" concentrations of anti-IFX Ab, respectively. Inclusion of anti-IFX Ab status/concentration improved the model's performance for all investigated relationships. The anti-IFX Ab concentrations were superior to the binary classifications, indicating that the magnitude of increase in IFX clearance imposed by anti-IFX Abs closely relates to their concentration. Furthermore, total anti-IFX Ab concentrations appeared superior to the unbound neutralizing fraction in identifying high clearance individuals. Simulations showed that even at low concentrations, anti-IFX Abs lead to sub-therapeutic IFX concentrations, supporting a need of treatment interventions in all anti-IFX Ab positive patients. The developed model can serve as a basis for further investigations to refine treatment recommendations for patients with anti-IFX Abs.

  4. Severe infusion reactions to infliximab: aetiology, immunogenicity and risk factors in patients with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Steenholdt, Casper; Svenson, M; Bendtzen, K

    2011-01-01

    BACKGROUND: Infliximab (IFX) elicits acute severe infusion reactions in about 5% of patients with inflammatory bowel disease (IBD). AIM: To investigate the role of anti-IFX antibodies (Ab) and other risk factors. METHODS: The study included all IBD patients treated with IFX at a Danish university...

  5. INFLIXIMAB EFFECT ON CLINICAL AND LABORATORY ACTIVITY PARAMETERS IN CASES OF VARIOUS JUVENILE ARTHRITIS VARIANTS

    Directory of Open Access Journals (Sweden)

    E.I. Alexeeva

    2008-01-01

    Full Text Available The study analyses efficiency and safety of using mono clone antibodies for tumor necrosis factor (infliximab for children with system (n = 21 and articular (n = 59 juvenile arthritis (JA. Infliksimab was injected intravenously (average dose of 6,8 ± 2,3 mg/kg/per injection by a standard scheme (0, 2, 6, and each 8 following weeks. Together with antibcytokine therapy children still received immunity depressants (cyclosporine, methotraksat, leflunomid, peroral glucocorticoids. Research results prove that infliximab has pronounced hormone like anti-inflammatory effect after first injection for both patients with early and delayed articular JA variants. It reserved articular syndrome, reduced laboratory activity parameters, reduced degree of invalidity, improved quality of patients' lives. At the same time after three first infusions 88% of patients with system JA the effect was neutralized, articular syndrome activity increased, laboratory activity parameters increased, systematic indicators recurred. On the contrary, patients with both early and delayed JA variant the medication quickly and efficiently reduced activity of articular syndrome, personal estimations of pain levels and disease activity. Index of life quality was significantly improved, much like the selfbservice ability. Medication effect was registered after the first injection and remained over the whole period of observation (up to two years in 61% cases of delayed and 93% of early articular ja variant. Thus, infliximab therapy is a reasonable, efficient and safe treatment of patients with both early and delyed articular JA.Key words: juvenile arthritis, infliximab, treatment.

  6. Certolizumab pegol in patients with moderate to severe Crohn's disease and secondary failure to infliximab

    NARCIS (Netherlands)

    Sandborn, William J.; Abreu, Maria T.; D'Haens, Geert; Colombel, Jean-Frédéric; Vermeire, Severine; Mitchev, Krassimir; Jamoul, Corinne; Fedorak, Richard N.; Spehlmann, Martina E.; Wolf, Douglas C.; Lee, Scott; Rutgeerts, Paul

    2010-01-01

    Patients with moderate to severe Crohn's disease who receive infliximab may experience secondary failure (loss of response and/or hypersensitivity). Data on the utility of switching to certolizumab pegol in these patients are limited. A total of 539 patients with active Crohn's disease and secondary

  7. Inadvertent yellow fever vaccination of a patient with Crohn's disease treated with infliximab and methotrexate

    DEFF Research Database (Denmark)

    Ekenberg, C.; Friis-Møller, N.; Ulstrup, Thomas

    2016-01-01

    We present a case of a 56-year-old woman with Crohn's disease, treated with methotrexate and infliximab, who inadvertently received yellow fever vaccination (YFV) prior to a journey to Tanzania. She was not previously vaccinated against YF. YFV contains live-attenuated virus, and is contraindicated...

  8. Infliximab Reduces Endoscopic, but Not Clinical, Recurrence of Crohn's Disease After Ileocolonic Resection

    NARCIS (Netherlands)

    Regueiro, Miguel; Feagan, Brian G.; Zou, Bin; Johanns, Jewel; Blank, Marion A.; Chevrier, Marc; Plevy, Scott; Popp, John; Cornillie, Freddy J.; Lukas, Milan; Danese, Silvio; Gionchetti, Paolo; Hanauer, Stephen B.; Reinisch, Walter; Sandborn, William J.; Sorrentino, Dario; Rutgeerts, Paul; Debinski, H.; Florin, T.; Hetzel, D.; Lawrance, I.; Radford-Smith, G.; Sloss, A.; Sorrentino, D.; Gassner, S.; Haas, T.; Reicht, G.; Reinisch, W.; Strasser, M.; Vogelsang, H.; Bossuyt, P.; Dewit, O.; D'Haens, G.; Franchimont, D.; Louis, E.; Vermeire, S.; Bernstein, C. N.; Bourdages, R.; Chiba, N.; Dhalla, S. S.; Feagan, B. G.; Fedorak, R. N.; Lachance, J. R.; Panaccione, R.; Ropeleski, M.; Singh Salh, B.; Lukas, M.; Colombel, J.-F.; Allez, M.; Desreumaux, P.; Dupas, J. L.; Grimaud, J.-C.; Hebuterne, X.; Laharie, D.; Lerebours, E.; Peyrin-Biroulet, L.; Reimund, J.-M.; Viennot, S.; Zerbib, F.; Antoni, C.; Atreya, R.; Baumgart, D. C.; Berg, C.; Boecker, U.; Bramkamp, G.; Bünning, C.; Ehehalt, R.; Howaldt, S.; Kucharzik, T.; Lamprecht, H. G.; Mudter, J.; Preiss, J. C.; Schreiber, S.; Seidler, U.; Altorjay, I.; Banai, J.; Lakatos, P. L.; Varga, M.; Vincze, A.; Avni-Biron, I.; Fishman, S.; Fraser, G. M.; Goldin, E.; Rachmilewitz, D.; Annese, V.; Ardizzone, S.; Biancone, L.; Bossa, F.; Danese, S.; Fries, W.; Gionchetti, P.; Maconi, G.; Terrosu, G.; Usai, P.; Gearry, R. B.; Hill, J.; Rowbotham, D. S.; Schultz, M.; Stubbs, R. S.; Wallace, D.; Walmsley, R. S.; Wyeth, J.; Malecka-Panas, E.; Paradowski, L.; Regula, J.; Beales, I. P.; Campbell, S.; Hawthorne, A. B.; Parkes, M.; Travis, S. P.; Achkar, J. P.; Behm, B. W.; Bickston, S. J.; Brown, K. J.; Chiorean, M. V.; DeVilliers, W. J. S.; Elliott, D. E.; Grunkmeier, D.; Hamilton, J. W.; Hanauer, S. B.; Hanson, J. S.; Hardi, R.; Helper, D. J.; Herfarth, H.; Higgins, P. D. R.; Holderman, W. H.; Kottoor, R.; Kreines, M. D.; Leman, B. I.; Li, X.; Loftus, E. V.; Noar, M.; Oikonomou, I.; Onken, J.; Peterson, K. A.; Phillips, R. P.; Randall, C. W.; Ricci, M.; Ritter, T.; Rubin, D. T.; Safdi, M.; Sandborn, W. J.; Sauberman, L.; Scherl, E.; Schwarz, R. P.; Sedghi, S.; Shafran, I.; Sninsky, C. A.; Stein, I.; Swoger, J.; Vecchio, J.; Weinberg, D. I.; Wruble, L. D.; Yajnik, V.; Younes, Z.

    2016-01-01

    BACKGROUND & AIMS: Most patients with Crohn's disease (CD) eventually require an intestinal resection. However, CD frequently recurs after resection. We performed a randomized trial to compare the ability of infliximab vs placebo to prevent CD recurrence. METHODS: We evaluated the efficacy of

  9. Infliximab for the treatment of fistulas in patients with Crohn's disease

    NARCIS (Netherlands)

    Present, D. H.; Rutgeerts, P.; Targan, S.; Hanauer, S. B.; Mayer, L.; van Hogezand, R. A.; Podolsky, D. K.; Sands, B. E.; Braakman, T.; DeWoody, K. L.; Schaible, T. F.; van Deventer, S. J.

    1999-01-01

    Enterocutaneous fistulas are a serious complication of Crohn's disease and are difficult to treat. Infliximab, a chimeric monoclonal antibody to tumor necrosis factor alpha, has recently been developed as a treatment for Crohn's disease. We conducted a randomized, multicenter, double-blind,

  10. Recommendations for the long-term treatment of psoriasis with infliximab: A dermatology expert group consensus

    DEFF Research Database (Denmark)

    Reich, K.; Griffiths, C.; Barker, J.

    2008-01-01

    Background/Aims: Infliximab has been approved for the treatment of chronic plaque psoriasis for only a few years. As physicians gain confidence in initiating and maintaining this therapy, guidance on the management of patients beyond several months or years is needed. To date, there is little or ...

  11. Length of hospital stay and associated hospital costs with infliximab versus cyclosporine in severe ulcerative colitis

    NARCIS (Netherlands)

    Löwenberg, Mark; Duijvis, Nicolette W.; Ponsioen, Cyriel; van den Brink, Gijs R.; Fockens, Paul; D'Haens, Geert R. A. M.

    2014-01-01

    Cyclosporine and infliximab (IFX) seem equally effective as rescue therapy in hospitalized patients with severe ulcerative colitis (UC), although associated hospital stay and costs may differ. The aim of this study was to compare the duration of hospital stay and associated costs from initiation of

  12. Transferability of antibody pairs from ELISA to fiber optic surface plasmon resonance for infliximab detection

    Science.gov (United States)

    Van Stappen, Thomas; Lu, Jiadi; Bloemen, Maarten; Geukens, Nick; Spasic, Dragana; Delport, Filip; Verbiest, Thierry; Lammertyn, Jeroen; Gils, Ann

    2015-03-01

    Tumor necrosis factor (TNF)-alpha is a pleiotropic cytokine up-regulated in inflammatory bowel disease, rheumatoid arthritis and psoriasis. The introduction of anti-TNF drugs such as infliximab has revolutionized the treatment of these diseases. Recently, therapeutic drug monitoring (TDM) of infliximab has been introduced in clinical decision making to increase cost-efficiency. Nowadays, TDM is performed using radio-immunoassays, homogeneous mobility shift assays or ELISA. Unfortunately, these assays do not allow for in situ treatment optimization, because of the required sample transportation to centralized laboratories and the subsequent assay execution time. In this perspective, we evaluated the potential of fiber optic-surface plasmon resonance (FO-SPR). To achieve this goal, a panel of 55 monoclonal anti-infliximab antibodies (MA-IFX) was developed and characterized in-house, leading to the identification of nine different clusters. Based on this high diversity, 22 antibody pairs were selected and tested for their reactivity towards IFX, using one MA-IFX as capture and one MA-IFX for detection, in a sandwich type ELISA and FO-SPR. This study showed that the reactivity towards IFX of each antibody pair in ELISA is highly similar to its reactivity on FO-SPR, indicating that antibody pairs are easily transferable between both platforms. Given the fact that FO-SPR shows the potential for miniaturization and fast assay time, it can be considered a highly promising platform for on-site infliximab monitoring.

  13. Clinical outcome of adalimumab therapy in patients with ulcerative colitis previously treated with infliximab

    DEFF Research Database (Denmark)

    Christensen, Katrine Risager; Steenholdt, Casper; Brynskov, Jørn

    2015-01-01

    clinical outcomes of ADL therapy in a clinical setting where infliximab (IFX) had been used as first choice of anti-TNF agent, and followed by ADL as second line agent. METHODS: Retrospective, observational single-center cohort study including all ulcerative colitis patients treated with ADL at a tertiary...

  14. Mucosal healing of Crohn's disease in a patient with concurrent systemic lupus erythematosus using infliximab.

    Science.gov (United States)

    Kagaya, Yuka; Sakamoto, Hirotsugu; Yano, Tomonori; Sunada, Keijiro; Lefor, Alan Kawarai; Niki, Toshiro; Yamamoto, Hironori

    2017-06-01

    We describe a patient with Crohn's disease (CD) concurrent with systemic lupus erythematosus (SLE). Continuous prednisolone and cyclosporine treatment resulted in no recurrent symptoms. However, diarrhea, vomiting, and fever occurred for approximately 3 months. A colonoscopy was then performed, which showed a discontinuous cobblestone appearance and longitudinal ulcers extending from the sigmoid colon to the descending colon and distal ileum. A biopsy revealed a noncaseating granulomatous lesion in the colonic mucosa. These findings led to a diagnosis of CD concurrent with SLE. We first attempted treatment with a full elemental diet, mesalazine, and azathioprine, in that order. However, as there was no improvement in inflammation, we started infliximab, a tumor necrosis factor-alpha inhibitor. Transanal double-balloon enteroscopy performed 4 months after starting infliximab showed mucosal healing, suggesting that infliximab was effective. There are few reports of treating patients with CD concurrent with SLE using a tumor necrosis factor-alpha inhibitor. We report our experience with a patient who had mucosal healing with infliximab and review the literature.

  15. Treatment persistence during therapeutic sequences with adalimumab and infliximab in the treatment of Crohn's disease

    Directory of Open Access Journals (Sweden)

    Carlos Taxonera

    Full Text Available Background and aim: Tumor necrosis factor (TNF inhibitors have demonstrated efficacy and safety in the treatment Crohn's disease (CD. However, the loss of response over time means that they are usually used sequentially. The aim of this study was to compare treatment persistence with different sequences of TNF inhibitors in patients with active luminal CD. Methods: A Markov model (3-month cycles was developed to simulate the therapeutic sequences of beginning biological treatment with infliximab or adalimumab, with a time horizon of three years. Each state of the model represented treatment (induction, standard dose or escalated dose with each TNF inhibitor or the state without biological treatment. The transition probabilities between states were determined by the clinical response to TNF inhibitors obtained from the literature. The likelihood of discontinuation due to adverse effects was also considered. Results: After three years, the percentage of CD patients receiving infliximab and adalimumab as a first TNF inhibitor that remained in treatment was 52.8% and 59.3% (p = 0.1 respectively. Median time to discontinuation of the standard dose was 26.26 months in patients who started with adalimumab and 24.39 months in patients who started with infliximab. Conclusion: In the model, there were no significant differences in persistence after three years with the initial drug among patients with active luminal CD starting treatment with infliximab or adalimumab.

  16. Recommendations for the treatment of ulcerative colitis with infliximab: A gastroenterology expert group consensus

    NARCIS (Netherlands)

    Reinisch, Walter; van Assche, Gert; Befrits, Ragnar; Connell, William; D'Haens, Geert; Ghosh, Subrata; Michetti, Pierre; Ochsenkühn, Thomas; Panaccione, Remo; Schreiber, Stefan; Silverberg, Mark S.; Sorrentino, Dario; van der Woude, C. Janneke; Vermeire, Séverine; Panes, Julian

    2012-01-01

    Background and aims: Infliximab is currently the only biologic approved for treatment of adults with moderate to severe, active ulcerative colitis (UC) unresponsive to conventional therapies. It rapidly controls symptoms, induces and sustains steroid-free remission, stimulates mucosal healing, and

  17. Budget impact analysis of biosimilar infliximab (CT-P13) for the treatment of rheumatoid arthritis in six Central and Eastern European countries.

    Science.gov (United States)

    Brodszky, Valentin; Baji, Petra; Balogh, Orsolya; Péntek, Márta

    2014-05-01

    The first biosimilar monoclonal antibody (infliximab, CT-P13) was registered by the European Medicines Agency in 2013 for the treatment of several inflammatory conditions including rheumatoid arthritis (RA). Biosimilar infliximab is first being marketed in the Central and Eastern European countries. This paper presents the estimated budget impact of the introduction of biosimilar infliximab in RA over a 3-year time period in six selected countries, namely Bulgaria, the Czech Republic, Hungary, Poland, Romania and Slovakia. A prevalence-based model was constructed for budget impact analysis. Two scenarios were compared to the reference scenario (RSc) where no biosimilar infliximab is available: biosimilar scenario 1 (BSc1), where interchanging the originator infliximab with biosimilar infliximab is disallowed, and only patients who start new biological therapy are allowed to use biosimilar infliximab; as well as biosimilar scenario 2 (BSc2), where interchanging the originator infliximab with biosimilar infliximab is allowed, and 80% of patients treated with originator infliximab are interchanged to biosimilar infliximab. Compared to the RSc, the net savings are estimated to be €15.3 or €20.8 M in BSc1 and BSc2, respectively, over the 3 years. If budget savings were spent on reimbursement of additional biosimilar infliximab treatment, approximately 1,200 or 1,800 more patients could be treated in the six countries within 3 years in the two biosimilar scenarios, respectively. The actual saving is most sensitive to the assumption of the acquisition cost of the biosimilar drug and to the initial number of patients treated with biological therapy. The study focused on one indication (RA) and demonstrated that the introduction of biosimilar infliximab can lead to substantial budget savings in health care budgets. Further savings are expected for other indications where biosimilar medicines are implemented.

  18. Contrast-enhanced ultrasonography with SonoVue after infliximab therapy in Crohn's disease.

    Science.gov (United States)

    Guidi, L; De Franco, A; De Vitis, I; Armuzzi, A; Semeraro, S; Roberto, I; Papa, A; Bock, E; Gasbarrini, G; Fedeli, G

    2006-01-01

    The introduction of biological treatments like monoclonal anti TNF-a antibodies (infliximab), is changing the clinical history of Crohn's disease (CD). The effects of these therapies are monitored emplying clinical indexes of active disease, laboratory parameters, endoscopy and histology, and also with imaging techniques. A new ultrasound contrast agent, SonoVue (Bracco SpA, Milano, Italy), is opening new perspectives in the study of microvasculature of several organs. Aim of this study is to evaluate by SonoVue enhanced ultrasonography (US) the occurrence of modifications in bowel wall microvasculature of CD patients and to correlate them with parameters of disease activity and to follow up the findings during infliximab therapy. After performing a basal color-doppler ultrasonography, the study of the affected bowel loop is performed after i.v. injection of SonoVue and the enhancement is evaluated on a qualitative basis. We report on the preliminary results obtained in twenty patients, eight of which have been treated with three infusions of infliximab (induction cycle) and evaluated at baseline and after the treatment. While at baseline we describe a positive correlation of SonoVue enhancement of the affected bowel loop with CRP, alpha1-glycoprotein and white blood cell number, after infliximab treatment in 6/8 cases a definite improvement was detected. Ultrasonographic evaluation of the changes of bowel wall enhancement after i.v. SonoVue during infliximab therapy might represent an useful, not invasive and relatively low cost imaging modality for the clinical monitoring of activity of small bowel Crohn's disease.

  19. Documented tuberculin skin testing among infliximab users following a multi-modal risk communication interventions.

    Science.gov (United States)

    Shatin, Deborah; Rawson, Nigel S B; Curtis, Jeffrey R; Braun, M Miles; Martin, Carolyn K; Moreland, Larry W; Becker, Angela F; Patkar, Nivedita M; Allison, Jeroan J; Saag, Kenneth G

    2006-01-01

    Following its licensure, tuberculosis (TB) was reported as a potential adverse effect of infliximab. Subsequently, the product circular was changed to recommend tuberculin skin testing before patients received infliximab, which was reinforced by several risk communication efforts. The aim of this study was to evaluate patterns and predictors of documented tuberculin skin testing in patients before and after manufacturer, federal, and academic risk communications. Patients administered infliximab were identified from 11 health plans located throughout the United States, and claims data were examined to determine whether the patients had received a tuberculin skin test. Patients were divided into three cohorts depending on the timing of their first infliximab treatment in relation to the risk communication efforts. The overall tuberculin skin testing rate doubled from 15.4% in the first cohort to 30.9% in the last cohort, while the rate of pre-infliximab treatment testing increased from 0 to 27.7% (Chi-squared test for trend, p skin testing rates were significantly higher in women, those with a diagnosis of rheumatoid or psoriatic arthritis, and those with a rheumatologist as prescriber. After multivariable analysis, only rheumatologist remained significantly associated with tuberculin skin testing. Although the tuberculin skin testing rate was relatively low overall, tuberculin skin testing doubled over 30 months of ongoing risk communication efforts and under ascertainment likely occurred. We also found variation in the tuberculin skin testing rate associated with physician specialty. This study demonstrates a significant change in patient care following risk communication efforts. (c) 2005 John Wiley & Sons, Ltd.

  20. Efficiency of adalimumab, etanercept and infliximab in ankylosing spondylitis in clinical practice.

    Science.gov (United States)

    Escudero-Vilaplana, Vicente; Ramírez-Herráiz, Esther; Alañón-Plaza, Estefanía; Trovato-López, Nicolás; García-Vicuña, Rosario; Carreño-Pérez, Luis; Morell-Baladrón, Alberto; Sanjurjo-Sáez, María

    2015-10-01

    Information on the use of ankylosing spondylitis (AS) therapies in clinical practice is a key factor in decision making, as more efficient treatments may involve substantial savings while maintaining the clinical benefits for the patient. To assess the mean annual doses and associated costs of the three main anti-tumour necrosis factor agents used in Spanish daily clinical practice in ankylosing spondylitis patients and to correlate these costs with disease activity. This retrospective, observational study included adult ankylosing spondylitis patients over a 4-year period that had been treated for at least 6 months with adalimumab, etanercept or infliximab at two University Hospitals in Spain. Disease activity was estimated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores at the start of anti-tumour necrosis factor (anti-TNF) therapy and in the last visit or whenever the drug was switched. Mean costs were estimated for a 52-week horizon from the delivered doses registered by pharmacy records. Outcomes were the doses and costs of anti TNFs administered to each patient, and the BASDAI score. A total of 119 patients (137 cases) were included (28 cases treated with adalimumab, 48 cases with etanercept and 61 with infliximab). Mean doses of adalimumab and etanercept were 92.8 and 88.8% of the initially prescribed doses, respectively, while the mean dose of infliximab administered was 102%. There were no statistical differences among treatments in terms of clinical effectiveness. Associated mean patient-year costs were significantly higher in the infliximab group (€14,235), compared to the other treatments [adalimumab €11,934; etanercept €10,516; (P ankylosing spondylitis patients, doses and associated costs of biological therapies can be reduced while controlling disease activity. Mean doses used in our clinical practice vary from the recommended doses and are significantly lower for adalimumab and etanercept than for infliximab. These

  1. Infliximab to Treat Refractory Inflammation After Pelvic Pouch Surgery for Ulcerative Colitis.

    Science.gov (United States)

    Kelly, Orlaith B; Rosenberg, Morgan; Tyler, Andrea D; Stempak, Joanne M; Steinhart, A Hillary; Cohen, Zane; Greenberg, Gordon R; Silverberg, Mark S

    2016-04-01

    Inflammatory pouch complications refractory to first-line therapies remain problematic following ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC). We evaluated infliximab efficacy and associations with therapeutic response. Data from individuals who underwent colectomy and IPAA for UC (2000-2014) were reviewed. Patients with chronic refractory pouchitis (CP) and Crohn's disease (CD)-like outcomes treated with infliximab were included. Pre-treatment parameters and response at median 8 (initial) and 48 weeks (sustained) were measured. Complete response was defined as symptomatic and endoscopic resolution with modified Pouchitis Disease Activity Index (mPDAI) 2. Serum was analysed for Anti-Saccharomyces cerevisiae antibodies (ASCA), anti-OmpC, anti-CBir1 and perinuclear Anti-Neutrophil Cytoplasmic Antibodies (pANCA). One hundred and fifty-two patients with CP or a CD-like phenotype were identified. Forty-two were treated with infliximab (33% male; age 32.6±2.6 years, 28.5% CD-like). Post-induction response was achieved in 74% (48% complete) and sustained response in 62.6% (29.6% complete). Mean mPDAI and C-reactive protein declined from 8.5±0.3 to 2±3.4 (p infliximab use (p Infliximab can effectively treat inflammatory pouch complications. Pre-treatment mPDAI <10 and early endoscopy may identify responders. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  2. Five-year experience with infliximab: Follow up of the product familiarisation program.

    Science.gov (United States)

    Nguyen, Rebecca; Braue, Anna; Baker, Chris; Foley, Peter

    2016-11-01

    This 5-year retrospective analysis is of 22 patients who participated in the product familiarisation program (PFP) at St Vincent's Hospital Melbourne, prior to the listing of infliximab on the Pharmaceutical Benefit Scheme. Criteria for inclusion were being an adult with chronic plaque psoriasis, having a psoriasis area and severity index (PASI) score of at least 15 with an inadequate response or intolerance to three of the following: phototherapy, acitretin, cyclosporin and methotrexate. Participants were infused with infliximab 5 mg/kg on the standard induction (weeks 0, 2 and 6) and maintenance (8-weekly) protocols. At each visit PASI and dermatology life quality index (DLQI) scores were recorded. Success was determined as the proportion of patients achieving at least a 75% improvement in the PASI score from baseline (PASI 75). At 60 months after commencement of therapy, 31% of patients remained on infliximab. Those who did retained PASI 75 with a DLQI of 0 or 1. Of those who ceased infliximab, nine did so due to loss of efficacy, three for personal reasons, two for serious adverse events and one was lost to follow up. Adverse events included non-melanoma skin cancers, infections and abnormal liver enzymes. Infliximab in the Australian context has proven to be a highly effective treatment of chronic plaque psoriasis, and patients who remained on the drug derived a high level of satisfaction, assessed both subjectively (DLQI) and objectively (PASI 75). The variable response indicates that psoriasis is a heterogeneous disease and investigation into potential patient selection for treatment in the future is warranted. © 2015 The Australasian College of Dermatologists.

  3. A pharmacokinetic approach to model-guided design of infliximab schedules in ulcerative colitis patients

    Directory of Open Access Journals (Sweden)

    Alejandro Pérez-Pitarch

    2015-03-01

    Full Text Available Background: Infliximab, an anti-tumour necrosis factor approved for treatment of Crohn's disease and ulcerative colitis, is administered at predefined interdose-intervals. On insufficient response or loss of response, treatment can be intensified. The lack or loss of response is likely related to complex pharmacokinetics of infliximab. Aims: To explore optimal dosing strategies of infliximab in treatment-naïve patients with ulcerative colitis through predictive Monte Carlo simulations based on a validated population PK model. Methods: A population of 2,000 treatment-naïve patients was generated by Montecarlo simulation. Six dosing strategies for maintenance therapy were simulated on this population. Strategies 1 and 2 consisted on 5 mg/kg and 6 mg/kg doses, respectively, and 8 weeks inter-dose interval. Strategies 3 and 4 used Individualized doses, adjusted to albumin level, sex and body weight, and a fix inter-dose interval of 8 weeks to achieve a target trough concentration of 5 mg/L or 6 mg/L, respectively. Strategies 5 and 6 used a fix dose of 5 mg/kg and individualized inter-dose intervals, adjusted to the same covariates, to achieve a target concentration, of 5 mg/L or 6 mg/L, respectively. Results: Strategies 2-6 reached trough levels statistically higher than strategy 1 (p < 0.05. Strategy 5 proved to be the best dosing strategy. It was associated with a higher proportion of responder patients than strategy 1 (62 % vs. 40 % without reaching higher peak concentrations. Conclusions: Optimization of maintenance treatment of colitis with infliximab by a pharmacokinetic approach could benefit infliximab-naive patients with ulcerative colitis.

  4. Formation of antibodies against infliximab and adalimumab strongly correlates with functional drug levels and clinical responses in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Radstake, T R D J; Svenson, M; Eijsbouts, A M

    2008-01-01

    BACKGROUND: Tumour necrosis factor alpha (TNFalpha) neutralising antibody constructs are increasingly being used to treat rheumatoid arthritis (RA). OBJECTIVE: To determine potential differences in clinical responses, soluble drug levels and antibody formation between patients with RA receiving...... infliximab and adalimumab. METHODS: 69 patients with RA fulfilling the 1987 American College of Rheumatology criteria and about to start treatment with infliximab or adalimumab, were enrolled consecutively. All patients had active disease (28-joint count Disease Activity Score >3.2). Infliximab was given...... intravenously at 3 mg/kg at baseline and after 2, 6 and 14 weeks. Adalimumab was administered as 40 mg biweekly subcutaneously. Concomitant drug treatment was monitored and continued at constant dosage during the study. All serum samples were tested for infliximab/adalimumab levels and anti...

  5. Induction and Maintenance Infliximab Therapy for the Treatment of Moderat-to Severe Crohns Disease in Children

    DEFF Research Database (Denmark)

    Pærregaard, Anders; NN, NN

    2007-01-01

    BACKGROUND AND AIMS: The REACH study evaluated the safety and efficacy of infliximab in children with moderately to severely active Crohn's disease. METHODS: Patients (n = 112) with a Pediatric Crohn's Disease Activity Index (PCDAI) score >30 received infliximab 5 mg/kg at weeks 0, 2, and 6....... Patients responding to treatment at week 10 were randomized to infliximab 5 mg/kg every 8 or 12 weeks through week 46. A concurrent immunomodulator was required. Clinical response (decrease from baseline in the PCDAI score > or =15 points; total score ... points) were evaluated at weeks 10, 30, and 54. RESULTS: At week 10, 99 of 112 (88.4%) patients responded to infliximab (95% confidence interval: [82.5%, 94.3%]) and 66 of 112 (58.9%) patients achieved clinical remission (95% confidence interval: [49.8%, 68.0%]). At week 54, 33 of 52 (63.5%) and 29 of 52...

  6. The Production of a Stable Infliximab Powder: The Evaluation of Spray and Freeze-Drying for Production

    Science.gov (United States)

    Kanojia, Gaurav; Have, Rimko ten; Bakker, Arjen; Wagner, Koen; Frijlink, Henderik W.; Kersten, Gideon F. A.; Amorij, Jean-Pierre

    2016-01-01

    In prospect of developing an oral dosage form of Infliximab, for treatment of Crohn’s disease and rheumatoid arthritis, freeze-drying (vial vs Lyoguard trays) and spray-drying were investigated as production method for stable powders. Dextran and inulin were used in combination with sucrose as stabilizing excipients. The drying processes did not affect Infliximab in these formulations, i.e. both the physical integrity and biological activity (TNF binding) were retained. Accelerated stability studies (1 month at 60°C) showed that the TNF binding ability of Infliximab was conserved in the freeze-dried formulations, whereas the liquid counterpart lost all TNF binding. After thermal treatment, the dried formulations showed some chemical modification of the IgG in the dextran-sucrose formulation, probably due to Maillard reaction products. This study indicates that, with the appropriate formulation, both spray-drying and freeze-drying may be useful for (bulk) powder production of Infliximab. PMID:27706175

  7. Induction and maintenance infliximab therapy for the treatment of moderate-to-severe Crohn's disease in children

    DEFF Research Database (Denmark)

    Hyams, Jeffrey; Crandall, Wallace; Kugathasan, Subra

    2006-01-01

    BACKGROUND AND AIMS: The REACH study evaluated the safety and efficacy of infliximab in children with moderately to severely active Crohn's disease. METHODS: Patients (n = 112) with a Pediatric Crohn's Disease Activity Index (PCDAI) score >30 received infliximab 5 mg/kg at weeks 0, 2, and 6. Pati......, remission rates, but not response rates, at week 54 were superior with every 8-week dosing compared with every 12-week dosing. Udgivelsesdato: 2007-Mar...

  8. Discontinuation of Infliximab in Patients With Ulcerative Colitis Is Associated With Increased Risk of Relapse: A Multinational Retrospective Cohort Study.

    Science.gov (United States)

    Fiorino, Gionata; Cortes, Pablo Navarro; Ellul, Pierre; Felice, Carla; Karatzas, Pantelis; Silva, Marco; Lakatos, Peter L; Bossa, Fabrizio; Ungar, Bella; Sebastian, Shaji; Furfaro, Federica; Karmiris, Konstantinos; Katsanos, Konstantinos H; Muscat, Martina; Christodoulou, Dimitrios K; Maconi, Giovanni; Kopylov, Uri; Magro, Fernando; Mantzaris, Gerassimos J; Armuzzi, Alessandro; Boscà-Watts, Marta Maia; Ben-Horin, Shomron; Bonovas, Stefanos; Danese, Silvio

    2016-10-01

    Infliximab is a safe and effective therapy for ulcerative colitis (UC). We conducted a multicenter retrospective cohort study that included 7 European countries and Israel to examine whether infliximab discontinuation can be considered for patients who achieve sustained remission. We performed a retrospective cohort study, collecting medical records from 13 tertiary care referral inflammatory bowel disease centers of all patients with UC treated with infliximab (n = 193). We compared the disease course of patients with at least 12 months of clinical remission who discontinued infliximab (n = 111) with that of patients who continued scheduled treatment (controls, n = 82). We examined the incidence rates of relapse, hospitalization and colectomy, the comparative effectiveness of different therapeutic strategies after discontinuation, and assessed the rates of response, remission, and adverse effects after infliximab re-initiation. Statistical analyses used time-to-event methods. In the entire cohort, 67 patients (34.7%) relapsed during the follow-up period. The incidence rate of relapse was significantly higher after discontinuation (23.3 per 100 person-years) compared with the control group (7.2 per 100 person-years) in univariable analysis (log-rank P infliximab discontinuation (incidence of relapse: 15.0 per 100 person-years for thiopurines, 27.4 per 100 person-years for thiopurines plus aminosalicylates, and 31.2 per 100 person-years for aminosalicylates alone; log-rank P = .032). Response was regained in 77.1% of patients and remission in 51.4% of patients who re-initiated infliximab. However, 17.1% had infusion reactions and 17.1% reported other adverse events. In a multinational retrospective cohort study of patients with UC in sustained clinical remission, we associated discontinuation of infliximab with an increased risk of relapse. Treatment re-initiation is effective and safe. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights

  9. Mean Platelet Volume in Crohn's Disease Patients Predicts Sustained Response to a 52-Week Infliximab Therapy: A Pilot Study.

    Science.gov (United States)

    Sobolewska, Aleksandra; Włodarczyk, Marcin; Stec-Michalska, Krystyna; Fichna, Jakub; Wiśniewska-Jarosińska, Maria

    2016-02-01

    The loss of response to infliximab in Crohn's disease (CD) patients is currently a major clinical problem. Recently, mean platelet volume (MPV) has been proposed as a new biomarker of CD activity. Here, we hypothesized that MPV may be used as cheap and efficient biomarker of subclinical inflammation during 52-week therapy in CD patients responding to infliximab induction treatment. The aim of study was to establish whether MPV at baseline and pre-infusion at week 14 are good predictors of sustained response after week 14 in CD patients undergoing 52-week infliximab therapy. A retrospective study of 30 adult CD patients who underwent a 52-week course of treatment with infliximab and achieved response at week 14 to induction treatment was performed. The association between MPV, baseline disease parameters and maintained clinical response or remission during infliximab therapy was assessed. Higher MPV at week 14 was observed in CD patients with sustained response to infliximab after week 14 than in patients with loss of response (p = 0.0019). In patients with loss of response to maintenance infliximab treatment, lower ΔMPV between baseline and week 14 was calculated (p = 0.0003). MPV > 10.3 fl at week 14 predicts sustained response with 67 % sensitivity and 80 % specificity. ΔMPV between baseline and week 14 >0.4 fl predicts sustained response with 87 % sensitivity and 93 % specificity. MPV at week 14 and ΔMPV between baseline and week 14 are good predictors of sustained response to infliximab maintenance treatment in CD patients.

  10. Ashkenazi Jewish Origin Protects Against Formation of Antibodies to Infliximab and Therapy Failure

    Science.gov (United States)

    Ungar, Bella; Haj-Natour, Ola; Kopylov, Uri; Yavzori, Miri; Fudim, Ella; Picard, Orit; Loebstein, Ronen; Lahat, Adi; Maor, Yaakov; Avidan, Benjamin; Lang, Alon; Weiss, Batia; Chowers, Yehuda; Eliakim, Rami; Ben-Horin, Shomron

    2015-01-01

    Abstract Infliximab is an anti-tumor necrosis factor (TNF) used for treatment of inflammatory bowel disease (IBD) as well as rheumatoid arthritis, psoriasis, and other inflammatory conditions. Antibodies to infliximab (ATI) develop in approximately 45% of infliximab-treated IBD patients and are correlated with loss of clinical response. Scarce data exist as to factors which predict infliximab immunogenicity. To investigate factors that may predict formation of antibodies to infliximab (ATI) and infliximab therapy failure an observational study of consecutive IBD patients treated with infliximab between 2009 and 2013 was performed. Trough levels of ATI were measured. Patients were monitored for disease activity using clinical activity indexes and were classified according to ATI formation and clinical response. All clinical and demographic parameters were analyzed for association with the designated outcomes. One hundred fifty-nine patients were included and 1505 sera were tested. On multivariate analysis, Jewish Ashkenazi ethnicity was protective against both development of ATI (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.17–0.7, P = 0.005) and treatment failure (OR 0.29, 95% CI 0.13–0.66, P = 0.003). Concomitant immunomodulator therapy was also negatively associated with immunogenicity and infliximab therapy failure (OR 0.31, 95% CI 0.15–0.65, P = 0.002; OR 0.42 95% CI 0.18−0.99, p = 0.04, respectively), whereas episodic therapy was positively associated with both outcomes (OR 4.2 95% CI 1.07−16.1, p = 0.04, OR 4.45 95% CI 1.2−16.6, p = 0.026 respectively). All other variables, including IBD type, gender, weight, age, smoking status and disease duration, were not predictive of ATI formation or clinical failure. However, among Crohn's disease patients, a non-stricturing non-penetrating phenotype was protective against ATI formation (OR 0.4, 95% CI 0.14−0.96, p = 0.04). P = 0.04, respectively), whereas episodic

  11. Analysis of Th Cell-related Cytokine Production in Behçet Disease Patients with Uveitis Before and After Infliximab Treatment.

    Science.gov (United States)

    Takeuchi, Masaru; Karasawa, Yoko; Harimoto, Kohzou; Tanaka, Atsushi; Shibata, Masaki; Sato, Tomohito; Caspi, Rachel R; Ito, Masataka

    2017-02-01

    To examine antigen-stimulated cytokine production by Behçet disease patients (BD) before and after infliximab infusion. PBMCs were obtained before and after infliximab infusion in BD patients with or without recurrent uveitis during at least 1 year of infliximab therapy, and from healthy subjects. PBMCs were cultured with IRBP, and Th-related cytokines in cultures were measured. Levels of IL-4, IL-6, IL-10 IL-17A, IL-17F, IL-31, IFN-γ, and TNFα were higher in BD before infliximab infusion than in healthy subjects, and these levels were the highest in BD with recurrent uveitis. After infliximab infusion, these cytokine levels were reduced to a greater extent in BD without recurrent uveitis than in BD with recurrence. Th-related cytokines produced by IRBP-stimulated PBMCs were elevated in BD, and infliximab infusion suppressed these cytokines to a greater extent in BD without recurrent uveitis than in those with recurrence.

  12. Præhospital behandling af svært tilskadekomne patienter med fokus på damage control-kirurgi

    DEFF Research Database (Denmark)

    Sørensen, Anne Marie; Larsen, Claus Falck; Steinmetz, Jacob

    2011-01-01

    The majority of patients undergoing damage control surgery initially receive prehospital treatment. Bleeding causes 40% of trauma deaths, half of which happen in the prehospital setting. Future research and improved treatment before hospital admission should focus on control of the bleeding, avoi...

  13. Mænd med rejsningsbesvær efter radikal prostatektomi bør behandles efter sædvanlige retningslinjer

    DEFF Research Database (Denmark)

    Fode, Mikkel; Hansen, Rikke Bølling; Maigaard, Thomas

    2014-01-01

    Penile rehabilitation programmes aim to improve long-term sexual function after nerve-sparing radical prostatectomy. Programmes aim to improve cavernous oxygenation to avoid structural damage in penile tissue. Especially, daily use of phosphodiesterase type 5 (PDE5) inhibitors has been studied. T......, urethral suppositories and penile implants....

  14. Mænd med rejsningsbesvær efter radikal prostatektomi bør behandles efter sædvanlige retningslinjer

    DEFF Research Database (Denmark)

    Fode, Mikkel; Hansen, Rikke Bølling; Maigaard, Thomas

    2015-01-01

    Penile rehabilitation programmes aim to improve long-term sexual function after nerve-sparing radical prostatectomy. Programmes aim to improve cavernous oxygenation to avoid structural damage in penile tissue. Especially, daily use of phosphodiesterase type 5 (PDE5) inhibitors has been studied. T......, urethral suppositories and penile implants....

  15. Præhospital behandling af svært tilskadekomne patienter med fokus på damage control-kirurgi

    DEFF Research Database (Denmark)

    Sørensen, Anne Marie; Larsen, Claus Falck; Steinmetz, Jacob

    2011-01-01

    The majority of patients undergoing damage control surgery initially receive prehospital treatment. Bleeding causes 40% of trauma deaths, half of which happen in the prehospital setting. Future research and improved treatment before hospital admission should focus on control of the bleeding...

  16. Kontrollmestringsteori og Becks kognitve teori. En sammenlignende undersøkelse av teoriene med henblikk på forståelse og behandling av depresjon

    OpenAIRE

    Brabrand, Kristin; Søvik, Ellen; Blomdal, Ane Jostedt

    2012-01-01

    Psychotherapy theories differ in how they understand and approach depression (Nordahl et al., 2012). In this paper we compare the control-mastery theory and Beck`s cognitive theory, with the aim to identify similarities and differences between the theories. In this comparison, similarities in conceptualization appeared. Both the control- mastery theory and Beck`s cognitive theory describe depression as developed on the basis of maladaptive cognitions (Beck, 1970; Weiss, 1993). At the same tim...

  17. OPUS: Randomiseret multicenterundersøgelse af integreret behandling sammenlignet med standardbehandling før første psykoseepisode--sekundaerpublikation

    DEFF Research Database (Denmark)

    Nordentoft, Merete; Petersen, Lone; Jeppesen, Pia

    2006-01-01

    A total of 547 patients with first-episode psychosis were included in a randomised clinical trial comparing integrated treatment with standard treatment. The integrated treatment consisted of assertive community treatment with programmes for family involvement and social skills training. Patients...

  18. Patienter med basalcellenævussyndrom bør tilbydes tidlig interdisciplinær opfølgning og behandling

    DEFF Research Database (Denmark)

    Bay, Christiane; Ousager, Lilian Bomme; Jelsig, Anne Marie

    2016-01-01

    cerebri. Other important clinical features are skeletal abnormalities and facial dysmorphism including macrocephaly. Germ-line mutations are found in PTCH1. Management of the syndrome requires a multidisciplinary approach, and in this article management guidelines are reviewed and discussed....

  19. Rusmisbruk, angst og depresjon etter 10 år: En prospektiv undersøkelse av stoffmisbrukere med og uten LAR-behandling

    Directory of Open Access Journals (Sweden)

    Ravndal Edle

    2015-12-01

    Full Text Available Substance abuse, anxiety and depression after 10 years: A prospective study of drug users in and outside OMT treatment AIMS - The national Opiate Maintenance Treatment (OMT program in Norway started officially in 1998. The same year a treatment study was initiated, including the most used treatment measures for drug users in Norway. The main aim in the present study was to investigate the prevalence of live OMT patients in the total sample after 10 years, and to compare the outcome of primarily substance abuse, anxiety and depression among OMT patients versus non-OMT patients. DESIGN & METHODS - Four hundred and seven patients, in Oslo and the nearby regions, who started in 16 different in- and outpatients programs, were followed from intake to treatment and during ten years (1998-2009. Patients in the sample were interviewed after one, two, seven and ten years, and they were divided into three different treatment groups: inpatient residency for grown-ups, outpatient psychiatric youth teams and youths living in collectives. Data was collected through use of EuropASI and HSCL-25 at all follow-ups. RESULTS - After ten years 15 % were deceased. Of the 333 persons left, 73 % (n=248 were interviewed after ten years. Forty percent (n=99 were then in OMT. After ten years there were no gender differences regarding attendance to OMT, but the OMT-group was older (30 vs .28 yrs, p<0.05, and they used more benzodiazepines (p<0.000 and cannabis (p<0.01 than the others. The OMT-group reported to a larger extent more anxiety and depression throughout the total observation period than the non OMT participants. Use of heroin and criminality were significantly reduced in both groups. CONCLUSIONS - In spite of reduced use of heroin, the OMT patients seemed to have more difficulties in reducing the use of benzodiazepines and cannabis, whereas the anxiety and depression scores were high and stable through the total observation time.

  20. Infliximab vs. adalimumab in Crohn's disease: results from 327 patients in an Australian and New Zealand observational cohort study.

    Science.gov (United States)

    Doecke, J D; Hartnell, F; Bampton, P; Bell, S; Mahy, G; Grover, Z; Lewindon, P; Jones, L V; Sewell, K; Krishnaprasad, K; Prosser, R; Marr, D; Fischer, J; R Thomas, G; Tehan, J V; Ding, N S; Cooke, S E; Moss, K; Sechi, A; De Cruz, P; Grafton, R; Connor, S J; Lawrance, I C; Gearry, R B; Andrews, J M; Radford-Smith, G L

    2017-02-01

    Maintenance anti-tumour necrosis factor-α (anti-TNFα) treatment for Crohn's disease is the standard of care for patients with an inadequate response to corticosteroids and immunomodulators. To compare the efficacy and safety of infliximab and adalimumab in clinical practice and assess the value of concomitant immunomodulator therapy. We performed an observational cohort study in consecutive patients with Crohn's disease qualifying for anti-TNFα treatment in Australia and New Zealand between 2007 and 2011. Demographic and clinical data were prospectively recorded to identify independent factors associated with induction and maintenance of response to infliximab or adalimumab, or to either anti-TNFα therapy. Three hundred and twenty-seven patients (183 infliximab, 144 adalimumab) successfully applied for treatment. Eighty-nine percent responded in all groups and median maintenance of response was similar for the two agents. Concomitant immunomodulator with infliximab, but not adalimumab, demonstrated a significantly longer response overall (P = 0.002), and significantly fewer disease and treatment-related complications (P = 0.017). Corticosteroids at baseline, and/or in the preceding 12 months, were associated with a 9-13 times greater risk of disease flare during maintenance treatment as compared to no corticosteroids (P infliximab and adalimumab to have similar response characteristics. However, infliximab requires concomitant immunomodulator to achieve optimal maintenance of response comparable to adalimumab monotherapy. The results of this study will assist clinicians in further optimising patient care in their day-to-day clinical practice. © 2016 John Wiley & Sons Ltd.

  1. Evaluation of the infliximab therapy of severe form of pediatric Crohn's disease in Poland: Retrospective, multicenter studies.

    Science.gov (United States)

    Iwańczak, Barbara M; Ryżko, Józef; Jankowski, Piotr; Sładek, Małgorzata; Wasilewska, Agata; Szczepanik, Mariusz; Sienkiewicz, Edyta; Szaflarska-Popławska, Anna; Więcek, Sabina; Czaja-Bulsa, Grażyna; Korczowski, Bartosz; Maślana, Jolanta; Iwańczak, Franciszek; Kacperska, Magdalena

    2017-01-01

    Registration of infliximab in Poland has increased chances to induce clinical remission and mucosal healing in the severe form of pediatric Crohn's disease. The aim of this retrospective study was to assess the results and safety of infliximab therapy in the severe form of pediatric Crohn's disease. The study included 153 children with severe form of non-fistulizing Crohn's disease treated with infliximab. The clinical activity of Crohn's disease was assessed according to PCDAI scale, endoscopic scoring was graded according to SES-CD, body mass was measured with body mass index (BMI). Infliximab was administered at the dose 5 mg/kg body mass in the 0.2 and 6th week, and then, after clinical response, every 8 for the period of 12 months. One hundred thirty-six children (88.89%) achieved clinical response after induction therapy and 75.21% of children after the maintenance therapy. 39.68% of children achieved remission as graded with endoscopic scoring SES-CD. There was a statistically significant increase in body weight following the treatment. Side effects such as anaphylaxis, rash, and the activation of EBV infection appeared in 9 children at the time of infliximab injection. In other children the drug was well tolerated. Induction and maintenance therapy with infliximab resulted in clinical remission of Crohn's disease in 75.21% of children, and in the intestinal mucosa healing in 39.68% of children.

  2. Infliximab exerts a dose-dependent effect on retinal safety in the albino rabbit.

    Science.gov (United States)

    Zayit-Soudry, Shiri; Vainer, Igor; Zemel, Esther; Mimouni, Michael; Rabena, Melvin; Pieramici, Dante J; Perlman, Ido; Loewenstein, Anat

    2017-12-01

    To assess the retinal toxicity of an intravitreal injection of infliximab, a monoclonal antibody to tumor necrosis factor α, in a rabbit model. Two groups of adult albino rabbits (n = 5) received intravitreal injections of infliximab (0.1 ml) in the study eye and balanced salt solution (BSS, 0.1 ml) in the control eye at baseline. Group 1 was administered with 1.5 mg/0.1 ml, and group 2 was injected with 7.5 mg/0.1 ml of infliximab solution. Electroretinography (ERG) was performed at baseline and at 1, 7, 30, and 45 days after the injection. Visual evoked potentials (VEPs) were recorded at 7 and 45 days after the injection. After the last electrophysiological assessment, the rabbits were euthanized and retinal histopathology and immunhistochemistry for glial fibrillary acidic protein (GFAP) were performed. ERG responses demonstrated no significant deficit in retinal function in eyes injected with infliximab. Mean dark-adapted a-wave and b-wave maximal amplitude and semi-saturation constant values at baseline and throughout the 45 days of follow-up after the injection indicated no remarkable difference in outer retinal function between the control and experimental eyes. VEP responses were similar at each time point (7 and 45 days). No difference was seen in retinal histopathology and immunocytochemistry sections in eyes receiving the 1.5 mg/0.1 ml dose compared to the control eyes. However, increased GFAP labeling in retinal Müller cells was detected in rabbit eyes treated with the 7.5 mg/0.1 ml dose. Intravitreal injection of 1.5 mg/0.1 ml infliximab dose has no toxic effect on the integrity (functional or structural) of the retina in rabbits. A higher dose of 7.5 mg/0.1 ml may be slightly toxic as suggested by positive Müller cell GFAP expression. Additional studies of retinal toxicity at higher doses and after multiple injections are needed to establish the retinal safety of intravitreal infliximab therapy in humans.

  3. Musikalsk leg med formgivning, timing og vitalitetsformer

    DEFF Research Database (Denmark)

    Holck, Ulla

    2015-01-01

    Ifølge de Udviklingsorienterede Social-Pragmatiske Interventionsformer til børn med Autisme Spektrum Forstyrrelse er en legende indfaldsvinkel, hvor man følger barnets lead, den mest effektive til at engagere yngre børn med autisme eller børn med svær autisme i et gensidigt samspil. Artiklen...

  4. Langtidsforsøg med totrinsforgasseren "Viking"

    DEFF Research Database (Denmark)

    Henriksen, Ulrik Birk; Ahrenfeldt, Jesper; Bentzen, Jens Dall

    Projektets formål har været at få erfaringer med langtidsdrift, samt at løbende forbedre anlæggets komponenter i takt med de indvundne driftserfaringer. Status for Vikingforgasseren ved projektets afslutning er: • En række komponenter er løbende forbedret med henblik på driftssikkerhed, levetid, ...

  5. Lærere arbejder med landskabsdannelse

    DEFF Research Database (Denmark)

    2012-01-01

    Valg af materiale/medie/form: YOUtube videoklip. Valg af arbejdsform: Lærere der er igang med at afprøve praktisk undersøgende arbejde med danske landskabsformer. Begrundelse for valg af materiale/medie/form/arbejdsform: Ultrakort videoklip valgt så 1) lærerne kan dele med kolleger, 2) øvrige...

  6. Comparative efficacy of golimumab, infliximab, and adalimumab for moderately to severely active ulcerative colitis: a network meta-analysis accounting for differences in trial designs.

    Science.gov (United States)

    Thorlund, Kristian; Druyts, Eric; Toor, Kabirraaj; Mills, Edward J

    2015-05-01

    To conduct a network meta-analysis (NMA) to establish the comparative efficacy of infliximab, adalimumab and golimumab for the treatment of moderately to severely active ulcerative colitis (UC). A systematic literature search identified five randomized controlled trials for inclusion in the NMA. One trial assessed golimumab, two assessed infliximab and two assessed adalimumab. Outcomes included clinical response, clinical remission, mucosal healing, sustained clinical response and sustained clinical remission. Innovative methods were used to allow inclusion of the golimumab trial data given the alternative design of this trial (i.e., two-stage re-randomization). After induction, no statistically significant differences were found between golimumab and adalimumab or between golimumab and infliximab. Infliximab was statistically superior to adalimumab after induction for all outcomes and treatment ranking suggested infliximab as the superior treatment for induction. Golimumab and infliximab were associated with similar efficacy for achieving maintained clinical remission and sustained clinical remission, whereas adalimumab was not significantly better than placebo for sustained clinical remission. Golimumab and infliximab were also associated with similar efficacy for achieving maintained clinical response, sustained clinical response and mucosal healing. Finally, golimumab 50 and 100 mg was statistically superior to adalimumab for clinical response and sustained clinical response, and golimumab 100 mg was also statistically superior to adalimumab for mucosal healing. The results of our NMA suggest that infliximab was statistically superior to adalimumab after induction, and that golimumab was statistically superior to adalimumab for sustained outcomes. Golimumab and infliximab appeared comparable in efficacy.

  7. Infliximab no tratamento da sarcoidose - Experiência de um hospital central

    Directory of Open Access Journals (Sweden)

    M. Aguiar

    2011-03-01

    Full Text Available Resumo: Apesar de tratamento agressivo e atempado, a Sarcoidose pode ser, por vezes, uma doença progressiva e bastante debilitante. O papel do factor de necrose tumoral (TNF-α na génese dos granulomas é ambíguo. Por um lado a sua presença é necessária para a formação e manutenção da inflamação granulomatosa, sendo, portanto, o seu antagonista utilizado com sucesso no tratamento de doentes com sarcoidose; por outro lado e para outras situações, há referência do aparecimento dessa patologia em doentes submetidos a Infliximab.O Infliximab foi por nós utilizado no tratamento de doentes com sarcoidose que não apresentavam resposta à corticoterapia ou a outras terapêuticas convencionais ou que desenvolviam efeitos secundários inaceitáveis a essa terapêutica. A dose inicial foi de 5 mg/Kg de peso e as doses subsequentes foram administradas na 2.a semana, na 6.a semana e depois, durante o período de um ano de 8 em 8 semanas.Dez doentes com diagnóstico de sarcoidose por biopsia, iniciaram terapêutica com este fármaco. Destes cinco eram homens e cinco mulheres, com uma idade média de 47,1 anos, variando a idade entre 28 e 63 anos. Três doentes apresentavam sintomas graves do sistema nervoso central, dois, cirrose hepática, uma inflamação granulomatosa da glândula lacrimal já submetida a múltiplas cirurgias, uma com envolvimento pulmonar extenso (estádio III, uma, com lúpus pérnio desfigurante e dois, com nódulos cutâneos desfigurantes. Oito doentes apresentavam mais do que um local de doença. Todos os doentes completaram pelo menos sete ciclos de tratamento. Em quatro doentes a dose de corticóides ou de outra terapêutica imunosupressora foi suspensa, em três foi reduzida, e apenas em uma doente foi necessário juntar corticóides à terapêutica com Infliximab. Cinco doentes apresentaram uma melhoria

  8. Uso de infliximab en pacientes de un centro reumatológico Use of infliximab in patients of a rheumatologic center

    Directory of Open Access Journals (Sweden)

    Ingrid Strusberg

    2005-03-01

    Full Text Available El objetivo de este estudio fue obtener información postmarketing sobre el uso de infliximab en un centro reumatológico de atención ambulatoria. Se realizó un análisis retrospectivo y prospectivo de las historias clínicas de pacientes con diagnóstico de artritis reumatoidea ( n=37 , artritis psoriásica ( n=5 , enfermedad mixta del tejido conectivo ( n=1 y espondilitis anquilosante ( n=2 que recibieron infliximab (3 mg / kg desde agosto de 2000 a junio de 2003. El análisis descriptivo se realizó con porcentajes, media o mediana y desviación estándar o intervalo intercuartilo . La prueba de Wilcoxon se utilizó para el análisis apareado de dosis de antiinflamatorios no esteroideos y metotrexato , anterior y posterior a la administración de infliximab. Se consideraron significativos valores de p £ 0.05. Se incluyeron 45 pacientes a los que se les administraron un total de 207 infusiones. En 2 pacientes el infliximab se discontinuó debido a lumbalgia severa durante la infusión y en otros 2 por anafilaxia intrainfusional. Otras reacciones adversas ocurridas durante las infusiones fueron moderadas y respondieron adecuadamente al tratamiento estándar. Se presentó un caso de artritis séptica de rodilla por estafilococos. Un caso de artritis reumatoidea con insuficiencia renal compensada recibió infliximab en dosis de 1.9 mg / kg cada 30 días, sin cambios en la función renal. Al momento, ningún paciente ha desarrollado tuberculosis activa. Debido a la mejoría clínica, se redujo la dosis de corticoides en 14/39 (35.9% pacientes, de antiinflamatorios no esteroideos en 15/43 (34.8% y de metotrexato en 12/34 (35.3%. En esta serie de casos se muestra el perfil de seguridad de infliximab, la posibilidad de reducir la dosis de drogas concomitantes, así como algunos enfoques individuales sobre situaciones para las cuales no disponemos de guías basadas en la evidencia médica, y en las que los reumatólogos debemos tomar decisiones seg

  9. Defining the ultrasound longitudinal natural history of newly diagnosed pediatric small bowel Crohn disease treated with infliximab and infliximab-azathioprine combination therapy.

    Science.gov (United States)

    Dillman, Jonathan R; Dehkordy, Soudabeh Fazeli; Smith, Ethan A; DiPietro, Michael A; Sanchez, Ramon; DeMatos-Maillard, Vera; Adler, Jeremy; Zhang, Bin; Trout, Andrew T

    2017-07-01

    Little is known about changes in the imaging appearances of the bowel and mesentery over time in either pediatric or adult patients with newly diagnosed small bowel Crohn disease treated with anti-tumor necrosis factor-alpha (anti-TNF-α) therapy. To define how bowel ultrasound findings change over time and correlate with laboratory inflammatory markers in children who have been newly diagnosed with pediatric small bowel Crohn disease and treated with infliximab. We included 28 pediatric patients treated with infliximab for newly diagnosed ileal Crohn disease who underwent bowel sonography prior to medical therapy and at approximately 2 weeks, 1 month, 3 months and 6 months after treatment initiation; these patients also had laboratory testing at baseline, 1 month and 6 months. We used linear mixed models to compare mean results between visits and evaluate whether ultrasound measurements changed over time. We used Spearman rank correlation to assess bivariate relationships. Mean subject age was 15.3±2.2 years; 11 subjects were girls (39%). We observed decreases in mean length of disease involvement (12.0±5.4 vs. 9.1±5.3 cm, P=0.02), maximum bowel wall thickness (5.6±1.8 vs. 4.7±1.7 mm, P=0.02), bowel wall color Doppler signal (1.7±0.9 vs. 1.2±0.8, P=0.002) and mesenteric color Doppler signal (1.1±0.9 vs. 0.6±0.6, P=0.005) at approximately 2 weeks following the initiation of infliximab compared to baseline. All laboratory inflammatory markers decreased at 1 month (P-valuesinfliximab, when adjusted for age, sex, azathioprine therapy, scanning radiologist and baseline short pediatric Crohn's disease activity index score. The ultrasound appearance of the bowel changes as early as 2 weeks after the initiation of infliximab therapy. There is strong correlation between bowel wall color Doppler signal and fecal calprotectin.

  10. Yellow fever vaccination during treatment with infliximab in a patient with ulcerative colitis: A case report.

    Science.gov (United States)

    Rüddel, J; Schleenvoigt, B T; Schüler, E; Schmidt, C; Pletz, M W; Stallmach, A

    2016-09-01

    We report the case of a 59-year-old patient who accidentally underwent live vaccination against yellow fever during continuous treatment with the TNF-α-antibody (AB) infliximab for ulcerative colitis. The clinical course showed fever of short duration and elevation of liver enzymes without further clinical complications. Yellow fever viremia was not detectable and protective antibodies were developed. A primary vaccination against yellow fever under infliximab has not been reported in the literature before, although vaccination is an important topic in IBD. Live vaccinations, like Stamaril(®) against yellow fever, are contraindicated during TNF-α-AB treatment. Treatment regimens containing TNF-α-AB are of growing importance, not only in gastroenterology, but also in rheumatology and dermatology. We discuss this topic by presenting our case and reviewing the current literature. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Severe Henoch-Schönlein purpura with infliximab for ulcerative colitis.

    Science.gov (United States)

    Song, Yang; Shi, Yan-Hong; He, Chong; Liu, Chang-Qin; Wang, Jun-Shan; Zhao, Yu-Jie; Guo, Yan-Min; Wu, Rui-Jin; Feng, Xiao-Yue; Liu, Zhan-Ju

    2015-05-21

    Infliximab (IFX) is an anti-tumor necrosis factor chimeric antibody that is effective for treatment of autoimmune disorders such as Crohn's disease and ulcerative colitis (UC). IFX is well tolerated with a low incidence of adverse effects such as infections, skin reactions, autoimmunity, and malignancy. Dermatological manifestations can appear as infusion reaction, vasculitis, cutaneous infections, psoriasis, eczema, and skin cancer. Here, we present an unusual case of extensive and sporadic subcutaneous ecchymosis in a 69-year-old woman with severe UC, partial colectomy and cecostomy, following her initial dose of IFX. The reaction occurred during infliximab infusion, and withdrawal of IFX led to gradual alleviation of her symptoms. We concluded that Henoch-Schönlein purpura, a kind of leukocytoclastic vasculitis, might have contributed to the development of the bruising. Although the precise mechanisms of the vasculitis are still controversial, such a case highlights the importance of subcutaneous adverse effects in the management of UC with IFX.

  12. A review of six methods for monitoring infliximab concentrations and antibodies to infliximab
.

    Science.gov (United States)

    Cao, Fang; Cao, Hailong; Cao, Xiaocang

    2017-07-01

    Anti-TNF-α therapy, such as infliximab (IFX), has profoundly changed treatment to induce and maintain remission for inflammatory bowel diseases patients who do not respond to conventional therapies. Unfortunately, IFX, as a chimeric protein, is potentially immunogenic, and antibodies to infliximab (ATI) may interfere with the pharmacodynamics and pharmacokinetics of the drug, thus resulting in a loss of response for a substantial proportion of patients. The clinical efficacy of IFX is correlated with the levels of IFX and ATI. Therefore, monitoring patients for the trough levels of IFX and the presence of ATI is very important. The procedures and characteristics of six assays for monitoring IFX and ATI are described in this review, and the comparisons between them are also discussed. To date, there has been no optimal assay for monitoring IFX and ATI. Therefore, many technical problems need to be solved to make therapeutic drug and immunogenicity monitoring a part of routine clinical management.
.

  13. Tur-samspil i musikterapi med børn med svære kommunikationsvanskeligheder

    DEFF Research Database (Denmark)

    Holck, Ulla

    2006-01-01

    præcisering af de træk ved barnets deltagelse i tur-samspillet, som kan indgå i musikterapeutisk assessment af samspil med kommunikationssvage børn. Klinisk tager artiklen udgangspunkt i musikterapeutisk samspil med børn med betydelige funktionsnedsættelser, herunder børn med autisme. Artiklens indhold...

  14. Biologic-free remission by orthopaedic surgery in non-responder to infliximab for rheumatoid arthritis.

    Science.gov (United States)

    Kanbe, Katsuaki; Chiba, Junji; Inoue, Yasuo; Taguchi, Masashi; Yabuki, Akiko

    2015-01-01

    The aim of this study was to investigate remission and biologic-free remission after orthopaedic surgery and related clinical factors in non-responder to infliximab for rheumatoid arthritis (RA). We analyzed 74 patients who were treated with 3 mg/kg infliximab and methotrexate and underwent orthopaedic surgery after non-responder to infliximab with disease activity score (DAS) 28 (CRP) of ≥3.2. The rates of remission and biologic-free remission at 52 weeks after orthopaedic surgery were investigated and the clinical factors related to remission and biologic-free remission were analyzed by logistic regression and receiver-operating characteristic analyses. The rates of total remission and biologic-free remission were 37/74 (50 %) and 9/74 (12.2 %), respectively. Regarding orthopaedic surgery, the rates of remission and biologic-free remission were 25/38 (65.8 %) and 7/38 (18.4 %) for synovectomy, 7/20 (35 %) and 0/20 (0 %) for arthroplasty, and 5/16 (31.3 %) and 2/16 12.5) for others including spine surgery and foot surgery. DAS28(CRP) at baseline was significantly related to both remission and biologic-free remission. Prednisolone was negatively associated with remission, and DAS28(CRP) was related to biologic-free remission by logistic regression analyses. DAS28(CRP) below 3.7 was cutoff point for acquiring biologic-free remission of non-responder to infliximab after orthopaedic surgery. Therefore orthopaedic surgery may be effective to obtain remission or biologic-free remission in RA patients treated with biologics.

  15. Episcleritis Related to Drug-Induced Lupus Erythematosus following Infliximab Therapy: A Case Report

    OpenAIRE

    Chatziralli, Irini P.; Kanonidou, Evgenia; Chatzirallis, Alexandros; Dimitriadis, Prodromos; Keryttopoulos, Petros

    2011-01-01

    Drug-induced lupus erythematosus is defined as a lupus-like syndrome temporally related to continuous drug exposure which resolves after discontinuation of the offending drug. Herein, we describe a patient with distinct clinical manifestations of anti-TNF-associated DILE related to infliximab therapy. The patient exhibited clinical and laboratory findings of lupus-like illnesses as well as ocular disorders, such as episcleritis. The main message is that the symptoms of DILE should not be over...

  16. Visceral leishmaniasis with cutaneous symptoms in a patient treated with infliximab followed by fatal consequences.

    Science.gov (United States)

    Juzlova, Katerina; Votrubova, Jana; Kacerovska, Denisa; Lukas, Milan; Bortlik, Martin; Rohacova, Hana; Nohynkova, Eva; Vojackova, Nadezda; Fialova, Jorga; Hercogova, Jana

    2014-01-01

    Leishmaniasis is an infectious disease caused by parasitic flagellates of the genus Leishmania. The authors present a case of 44-year-old man with Crohn's disease treated successfully with infliximab. This case report shows rare visceral leishmaniasis with cutaneous symptoms in an immunocompromised patient. Skin manifestations may occur before or after the visceral infection and they are often diverse. © 2013 Wiley Periodicals, Inc.

  17. Efficacy of infliximab in refractory posterior uveitis in Behcet's disease patients

    OpenAIRE

    Ayman K. El Garf; Amira A. Shahin; Sherif A. Shawky; Mohammed A. Azim; Dina A. Effat; Sherry K. Abdelrahman

    2018-01-01

    Aim of the work: Ocular manifestations are the main cause of morbidity in Behcet's disease (BD). Infliximab (IFX), a chimeric monoclonal antibody directed against tumor necrosis factor-alpha, may be efficient in refractory uveitis due to BD. The aim of this study was to assess the efficacy and safety of IFX in the treatment of patients with BD-associated refractory posterior uveitis (PU). Patient and Methods: Twenty patients with refractory Behcet's PU received IFX therapy as intravenous infu...

  18. Absence of radiographic progression of hip arthritis during infliximab treatment for ankylosing spondylitis.

    Science.gov (United States)

    Konsta, M; Sfikakis, P P; Bournia, V K; Karras, D; Iliopoulos, A

    2013-08-01

    This study aims to examine the impact of long-term treatment with the anti-TNF antibody infliximab on radiographic progression of hip arthritis in ankylosing spondylitis. Anteroposterior X-rays of the pelvis obtained at baseline from consecutive patients with ankylosing spondylitis and bilateral hip arthritis were compared with X-rays obtained after 6 ± 2.5 years (mean ± SD) of continuous infliximab treatment. Analysis was performed by the Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-h) scoring system (min 0, max 4). Hip joint space width was also assessed by the average of measurements at three distinct sites between the acetabulum and femoral head. In 23 patients with active disease (21 men, mean age and disease duration of 45 and 16 years, respectively), the BASRI-h score at baseline was 1 in 7, 2 in 16, 3 in 16, and 4 in 7 hips (including two arthroplasties). Individual BASRI-h scores at baseline (2.50 ± 0.86, mean ± SD) remained unchanged in all patients at end of follow-up. At baseline, the average width of the whole joint space (3.56 ± 0.70 mm, n = 44) was not associated with disease activity measurements but negatively correlated with BAS functional index (Spearman r = -0.5, P = 0.007). After 2-10 years of infliximab treatment, the average width of the whole joint space in these patients (3.59 ± 0.79 mm) was not reduced. These results suggest that radiographic progression of hip arthritis in ankylosing spondylitis may be arrested during infliximab treatment.

  19. Infliximab for the Treatment of Crohn'S Disease: Review and Indications for Clinical Use in Canada

    Directory of Open Access Journals (Sweden)

    Remo Panaccione

    2001-01-01

    Full Text Available Crohn's disease is a chronic inflammatory disorder of the gastrointestinal tract. It may affect any portion of the gastrointestinal tract from the mouth to the anus. Symptoms typically include cramping abdominal pain, diarrhea (which may be bloody and nausea. As the severity of the illness worsens, patients may experience constant abdominal pain, vomiting, weight loss and fever. From the perspective of the patient, disease symptoms significantly impair quality of life, and interfere with their work environment and activities of daily living. Unfortunately, there is no cure for Crohn's disease. Patients experience a chronic, relapsing course characterized by recurrent flares of their disease. Conventional medical treatment of Crohn's disease includes the use of non-specific anti-inflammatory drugs (5-aminosalicylic acid agents, prednisone, budesonide, immunosuppressives (6-mercaptopurine, azathioprine, methotrexate and antibiotics. A variable onset of action, incomplete response rates and a significant risk of adverse effects characterize current therapies. Although surgery is frequently used to treat complications or medically refractory disease, postoperative recurrence is a common problem. Infliximab, a murine chimeric monoclonal antibody directed toward tumour necrosis factor-alpha, is a highly effective treatment of active Crohn's disease. In randomized, placebo-controlled clinical trials, 33% of patients treated with infliximab 5 mg/kg achieved remission (Crohn's Disease Activity Index score less than 150, compared with only 4% of those receiving placebo (P<0.001. Additionally, infliximab is the only drug therapy shown to be effective for the treatment of fistulizing Crohn's disease. In studies done to date, infliximab appears to be well tolerated and has a favourable side effect profile.

  20. Efficacy of Infliximab Biosimilar CT-P13 Induction Therapy on Mucosal Healing in Ulcerative Colitis.

    Science.gov (United States)

    Farkas, Klaudia; Rutka, Mariann; Golovics, Petra A; Végh, Zsuzsanna; Lovász, Barbara D; Nyári, Tibor; Gecse, Krisztina B; Kolar, Martin; Bortlik, Martin; Duricova, Dana; Machkova, Nadezda; Hruba, Veronika; Lukas, Martin; Mitrova, Katarina; Malickova, Karin; Bálint, Anita; Nagy, Ferenc; Bor, Renáta; Milassin, Ágnes; Szepes, Zoltán; Palatka, Károly; Lakatos, Péter L; Lukas, Milan; Molnár, Tamás

    2016-11-01

    CT-P13 is the first biosimilar to infliximab that has been approved for the same indications as its originator infliximab. No data are available on the effect of infliximab biosimilar on mucosal healing. The aim of this study was to evaluate the efficacy of CT-P13 induction therapy on mucosal healing in patients with ulcerative colitis [UC]. UC patients, who received CT-P13 therapy from its local introduction at three Hungarian and one Czech inflammatory bowel disease centres, were prospectively enrolled. Sigmoidoscopy was performed after the end of the induction therapy at week 14. Mucosal healing was defined as Mayo endoscopic subscore 0 or 1. Complete mucosal healing was defined as Mayo endoscopic subscore 0. Trough level of CT-P13 was measured at week 14. Sixty-three UC patients who underwent CT-P13 induction therapy were enrolled in the study. Indication for the therapy was acute, severe flare up and chronic, refractory activity in 24 and 39 patients, respectively. Cumulative clinical response and steroid-free remission at week 14 were achieved in 82.5% and 47.6% of the patients, respectively. Sigmoidoscopy revealed steroid-free mucosal healing in 47.6% of the patients, and complete mucosal healing was present in 27%. Mayo endoscopic subscore decreased significantly at week 14 compared to baseline. Trough levels of infliximab correlated with mucosal healing. This is, to our knowledge, the first study examining the efficacy of CT-P13 induction therapy on mucosal healing in UC. The results indicate that mucosal healing is achieved in two-thirds of UC patients by the end of the induction treatment with CT-P13. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  1. Good response to infliximab in rheumatoid arthritis following failure of interleukin-1 receptor antagonist.

    Science.gov (United States)

    Bao, Jun; Yue, Tao; Li, Ting; He, Dong-Yi; Bao, Yi-Xiao

    2016-04-01

    To evaluate the efficacy of tumor necrosis factor inhibitor infliximab in patients with rheumatoid arthritis (RA) who were disease-resistant to recombinant human interleukin-1 receptor antagonist (IL-1Ra). A total of 104 patients with active RA despite methotrexate (MTX) treatment were enrolled in the open trial. Among them, 27 IL-1Ra nonresponders 'Switchers' and 51 biologic-naive patients 'Naivers' received an infusion of 3 mg/kg infliximab at weeks 0, 2, 6 and 14, combined with concurrent MTX therapy, while the other 26 patients who had never received any biologics 'Controls' continued MTX monotherapy. Clinical outcomes and safety were assessed at weeks 0, 2 and every 4 weeks thereafter for 18 weeks with the American College of Rheumatology (ACR) core set criteria, the Disease Activity Score in 28 joints, and records of adverse events (AEs) and abnormal laboratory findings. At week 18, an ACR20 response was achieved in 56% of Switchers and 61% of Naivers, compared with 23% of Controls (P = 0.0013 and 0.0126, respectively). Compared with Controls, both Switchers and Naivers achieved a significant improvement in tender-joint count, swollen-joint count, patient's assessment of pain, patient's and physician's global assessment of disease activity, erythrocyte sedimentation rate and C-reactive protein. Switchers even achieved a greater benefit from health assessment questionnaire (HAQ) scores than Naivers. Infliximab was well tolerated, with a similar incidence of AEs across all study groups. Switching from IL-1Ra to infliximab is effective in improving disease activity and maintaining joint function. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  2. Induction and maintenance infliximab therapy in children with moderate to severe ulcerative colitis: Retrospective, multicenter study.

    Science.gov (United States)

    Iwańczak, Barbara M; Kierkuś, Jarosław; Ryżko, Józef; Szczepanik, Mariusz; Więcek, Sabina; Czaja-Bulsa, Grażyna; Kacperska, Magdalena; Korczowski, Bartosz; Maślana, Jolanta; Iwańczak, Franciszek

    2017-01-01

    Pediatric ulcerative colitis (UC) is a severe disease characterised by the presence of extensive inflammatory lesions in the colon. The administration of intravenous corticosteroids is recommended in patients with acute relapse of the disease, whereas early treatment with cyclosporine, tacrolimus or infliximab is recommended if there is no improvement. The aim of this study was to retrospectively evaluate the efficacy and safety of infliximab therapy in the treatment of moderate-to-severe and severe relapse of pediatric UC. The analysis included 42 children aged 4-18 years (23 girls, 19 boys) treated in 7 pediatric gastroenterology departments in Poland during the past 4 years. The disease duration ranged from 2 to 100 months. The clinical activity of UC ranged from 35 to 85 points according to the PUCAI scale. Twenty-one children were diagnosed with pancolitis, 10 children with extensive UC, and the remaining with the left-sided UC. In the induction therapy infliximab was administered at doses of 5 mg/kg in the 0.2 and 6 weeks, and after the clinical response every 8 weeks to 12 months. Treatment results were assessed in 10 and 54 weeks. After the induction therapy the clinical response was achieved in 14 children (33.33%) and clinical remission in 11 children (26.19%). Two children required surgical treatment, and the remaining 2 suffered from anaphylactic shock. After the maintenance therapy clinical remission was maintained in 12 children (57.14%), whereas 3 children required surgery (colectomy). Infliximab therapy in children with moderate-to-severe UC induces remission and, in some children, proves to be effective in preventing early colectomy.

  3. A Severe Case of Ipilimumab-Induced Ileocolitis Refractory to Glucocorticosteroids and Infliximab

    Directory of Open Access Journals (Sweden)

    Behdod Poushanchi

    2018-01-01

    Full Text Available Ipilimumab is a monoclonal antibody that works as an immunotherapeutic agent through selective targeting of T cells to strengthen the response to metastatic melanoma. It is well known that this pharmaceutical agent can cause the adverse effect of colitis. We report a rare presentation of ileocolitis refractory to both glucocorticosteroids and infliximab with a resultant pneumatosis and perforation requiring subtotal colectomy and end ileostomy.

  4. Neuropathie périphérique sous Infliximab: étude d'une observation ...

    African Journals Online (AJOL)

    Les traitements Anti TNF alpha sont de prescription de plus en plus large. Des événements secondaires multiples ont été rapportés ses dernières années, en particulier les neuropathies périphériques. Nous rapportons un cas de neuropathie axonale survenant trois mois après le début d'un traitement par Infliximab. Il s'agit ...

  5. Crohn's Disease Associated with Sweet's Syndrome and Sjögren's Syndrome Treated with Infliximab

    Directory of Open Access Journals (Sweden)

    Erina N. Foster

    2005-01-01

    Full Text Available The association of Crohn's disease (CD and Sweet's syndrome is rare and the presence of Sjögren's syndrome in Crohn's disease is even rarer, with only three reports found in the literature. We describe two cases of Crohn's disease associated with Sweet's syndrome, one of which is the first case of CD and Sweet's concomitantly associated with Sjögren's syndrome. Both cases responded rapidly to Infliximab therapy with complete resolution of the skin lesions.

  6. Treatment of psoriasis: focus on clinic-based management with infliximab.

    Science.gov (United States)

    de Eusebio, Esther; Armario-Hita, José Carlos; de Miquel, Víctor Alegre

    2014-02-01

    Psoriasis is a disabling chronic inflammatory condition of the skin and joints that typically requires long-term treatment. Recommended treatments for psoriasis include a wide range of topical and systemic options, from topical agents and targeted phototherapy for mild psoriasis to traditional systemic agents such as methotrexate, cyclosporine and acitretin for more serious disease. The introduction of targeted biological agents such as T-cell-modulating agents, tumor necrosis factor α (TNFα) antagonists and interleukin (IL)-12 and IL-23 inhibitors has provided new choices for the management of psoriasis and psoriatic arthritis that may offer better long-term efficacy and tolerability than traditional approaches. Most biological agents are administered by subcutaneous injection. Infliximab, a TNFα antagonist, is the only biological agent approved for psoriasis that is administered by intravenous infusion, in the setting of hospital-based or specialized infusion center-based clinics. Infliximab allows weight-based dosing and may offer more rapid disease control than other biological agents, with significant improvements seen as early as 1 week after treatment initiation. This article gives an overview of psoriasis management, focusing on clinic-based infusion therapy with infliximab.

  7. Identification of acute phase reactants and cytokines useful for monitoring infliximab therapy in ankylosing spondylitis.

    Science.gov (United States)

    Romero-Sánchez, Consuelo; Robinson, William H; Tomooka, Beren H; Londoño, John; Valle-Oñate, Rafael; Huang, Feng; Deng, Xiaohu; Zhang, Liyun; Yang, Chunhua; Yu, David Tak Yan

    2008-11-01

    Although most ankylosing spondylitis patients show an apparent clinical response to infliximab therapy, there is considerable individual variation. Because current clinical assessment relies heavily on subjective patient self-evaluation, biomarkers of high sensitivity and specificity are much needed. Here, we assessed potential biomarkers in 47 ankylosing spondylitis patients who received three standard pulses of infliximab. Before each infusion and at week 10, the following were measured: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet count, serum levels of metalloproteinase-3 (MMP-3), and 22 different cytokines. We discovered that, 2 weeks after the first infusion, the combination of ESR, CRP, and platelet count distinguished responders from non-responders with 81.3% sensitivity and 72.7% specificity. The distinguishing power was much less when each acute phase reactant was used alone. Among the 22 cytokines, serum IL-1alpha was able to distinguish responders from non-responders at week 6, with sensitivity of 84.9% and specificity of 53.8%. Serum IL-1alpha was probably generated from the joint compartments, as synovial fluid levels were much higher than corresponding serum levels. Although infliximab infusions led to rapid and significant suppression of serum MMP-3 levels, serum MMP-3 levels did not distinguish responders from non-responders. Besides identifying potential biomarkers, our results also demonstrate the usefulness of using sensitivity and specificity to assess usefulness of potential biomarkers.

  8. EFFECTIVENESS AND SAFETY OF INFLIXIMAB IN PATIENTS WITH EARLY AND LATE JUVENILE RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    Е.I. Alexeeva

    2010-01-01

    Full Text Available The article presents results of a study of effectiveness and safety of infliximab — monoclonal antibodies to the tumor necrotizing factor (TNF in treatment of 100 patients11 months — 17 years old with early and late articular types of juvenile rheumatoid arthritis. The duration of treatment was 3 months — 2 years. Infliximap was delivered intravenously by scheme: infusion on 0, 2nd, 6th weeks and then every 8th week. The single dose of infliximab in patients with early rheumatoid arthritis was 6.7 (5.5; 9.0 mg/kg, with late type — 6.0 (5.0; 7.0 mg/kg of body weight. 102 weeks of treatment with anti-TNF-agent provided development of clinical remission, decrease and normalization of laboratory tests of disease’s activity, total restoration of joint’s function, increase of quality of life (on 97% in patients with early type, and 72% 0 in ones with late type. The drug was abolished in 39 (39% of patients, 23% — due to the development of secondary inefficiency, and 11% — due to the development of unfavorable effects.Key words: children, early and late rheumatoid arthritis, treatment, infliximab.(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(3:30-42

  9. The effect of infliximab on depressive symptoms in patients with ankylosing spondylitis.

    Science.gov (United States)

    Ersözlü-Bozkırlı, E D; Keşkek, S O; Bozkırlı, E; Yücel, A E

    2015-01-01

    Ankylosing spondylitis is a chronic inflammatory disease which physically, psychologically, and socially affects the patient's life. Previous studies have reported a correlation between ankylosing spondylitis and depression. In this study we investigated the effect of infliximab on depression in ankylosing spondylitis patients. A total of 29 patients with ankylosing spondylitis were enrolled in this prospective study. Infliximab was administered intravenously at a dose of 5 mg/kg at baseline, weeks 2 and 6. The measurements of morning stiffness, modified Schober's test, chest expansion, erythrocyte sedimentation rate, C-reactive protein, Bath ankylosing spondylitis disease activity index, Bath ankylosing spondylitis functional index and Beck depression inventory scores were compared with baseline and 12th week. The modified Schober's test and chest expansion increased, the morning stiffness duration, erythrocyte sedimentation rate and C-reactive protein levels decreased after infliximab treatment (p ankylosing spondylitis disease activity index, Bath ankylosing spondylitis functional index and Beck depression invantory scores of patients after 12 weeks (p ankylosing spondylitis..

  10. Infliximab-induced skin manifestations in patients with inflammatory bowel disease.

    Science.gov (United States)

    Hellström, Alec Eligius; Färkkilä, Martti; Kolho, Kaija-Leena

    2016-01-01

    The use of infliximab in rheumatoid and inflammatory bowel diseases (IBD) has been associated with a variety of adverse skin reactions, including paradoxical psoriatic lesions. The prevalence and possible predictors for these lesions were under observation in our cross-sectional prospective study. Nurses screened the skin of 118 adult patients with IBD during infliximab infusions between 4 September 2013 and 30 September 2014 based on the structured questionnaire. Data on skin manifestations, concomitant medications, extraintestinal manifestations and inflammatory markers were collected for analysis. Non-infectious skin manifestations were observed in 27 (22.9%) patients during the study period, of which eight (29.6%) were new-onset, eight (29.6%) were exacerbations of existing lesions and 11 (40.7%) were baseline lesions that did not worsen during the study. Scaling eczema was the most commonly described skin manifestation (n = 8; 29.6%), followed by exacerbated atopic eczema (n = 5; 18.5%) and plausible infliximab-induced psoriasiform lesions (n = 5; 18.5%). The strongest associating factor for skin manifestations was Crohn's disease, in nearly 80% of afflicted patients. Anti-TNF-α therapy is frequently associated with newly onset skin reactions, most commonly in patients with Crohn's disease. Non-infectious skin manifestations can be treated topically and do not require cessation of anti-TNF-α therapy.

  11. Efficacy and safety of infliximab in psoriatic patients over the age of 65.

    Science.gov (United States)

    Chiricozzi, Andrea; Pavlidis, Athanasios; Dattola, Annunziata; Bianchi, Luca; Chimenti, Maria Sole; Fida, Monika; Saraceno, Rosita

    2016-11-01

    Clinical data on the long-term safety and efficacy of infliximab on psoriatic patients who are older than 65 years are limited. The aim is to report the long-term efficacy, safety and tolerance of infliximab in geriatric patients. This was a retrospective study conducted at the Department of Dermatology of the University of Rome Tor Vergata. Clinical data were reported at week 12, 52, 104, 208. 151 charts were evaluated. A total of 27 patients were included. Range of the age was between 65 and 85 years; mean age was 73 years ±5.4; female to male ratio was 1:2; mean age of onset of psoriasis was 43 years±17. The average of treatment duration was 39 months ±27 (range 1-100). Fourteen patients suffered from plaque type psoriasis and 13 from psoriatic arthritis. At the baseline the mean PASI score was 15.6 ± 10.2. At week 12, 52, 104, and 208 the mean PASI was 2, 2.3, 1.9 and 1.8 respectively. A reduction in the mean PASI was maintained in the long-term treatment in 12 patients (p infliximab is effective and safe in patients over 65 years old and that IV therapy is also associated with a high compliance.

  12. Effect of infliximab top-down therapy on weight gain in pediatric Crohns disease.

    Science.gov (United States)

    Kim, Mi Jin; Lee, Woo Yong; Choi, Kyong Eun; Choe, Yon Ho

    2012-12-01

    This retrospective-medical-record review was conducted to evaluate effect of infliximab therapy, particularly with a top-down strategy, on the nutritional parameters of children with Crohns disease (CD). 42 patients who were diagnosed with Crohns disease at the Pediatric Gastroenterology center of a tertiary care teaching hospital and achieved remission at two months and one year after beginning of treatment were divided into four subgroups according to the treatment regimen; azathioprine group (n = 11), steroid group (n = 11), infliximab top-down group (n = 11) and step-up group (n = 9). Weight, height, and serum albumin were measured at diagnosis, and then at two months and one year after the initiation of treatment. At 2 months, the Z score increment for weight was highest in the steroid group, followed by the top-down, step-up, and azathioprine groups. At one year, the Z score increment was highest in top-down group, followed by steroid, azathioprine, and step-up group. There were no significant differences between the four groups in Z score increment for height and serum albumin during the study period. The top-down infliximab treatment resulted in superior outcome for weight gain, compared to the step-up therapy and other treatment regimens.

  13. Efficacy and safety of dose escalation of infliximab therapy in Japanese patients with psoriasis: Results of the SPREAD study.

    Science.gov (United States)

    Torii, Hideshi; Nakano, Masayuki; Yano, Toshiro; Kondo, Kazuoki; Nakagawa, Hidemi

    2017-05-01

    Although infliximab is approved for psoriasis, its efficacy is reduced over time in some patients. The aim of this phase III trial is to evaluate efficacy and safety of infliximab dose escalation in Japanese psoriasis patients with loss of efficacy to standard-dose therapy. Patients with plaque psoriasis, psoriatic arthritis, pustular psoriasis or psoriatic erythroderma who showed loss of efficacy to standard-dose therapy received infliximab dose escalation (10 mg/kg every 8 weeks) from weeks 0 to 32. Loss of efficacy was defined as not maintaining 50% reduction in the Psoriasis Area and Severity Index (PASI 50) after achieving PASI 75. Efficacy and safety were evaluated up to week 40. Fifty-one patients received dose escalation and 43 completed the study. PASI 75 and median improvement rate of PASI score at week 40 were 44% and 70.0%, respectively, showing efficacy in skin symptoms. Efficacies in quality of life, nail psoriasis and joint pain were also obtained. Median serum infliximab level increased from less than 0.1 to 1.1 μg/mL from weeks 0 to 40, showing positive correlation between efficacy and serum infliximab level at week 40. Favorable efficacy was observed in patients with detectable serum infliximab levels (≥0.1 μg/mL) at baseline. Incidences of adverse events, serious adverse events, serious infections and serious infusion reactions were 92%, 10%, 4% and 0%, respectively. No marked difference was observed in both efficacy and safety among psoriasis types. No new safety concerns were observed. Infliximab dose escalation was effective and well-tolerated in psoriasis patients with loss of efficacy to standard-dose therapy, suggesting that dose escalation may be a useful therapeutic option for these patients. © 2016 The Authors. The Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Dermatological Association.

  14. Accelerated Infliximab Infusion: Safety, Factors Predicting Adverse Events, Patients' Satisfaction and Cost Analysis. A Cohort Study in IBD Patients.

    Science.gov (United States)

    Mazzuoli, S; Tricarico, D; Demma, F; Furneri, G; Guglielmi, F W

    2016-01-01

    Standard Infliximab infusion consists of a 2-hour intravenous administration. Recently, Infliximab shortened infusion has been included in the Infliximab label as possible maintenance regimen for patients tolerating Infliximab induction therapy. To verify if accelerated 1-hour Infliximab infusions are as safe as standard administrations, in patients with Inflammatory Bowel Disease. Seventy-four patients treated between September 2008 and November 2014 were evaluated. Patients were eligible for 1-hour infusion if they had no history of infusion reactions during the previous 2-hour infusions. Twenty-three patients received 2-hour infusions, 16 patients received 1-hour infusions, 35 patients received 2-hour infusions followed by 1-hour infusions. A total of 1,123 Infliximab infusions were administered. The proportion of patients experiencing infusion reaction was: 4% over the 1-hour infusions and 9% over the 2-hour (P = 0.318). Adverse reaction/infusion rate was 0.55% over the 1-hour infusions and 0.66% over the 2-hour (P = 0.835). In the logistic model, accelerated infusion was the only statistically significant predictor of infusion reaction risk reduction (-90%; P = 0.024). Mean satisfaction was 8/10 (±0.84) with 1-hour regimen and 6/10 (±0.56) with 2-hour infusions (P = 0.000). The mean total cost was reduced by 47% with the 1-hour regimen (133.54€ and 250.86€ for 1-hour and 2-hour infusions, respectively). Accelerated Infliximab infusion does not increase the acute infusion reaction incidence. In patients with inflammatory bowel disease, the 1-hour regimen should be preferred to 2-hour protocol also due to positive effects on indirect costs and patient's satisfaction.

  15. Transcriptional Signatures Related to Glucose and Lipid Metabolism Predict Treatment Response to the Tumor Necrosis Factor Antagonist Infliximab in Patients with Treatment-Resistant Depression

    Science.gov (United States)

    Mehta, Divya; Raison, Charles L.; Woolwine, Bobbi J.; Haroon, Ebrahim; Binder, Elisabeth B.; Miller, Andrew H.; Felger, Jennifer C.

    2013-01-01

    The tumor necrosis factor (TNF) antagonist infliximab was recently found to reduce depressive symptoms in patients with increased baseline inflammation as reflected by a plasma C-reactive protein concentration >5mg/L. To further explore predictors and targets of response to infliximab, differential gene expression was examined in peripheral blood mononuclear cells from infliximab responders (n=13) versus non-responders (n=14) compared to placebo at baseline and 6hr, 24hr, and 2 weeks after the first infliximab infusion. Treatment response was defined as 50% reduction in depressive symptoms at any point during the 12-week trial. One-hundred-forty-eight gene transcripts were significantly associated (1.2 fold, adjusted p≤0.01) with response to infliximab and were distinct from placebo responders. Transcripts predictive of infliximab response were associated with gluconeogenesis and cholesterol transport, and were enriched in a network regulated by hepatocyte nuclear factor (HNF)4-alpha, a transcription factor involved in gluconeogenesis and cholesterol and lipid homeostasis. Of the 148 transcripts differentially expressed at baseline, 48% were significantly regulated over time in infliximab responders, including genes related to gluconeogenesis and the HNF4-alpha network, indicating that these predictive genes were responsive to infliximab. Responders also demonstrated inhibition of genes related to apoptosis through TNF signaling at 6hr and 24hr after infusion. Transcripts down-regulated in responders 2 weeks after infliximab were related to innate immune signaling and nuclear factor-kappa B. Thus, baseline transcriptional signatures reflective of alterations in glucose and lipid metabolism predicted antidepressant response to infliximab, and infliximab response involved regulation of metabolic genes and inhibition of genes related to innate immune activation. PMID:23624296

  16. Tratamento com infliximabe da doença de Behçet ativa Therapy with infliximab in active Behçet's disease

    Directory of Open Access Journals (Sweden)

    Alexandre Wagner Silva de Souza

    2005-04-01

    Full Text Available Os autores descrevem o caso de uma paciente de 41 anos de idade com diagnóstico de doença de Behçet, diagnosticada em abril de 2000. A paciente apresentava envolvimento mucocutâneo, articular e neurológico persistentes, apesar do tratamento com colchicina, corticosteróides e metotrexato, durante os três anos que se seguiram ao diagnóstico. Em abril de 2003, a paciente mantinha-se com a doença ativa, necessitando de altas doses de corticosteróides e de metotrexato. Optou-se, então, pela administração do infliximab, 3mg/kg por via endovenosa. Uma semana depois, havia ocorrido regressão completa das manifestações da doença de Behçet nesta paciente.The authors describe the case of a 41 years old woman with the diagnosis of Behçet's syndrome since April 2000, when she presented mucocutaneous, articular and ocular manifestations. The disease remained active despite of the treatment with colchicine, corticosteroid and methotrexate, during the three years following diagnosis. In April 2003, the patient still needed high doses of corticosteroid and methotrexate. Nevertheless, the disease remained active. Treatment with infliximab was then started with intravenous 3 mg/Kg and, one week later, all the manifestations of this patient were in complete remission.

  17. Switching from originator infliximab to biosimilar CT-P13 compared with maintained treatment with originator infliximab (NOR-SWITCH): a 52-week, randomised, double-blind, non-inferiority trial.

    Science.gov (United States)

    Jørgensen, Kristin K; Olsen, Inge C; Goll, Guro L; Lorentzen, Merete; Bolstad, Nils; Haavardsholm, Espen A; Lundin, Knut E A; Mørk, Cato; Jahnsen, Jørgen; Kvien, Tore K

    2017-06-10

    TNF inhibitors have improved treatment of Crohn's disease, ulcerative colitis, spondyloarthritis, rheumatoid arthritis, psoriatic arthritis, and chronic plaque psoriasis, but are expensive therapies. The aim of NOR-SWITCH was to examine switching from originator infliximab to the less expensive biosimilar CT-P13 regarding efficacy, safety, and immunogenicity. The study is a randomised, non-inferiority, double-blind, phase 4 trial with 52 weeks of follow-up. Adult patients on stable treatment with infliximab originator treated in a hospital setting for at least 6 months were eligible for participation. Patients with informed consent were randomised in a 1:1 ratio to either continued infliximab originator or to switch to CT-P13 treatment, with unchanged dosing regimen. Data were collected at infusion visits in 40 Norwegian study centres. Patients, assessors, and patient care providers were masked to treatment allocation. The primary endpoint was disease worsening during 52-week follow-up. 394 patients in the primary per-protocol set were needed to show a non-inferiority margin of 15%, assuming 30% disease worsening in each group. This trial is registered with ClinicalTrials.gov, number NCT02148640. Between Oct 24, 2014, and July 8, 2015, 482 patients were enrolled and randomised (241 to infliximab originator, 241 to CT-P13 group; one patient was excluded from the full analysis and safety set for CT-P13) and 408 were included in the per-protocol set (202 in the infliximab originator group and 206 in the CT-P13 group). 155 (32%) patients in the full analysis set had Crohn's disease, 93 (19%) had ulcerative colitis, 91 (19%) had spondyloarthritis, 77 (16%) had rheumatoid arthritis, 30 (6%) had psoriatic arthritis, and 35 (7%) had chronic plaque psoriasis. Disease worsening occurred in 53 (26%) patients in the infliximab originator group and 61 (30%) patients in the CT-P13 group (per-protocol set; adjusted treatment difference -4·4%, 95% CI -12·7 to 3·9). The

  18. Retreatment and maintenance therapy with infliximab in fistulizing Crohn' disease Retratamiento y tratamiento de mantenimiento con infliximab en la enfermedad de Crohn fistulizante

    Directory of Open Access Journals (Sweden)

    L. Rodrigo

    2004-08-01

    Full Text Available Objectives: infliximab has clearly demonstrated its efficacy in the short-term treatment of fistulizing Crohn' disease. We present here the results of retreatment and long-term maintenance therapy. Patients and methods: eighty one consecutive patients with active fistulizing Crohn' disease, in whom previous treatments had failed, were treated with infliximab. All patients received as the initial treatment of 5 mg/kg i.v. infusions (weeks 0, 2, and 6. Those patients who failed to respond after the initial cycle (group 1, n= 25, or those who relapsed after having responded (group 2, n=13, received retreatment with three similar doses (weeks 0,2, and 6. Those who responded to retreatment were included in a long-term maintenance programme (n=44, with repeated doses (5 mg/kg i.v. infusions every eight weeks for 1-2 years. Results: in the initial treatment 56% of the patients responded partially; this response being complete in 44%. In the retreatment, 28% of group 1 (non-responders presented a complete response, compared to 77% in group 2 (relapsers (pObjetivos: el infliximab ha demostrado su eficacia en el tratamiento a corto plazo de la enfermedad de Crohn (EC fistulosa. En este trabajo presentamos los resultados del retratamiento y del tratamiento de mantenimiento a largo plazo. Pacientes y métodos: se trataron con infliximab un total de 81 pacientes consecutivos con EC fistulosa activa, en los cuales, habían fallado tratamientos previos. Todos los pacientes recibieron como tratamiento inicial infusiones a dosis de 5 mg/kg i.v. en las semanas 0, 2 y 6. Aquellos pacientes que no respondieron después del ciclo inicial (grupo 1, n=25, o los que recayeron después de haber respondido (grupo 2, n=13, recibieron retratamiento con 3 dosis similares (semanas 0, 2 y 6. Aquellos que respondieron a la terapia de retratamiento fueron incluidos en un programa de mantenimiento a largo plazo (n=44, con dosis repetidas (infusiones con 5 mg/kg i.v. cada 8

  19. Tandlægers erfaringer med at foreslå og få gennemført behandling med kroner og broer i privat praksis [Experiences of Danish dentists in private practice in motivating treatment with crowns and bridges

    DEFF Research Database (Denmark)

    Isidor, F.; Moore, R.

    2003-01-01

    English:What subjective experiences have Danish dentists in private practice to propose and implement treatment with crowns and bridges? A mailed questionnaire were completed and returned by 216 private practice dentists for a random sample from Aarhus. Of these, 22% thought that it was uncomfort......English:What subjective experiences have Danish dentists in private practice to propose and implement treatment with crowns and bridges? A mailed questionnaire were completed and returned by 216 private practice dentists for a random sample from Aarhus. Of these, 22% thought...... that it was uncomfortable to propose crowns and bridges to the patients, 20% thought it was mostly without problems, while 57% had no problems. The dentists also stated that of the patients who came recommended crowning a molar, it is on average only 36% there actually get this treatment. The dentists felt that its...... and bridges, or lack of success in getting treatment completed hung mostly with practice type and location. Almost 76% of the dentists felt that it should be possible to learn how to motivate patients for the expensive treatments (eg bridges). More than 90% of the dentists felt the need for a better insurance...

  20. Politiske diskussioner med familie og venner

    DEFF Research Database (Denmark)

    Levinsen, Klaus; Yndigegn, Carsten

    2016-01-01

    Unge mennesker diskuterer gerne politik med familie og venner, men de er tilbøjelige til at undgå at diskutere politik med personer, der har andre holdninger end dem selv – både når det drejer sig om deres familiemedlemmer, venner og kærester.......Unge mennesker diskuterer gerne politik med familie og venner, men de er tilbøjelige til at undgå at diskutere politik med personer, der har andre holdninger end dem selv – både når det drejer sig om deres familiemedlemmer, venner og kærester....

  1. Enhanced CCR9 expression levels in psoriatic skin are associated with poor clinical outcome to infliximab treatment.

    Science.gov (United States)

    Koga, Aiko; Kajihara, Ikko; Yamada, Saori; Makino, Katsunari; Ichihara, Asako; Aoi, Jun; Makino, Takamitsu; Fukushima, Satoshi; Jinnin, Masatoshi; Ihn, Hironobu

    2016-05-01

    Infliximab is an anti-tumor necrosis factor (TNF)-α antibody drug that suppresses TNF-α and its associated inflammatory responses. Although infliximab therapy generally results in a 75% or greater improvement in the Psoriasis Area and Severity Index from baseline in psoriasis patients, there is the heterogeneity of therapeutic efficacy in psoriasis patients among patients of a similar PASI baseline score. However, there are few published reports about the predictors of the clinical response among psoriasis patients who undergo biologic therapies. We thus evaluated the possible existence of biologic markers that would indicate poor prognosis of infliximab using skin biopsy specimens. This was because we assumed that the inhibitors for upregulated chemokine/chemokine receptors in non-responders may have the ability to reduce the occurrence of psoriatic eruptions. PCR array analyses identified that the levels of various chemokines and chemokine receptors were increased in non-responders in comparison to responders. Immunohistochemical analyses revealed that upregulation of the CCR9 protein levels was not associated with the pretherapeutic PASI score, but with poor response to infliximab. Our results indicated that the expression levels of CCR9 in lesional skin may be a useful biologic marker of the clinical efficacy of infliximab therapy in psoriasis patients. © 2015 Japanese Dermatological Association.

  2. The frequency of anti-infliximab antibodies in patients with rheumatoid arthritis treated in routine care and the associations with adverse drug reactions and treatment failure

    DEFF Research Database (Denmark)

    Krintel, Sophine B; Grunert, Veit Peter; Hetland, Merete L

    2013-01-01

    To investigate the frequency of anti-infliximab antibodies in patients with RA and the associations with adverse drug reactions and treatment failure.......To investigate the frequency of anti-infliximab antibodies in patients with RA and the associations with adverse drug reactions and treatment failure....

  3. Individualized Therapy Is a Long-Term Cost-Effective Method Compared to Dose Intensification in Crohn's Disease Patients Failing Infliximab

    DEFF Research Database (Denmark)

    Steenholdt, Casper; Brynskov, Jørn; Thomsen, Ole Ø

    2015-01-01

    or by infliximab intensification. However, the sum of healthcare costs related to Crohn's disease was substantially lower (31 %) for patients randomized to algorithm-based interventions than infliximab intensification in the intention-to-treat population: $11,940 versus $17,236; p = 0.005. For per...

  4. Hva er det med Irma?

    Directory of Open Access Journals (Sweden)

    Anne Beate Reinertsen

    2016-10-01

    Full Text Available Abstract: This article is about formative quality assessment in a posthuman or newmaterial perspective; embodied knowledges.  Theory and method are written together in immanence to envision complexity.  The aim and scope of the article is to follow the flow of events Irma produces opening up for affirmative poetical critique praxis. Quality is forwarded as an intensity and force in a moment only.  The moment is therefore the only structure of the text, as moving quality. The intention and inner logic of the text is therefore designed to work against fixed definitions and conceptualizations of what quality and quality assessment is.  This way I hope to show what posthuman and newmaterial approaches can contribute with to build cultures of innovation in which quality is assessed and produces again and again. They put differences to work and open up for creating moments of educational justice. Sammendrag: Artikkelen handler om kvalitetsvurdering i et nymaterielt perspektiv: Kroppslig kunnskap og viten. Teori og metode skrives sammen i immanent samtidighet for å gi et bilde på kompleksitet. Både hensikt og mål med artikkelen er å følge den flyten som Irma som hendelse eller event produserer, for å åpne opp potensialitet for en bekreftende eller affirmativ poetiserende kritikkpraksis og en ny forståelse av- og vurdering for kvalitet. Kvalitet skrives fram som en hendelse, intensitet eller kraft i et øyeblikk. Øyeblikket er derfor tekstens eneste og bærende struktur, som kvalitet i bevegelse. Tekstens indre logikk har slik til hensikt å motvirke forsøk på å skape definerte, faste eller bestemte oppfatninger av hva kvalitet er og hvordan kvalitet kan vurderes. På denne måten håper jeg å vise hva nymaterielle perspektiver kan gjøre for å bygge kulturer for innovasjon hvor kvalitet vurderes og produseres igjen og igjen. De setter forskjellighet i bevegelse og åpner opp for å skape rettferdige utdanningsøyeblikk.

  5. Specifik mutation med nålestiksoperation

    DEFF Research Database (Denmark)

    Holme, Inger; Wendt, Toni; Brinch-Pedersen, Henrik

    2014-01-01

    Mutanter af byg er vigtige i forskningen og benyttes også, når der forædles nye sorter til dyrkning. Hidtil har det kun været muligt at inducere mutationer tilfældige steder i genomet. Med helt ny teknologi benyttes proteiner med betegnelsen TALENs til at inducere mutationer i helt specifikke...

  6. Automation med pneumatiske servodrev - status og fremtid

    DEFF Research Database (Denmark)

    Sørensen, Paul Haase

    1996-01-01

    Der er råd for problemer med ulineariteter. Med de nyeste metoder kan der lineære driftsområde udvides. Men pneumatikkomponenter skal være af høj kvalitet, når positionering skal være nøjagtig....

  7. Erfaringer med akkreditering af socialt arbejde

    Directory of Open Access Journals (Sweden)

    Trine Kokholm

    2016-03-01

    med akkreditering blandt døgninstitutioner og specialskoler landet over gennem vores erfaringer med Akkreditering Danmarks kvalitetsmodel – en model som i dag anvendes af ca. 200 sociale tilbud landet over, kommunale såvel som private.

  8. Serial intralesional injections of infliximab in small bowel Crohn’s strictures are feasible and might lower inflammation

    DEFF Research Database (Denmark)

    Hendel, Jakob; Karstensen, John Gásdal; Vilmann, Peter

    2014-01-01

    BACKGROUND: Crohn's disease can cause strictures throughout the gastrointestinal tract. Endoscopic balloon dilatation is a well-established treatment, but recurrence is seen in up to three out of four cases. Infliximab is playing an increasingly important role in the modern systemic treatment...... of severe Crohn's disease. Combining the anti-inflammatory effects of infliximab with the proven effect of endoscopic balloon dilatation could possibly improve outcome. In small studies, intralesional injections in perianal fistulas have been effective and endoscopic injection therapy in colonic strictures...... is feasible. OBJECTIVE: We wanted to assess whether serial intralesional injection of infliximab in small bowel strictures is feasible and reduces local inflammation. METHODS: We included six patients with Crohn's disease and inflammatory small bowel strictures. They were treated with endoscopic serial...

  9. Comparison of Infliximab and Adalimumab in Biologic-Naive Patients With Ulcerative Colitis: A Nationwide Danish Cohort Study

    DEFF Research Database (Denmark)

    Singh, Siddharth; Nyboe Andersen, Nynne; Andersson, Mikael

    2017-01-01

    BACKGROUND & AIMS: We compared the effectiveness and safety of infliximab and adalimumab in biologic-naïve patients with ulcerative colitis (UC), in a nationwide register-based propensity score-matched study of patients in Denmark. METHODS: We collected data from 1719 adults with UC, 15-75 years...... old, in Denmark who were treated with either infliximab or adalimumab as their first biologic agent. We compared rates of all-cause hospitalization, UC-related hospitalization, major abdominal surgery, and serious infections after a variable 2:1 propensity score matching, accounting for baseline...... clinical characteristics, disease severity, healthcare use, and use of UC-related medications. RESULTS: Compared to patients treated with infliximab, patients treated with adalimumab had a higher risk for all-cause hospitalization (hazard ratio [HR], 1.84; 95% CI, 1.18-2.85), with a trend towards higher...

  10. Redefining the MED13L syndrome.

    Science.gov (United States)

    Adegbola, Abidemi; Musante, Luciana; Callewaert, Bert; Maciel, Patricia; Hu, Hao; Isidor, Bertrand; Picker-Minh, Sylvie; Le Caignec, Cedric; Delle Chiaie, Barbara; Vanakker, Olivier; Menten, Björn; Dheedene, Annelies; Bockaert, Nele; Roelens, Filip; Decaestecker, Karin; Silva, João; Soares, Gabriela; Lopes, Fátima; Najmabadi, Hossein; Kahrizi, Kimia; Cox, Gerald F; Angus, Steven P; Staropoli, John F; Fischer, Ute; Suckow, Vanessa; Bartsch, Oliver; Chess, Andrew; Ropers, Hans-Hilger; Wienker, Thomas F; Hübner, Christoph; Kaindl, Angela M; Kalscheuer, Vera M

    2015-10-01

    Congenital cardiac and neurodevelopmental deficits have been recently linked to the mediator complex subunit 13-like protein MED13L, a subunit of the CDK8-associated mediator complex that functions in transcriptional regulation through DNA-binding transcription factors and RNA polymerase II. Heterozygous MED13L variants cause transposition of the great arteries and intellectual disability (ID). Here, we report eight patients with predominantly novel MED13L variants who lack such complex congenital heart malformations. Rather, they depict a syndromic form of ID characterized by facial dysmorphism, ID, speech impairment, motor developmental delay with muscular hypotonia and behavioral difficulties. We thereby define a novel syndrome and significantly broaden the clinical spectrum associated with MED13L variants. A prominent feature of the MED13L neurocognitive presentation is profound language impairment, often in combination with articulatory deficits.

  11. Secondary Loss of Response to Infliximab in Pediatric Crohn Disease: Does It Matter How and When We Start?

    Science.gov (United States)

    Bolia, Rishi; Rosenbaum, Jeremy; Schildkraut, Vered; Hardikar, Winita; Oliver, Mark; Cameron, Donald; Alex, George

    2018-04-01

    A significant proportion of children with Crohn disease develop a secondary loss of response (LOR) to infliximab. Our aim was to study the impact of initial treatment strategies on secondary LOR. We reviewed the medical records of children with Crohn disease who received scheduled maintenance infliximab therapy for at least 12 months. We compared children who developed LOR with those who did not; with regards to their clinical and laboratory parameters, disease phenotype, and treatment strategy before developing LOR. A total of 73 children (median age at diagnosis 11 (2-16) years, 41 boys) who had received a median duration of 33 (13-110) months of infliximab therapy were included in the final analysis. LOR was seen in 25(34.2%). Demographic variables, disease phenotype (age, disease location, and behavior), inflammatory parameters, and pediatric Crohn disease activity index at induction with infliximab were similar between both groups. Children with LOR had a significantly greater number of flares of the disease when compared to those who did not have LOR (4 [1-8] vs 2 [1-5] P = 0.03). The choice of the concomitant immunomodulator-methotrexate (11/29 [37.9%]) versus azathioprine (11/36 [30.5%]) (P = 0.6) did not affect LOR rates. The median time-lag between diagnosis and induction with infliximab was significantly longer in children with LOR as compared to those who did not have an LOR (28 [4-90] months vs 12.5 [1-121] months, P = 0.004). Early use of infliximab in pediatric Crohn disease is associated with a decrease in secondary LOR. The type of concomitant immunomodulator used does not make a difference to LOR rates.

  12. Infliximab effects compared to conventional therapy in the management of retinal vasculitis in Behçet disease.

    Science.gov (United States)

    Tabbara, Khalid F; Al-Hemidan, Amal I

    2008-12-01

    To assess the outcome of retinal vasculitis in patients with Behçet disease treated with infliximab compared to treatment with conventional therapy. Nonrandomized, retrospective comparative clinical study. Patients with Behçet disease with all four major criteria were included in this study. Patients had recurrent episodes of uveitis and retinal vasculitis. Thirty-three patients (Group 1) were treated with oral prednisone, cyclosporine, and azathioprine or methotrexate for a minimum period of three months. Ten patients (Group 2) who failed to respond to conventional therapy were given infliximab at a dose of 5 mg/kg in a single intravenous infusion on day 1 and every two weeks for a total of six doses. Patients were given the same treatment during each subsequent relapse. The main outcome measures were the number of relapses, visual outcome, and ocular complications. The mean follow-up period was 36 months in Group 1 and 30 months in Group 2. The mean number of relapses was significantly reduced and the duration of remission was longer in the infliximab therapy group compared to conventional therapy group (P < .0001). The visual acuity at 24 months follow-up was significantly better in patients treated with infliximab (Group 2) when compared to conventional therapy (Group 1) (P = .0059). Patients with Behçet disease had significant decrease in inflammation, improvement of visual acuity, and reduced ocular complications following infliximab when compared to conventional therapy. The number of relapses was less in the infliximab treatment group than the conventional therapy group.

  13. Efficacy and Safety of Infliximab Therapy and Predictors of Response in Korean Patients with Crohn's Disease: A Nationwide, Multicenter Study.

    Science.gov (United States)

    Choi, Chang Hwan; Song, In Do; Kim, Young Ho; Koo, Ja Seol; Kim, You Sun; Kim, Joo Sung; Kim, Nayoung; Kim, Eun Soo; Kim, Jae Hak; Kim, Ji Won; Kim, Tae Oh; Kim, Hyun Soo; Kim, Hyo Jong; Park, Young Sook; Park, Dong Il; Park, Soo Jung; Song, Hyun Joo; Shin, Sung Jae; Yang, Suk Kyun; Ye, Byong Duk; Lee, Kang Moon; Lee, Bo In; Lee, Sun Young; Lee, Chang Kyun; Im, Jong Pil; Jang, Byung Ik; Jeon, Tae Joo; Cho, Yu Kyung; Chang, Sae Kyung; Jeon, Seong Ran; Jung, Sung Ae; Jeen, Yoon Tae; Cha, Jae Myung; Han, Dong Soo; Kim, Won Ho

    2016-11-01

    Infliximab is currently used for the treatment of active Crohn's disease (CD). We aimed to assess the efficacy and safety of infliximab therapy and to determine the predictors of response in Korean patients with CD. A total of 317 patients who received at least one infliximab infusion for active luminal CD (n=198) and fistulizing CD (n=86) or both (n=33) were reviewed retrospectively in 29 Korean referral centers. Clinical outcomes of induction and maintenance therapy with infliximab, predictors of response, and adverse events were evaluated. In patients with luminal CD, the rates of clinical response and remission at week 14 were 89.2% and 60.0%, respectively. Male gender and isolated colonic disease were associated with higher remission rates at week 14. In week-14 responders, the probabilities of sustained response and remission were 96.2% and 93.3% at week 30 and 88.0% and 77.0% at week 54, respectively. In patients with fistulizing CD, clinical response and remission were observed in 85.0% and 56.2% of patients, respectively, at week 14. In week-14 responders, the probabilities of sustained response and remission were 94.0% and 97.1%, respectively, at both week 30 and week 54. Thirty-nine patients (12.3%) experienced adverse events related to infliximab. Serious adverse events developed in 19 (6.0%) patients including seven cases of active pulmonary tuberculosis. Infliximab induction and maintenance therapy are effective and well tolerable in Korean patients with luminal and fistulizing CD. However, clinicians must be aware of the risk of rare yet critical adverse events.

  14. Musikterapi med børn med fysiske og psykiske funktionsnedsættelser

    DEFF Research Database (Denmark)

    Holck, Ulla

    2014-01-01

    Indledning: I Danmark er der en lang tradition for musikterapeutisk arbejde med børn med fysiske og psykiske funktionsnedsættelser, og herunder børn med autismespektrumforstyrrelser. De ældste casebeskrivelser stammer fra 1940’erne, og op gennem 50’erne, 60’erne og 70’erne kombinerede pionerermed...

  15. Disseminated nocardiosis in a patient on infliximab and methylprednisolone for treatment-resistant Sweet′s syndrome

    Directory of Open Access Journals (Sweden)

    Elizabeth R Drone

    2014-01-01

    Full Text Available A 62-year-old white man with a 10-year history of treatment-refractory Sweet′s syndrome was admitted to the hospital with the onset of purpuric lesions. Methylprednisolone and infliximab were administered. Our patient developed disseminated Nocardia infection and eventually succumbed. Opportunistic infections such as Nocardia have been associated with infliximab and other tumour necrosis factor (TNF-α inhibitors. The astute clinician should be aware of the risk of rare opportunistic infections, particularly in patients on TNF-α inhibitors and systemic corticosteroids.

  16. A dramatic response to a single dose of infliximab in a patient with prolonged pustular psoriasis derived from inverse psoriasis.

    Science.gov (United States)

    Li, Mengmeng; Dai, Weiwei; Yan, Wei; Liu, Yuanzhen; Wang, Lian; Li, Wei

    2017-07-01

    We report a case of a 25-year-old Chinese man with an exceptionally prolonged history of pustular psoriasis derived from inverse psoriasis who was unsatisfied with conventional treatment and was successfully treated with a single dose of infliximab without noticeable adverse effects. No recurrence or flaring was observed after 3 months of follow-up. This case illustrates that infliximab may be an effective and safe therapeutic option for patients with refractory pustular psoriasis derived from inverse psoriasis. © 2017 Wiley Periodicals, Inc.

  17. Clinical role, optimal timing and frequency of serum infliximab and anti-infliximab antibody level measurements in patients with inflammatory bowel disease.

    Directory of Open Access Journals (Sweden)

    Renáta Bor

    Full Text Available Serum infliximab (IFX and antibody-to-infliximab (ATI levels are objective parameters, that may have a great role in the therapeutic decisions during maintenance biological therapy.48 inflammatory bowel disease patients receiving maintenance IFX therapy were prospectively enrolled and divided into adequate (complete remission N = 20 and inadequate responder (partial response, loss of response, dose escalation; N = 28 groups. Blood samples were collected just before (trough level, TL and two (W2aTL and six weeks (W6aTL after the administration of IFX.Single measurement of ATI titer was insufficient for predicting therapeutic response due to transient expression of ATI, however, using the three points' measurements, significant difference has been detected between the adequate and inadequate responder group (5.0% vs 35.7%; p = 0.016. The mean value of TL was significantly higher in the adequate responder group (3.11±1.64 vs.1.19±1.11; p<0.001 without further difference on the second and sixth week. Sensitivity and specificity for predicting the therapeutic response were 85.0% and 71.4% based on the cut-off value of TL 2.0 μg/ml.Simultaneous measurement of serum IFX level prior to administration of regular IFX infusion and ATI titers significantly increase the diagnostic accuracy for the therapeutic decision in patients uncertainly responding to the therapy. The measurement of W2aTL and W6aTL levels did not result in further improvement in the prediction of therapeutic response.

  18. Molecular patterns in human ulcerative colitis and correlation with response to infliximab

    Science.gov (United States)

    Halloran, Brendan; Chang, Jessica; Shih, David Q.; McGovern, Dermot; Famulski, Konrad; Evaschesen, Chad; Fedorak, Richard N; Thiesen, Aducio; Targan, Stephan; Halloran, Philip F.

    2016-01-01

    Objective As a T cell-mediated disease of the colonic epithelium, ulcerative colitis (UC) is likely to share pathogenic elements with other T cell-mediated inflammatory diseases. Recently microarray analysis revealed large scale molecular changes in T cell-mediated rejection (TCMR) of kidney and heart transplants. We hypothesized that similar disturbances might be operating in UC and could provide insights into responsiveness to therapy. Methods We studied 56 colon biopsies from patients with colitis characterizing the clinical and histological features and using microarrays to defined the mRNA phenotype. We expressed the microarray results using previously defined pathogenesis-based transcript sets (PBTs). We also studied 48 published microarray files from human colon biopsies downloaded from the Gene Expression Omnibus (GEO) database, classified by response to infliximab therapy, to examine if the molecular measurements derived from our studies correlated with non-responsiveness to treatment. Results UC biopsies manifested coordinate transcript changes resembling rejecting transplants, with effector T cell, IFNG-induced, macrophage, and injury transcripts increasing while parenchymal transcripts decreased. The disturbance in gene expression, summarized as principal component 1 (PC1), correlated with conventional clinical and histologic assessments. When assessed in microarray results from published studies, the disturbance (PC1) predicted response to infliximab: patients with intense disturbance did not achieve clinical response, although quantitative improvement was seen even in many clinical non-responders. Similar changes were seen in Crohn's colitis. Conclusions The molecular phenotype of UC manifests a large scale coordinate disturbance reflecting changes in inflammatory cells and parenchymal elements that correlates with conventional features and predicts response to infliximab. PMID:25397893

  19. Outcome after discontinuation of infliximab in patients with inflammatory bowel disease in clinical remission

    DEFF Research Database (Denmark)

    Steenholdt, Casper; Molazahi, Akbar; Ainsworth, Mark Andrew

    2012-01-01

    Abstract Objective. To investigate duration of remission, including risk factors for relapse and response to retreatment with infliximab (IFX), in patients with Crohn's disease (CD) and ulcerative colitis (UC) who had discontinued IFX while in clinical remission. Methods. Observational, single......-1673)), respectively; p = 0.057. Twelve percent with CD and 40% with UC were in remission at the end of follow-up after 10 and 4.5 years, respectively. Longer disease duration was associated with relapse in univariate analysis in CD, OR 1.1 (1.0-1.1), p = 0.022. Of 25, 24 CD patients (96%), and 5 of 7 UC patients (71...

  20. Episcleritis Related to Drug-Induced Lupus Erythematosus following Infliximab Therapy: A Case Report

    Directory of Open Access Journals (Sweden)

    Irini P. Chatziralli

    2011-01-01

    Full Text Available Drug-induced lupus erythematosus is defined as a lupus-like syndrome temporally related to continuous drug exposure which resolves after discontinuation of the offending drug. Herein, we describe a patient with distinct clinical manifestations of anti-TNF-associated DILE related to infliximab therapy. The patient exhibited clinical and laboratory findings of lupus-like illnesses as well as ocular disorders, such as episcleritis. The main message is that the symptoms of DILE should not be overlooked, although sometimes other systematic conditions may underlie them. As a result, it is very important for the clinicians to evaluate the symptoms of DILE and manage appropriately these cases.

  1. Efficacy and safety of infliximab in steroid-dependent ulcerative colitis patients.

    Science.gov (United States)

    Gavalas, Emmanuel; Kountouras, Jannis; Stergiopoulos, Christos; Zavos, Christos; Gisakis, Dimitrios; Nikolaidis, Nikolaos; Giouleme, Olga; Chatzopoulos, Dimitrios; Kapetanakis, Nikolaos

    2007-06-01

    Limited data exist concerning infliximab administration in steroid-dependent ulcerative colitis (UC) patients. The aim of this study was to evaluate the efficacy and safety of infliximab in steroid-dependent disease. Sixteen corticosteroid-dependent patients who received infusions of infliximab (5 mg/kg) at 0, 2 and 6 weeks and thereafter every 8 weeks (Group A), were compared with eight patients treated with methylprednisolone (0.8-1 mg/kg body weight) daily for three weeks followed by a tapering regimen up to the minimal dose to maintain a symptom-free condition (Group B). Steroid dependency was defined as recurrent flare-up on steroid reduction or withdrawal, or as the clinical need for steroid treatment twice within six consecutive months or three times within a year. Disease activity was assessed at recruitment, and clinical response was evaluated according to the two non-invasive indices [SEO and Simple Clinical Colitis Activity Index (SCCAI) scores]. In Group A, complete long-term response occurred in 68.75% and partial response in 18.75% of patients. Moreover, in the long-term follow-up, both SCCAI (10.37 +/- 2.27 vs. 3.31 +/- 2.65, p < 0.001) and SEO (209.33 +/- 13.6 vs. 123.3 +/- 34.8, p < 0.001) scores demonstrated a significant improvement. In group B, comparable features were also obtained regarding complete long-term (62.5%) and partial (25%) responses; both SCCAI (7.37 +/- 1.4 vs. 3.5 +/- 3.58, p = 0.039) and SEO (181.0 +/- 27.1 vs. 135.3 +/- 44.1, p = 0.038) scores also improved significantly. Six of eight patients in the methylprednisolone-treated group B developed Cushing-like symptoms. Infliximab appears to be a good alternative therapeutic regimen in steroid-dependent UC patients associated with long-term potential toxicity.

  2. USE OF INFLIXIMAB IN THE CASE OF INFLAMMATORY BOWEL DISEASE IN CHILDREN

    Directory of Open Access Journals (Sweden)

    N.E. Shchigoleva

    2010-01-01

    Full Text Available The Article is focused on the pressing issue, i.e. the therapy of inflammatory bowel diseases. It reviews in detail the aspects of using monoclonal antibodies to the tumor necrosis factor in the case of Crohn’s disease and unspecific ulcerative colitis. The article describes the results of the authors’ observations and provides data obtained by foreign researchers.Key words: ulcerative colitis, Crohn’s disease, treatment, Infliximab, antibodies to the tumor necrosis factor, children. (Pediatric Pharmacology. – 2010; 7(1:55-61

  3. Infliximab Biosimilars in the Treatment of Inflammatory Bowel Diseases: A Systematic Review.

    Science.gov (United States)

    Radin, Massimo; Sciascia, Savino; Roccatello, Dario; Cuadrado, Maria Jose

    2017-02-01

    Biological therapies represent a fundamental innovation for the management of inflammatory bowel diseases (IBD). However, many biological originators have reached, or are about to reach, patent expiry and long-term therapy costs have become progressively unsustainable. CT-P13, a biosimilar of the anti-tumor necrosis factor (anti-TNF) monoclonal antibody infliximab, might represent a significant alternative to its originator, with the potential to decrease medical care costs and, therefore, become available to a large number of patients. In this systematic review, we analyzed the data from available clinical trials that recently investigated the validity of indication extrapolation of CT-P13 for the treatment of IBD in naïve patients and in patients who switched from its originator infliximab, focusing on clinical efficacy, safety and immunogenicity. A detailed literature search was developed a priori to identify articles that investigated the validity of indication extrapolation of CT-P13 for the treatment of IBD in TNF inhibitor treatment-naïve patients and in patients who switched from the originator infliximab. This was applied to Ovid MEDLINE, In-Process and Other Non-Indexed Citations, EMBASE, Cochrane Central Register of Controlled Trials, and Scopus for content from 2012 to September 2016. We based our review on the available data from 11 studies that included a total of 1007 IBD patients: 570 patients suffering from Crohn's disease (294 switched and 276 naïve), 435 patients suffering from ulcerative colitis (127 switched and 308 naïve), and two IBD unclassified patients (switched). Overall, no significant difference in efficacy and safety between the originator infliximab and its biosimilar CT-P13 was observed. When assessing the safety of CT-P13, we found that 9.2% of patients experienced adverse effects (4.1% infusion-related reactions and 4.3% infections). The analyzed studies did not report a significant difference in terms of efficacy, safety and

  4. Infliximab Versus Conventional Combination Treatment and Seven-Year Work Loss in Early Rheumatoid Arthritis: Results of a Randomized Swedish Trial.

    Science.gov (United States)

    Eriksson, Jonas K; Wallman, Johan K; Miller, Heather; Petersson, Ingemar F; Ernestam, Sofia; Vivar, Nancy; van Vollenhoven, Ronald F; Neovius, Martin

    2016-12-01

    To compare long-term work loss in methotrexate-refractory early rheumatoid arthritis (RA) patients randomized to the addition of infliximab or conventional combination treatment. This study was a multicenter, 2-arm, parallel, randomized, active-controlled, open-label trial. RA patients with infliximab or conventional combination treatment with sulfasalazine plus hydroxychloroquine. Yearly sick leave and disability pension days >7 years after randomization were retrieved from nationwide registers kept by the Swedish Social Insurance Agency. Of 210 working-age patients, 109 were randomized to infliximab (mean age 48.4 years, 73% women) and 101 to conventional treatment (mean age 48.7 years, 77% women). The year before randomization, the mean number of annual work days lost was 127 in the infliximab arm and 118 in the conventional treatment group (mean difference 9 [95% confidence interval (95% CI) -23, 39]). Compared to the year before randomization, the mean changes at 7 years were -25 days in the infliximab and -26 days in the conventional treatment group (adjusted mean difference 10 [95% CI -25, 46]). The cumulative mean for work-loss days was 846 in the infliximab group and 701 in the conventional treatment group (adjusted mean difference 104 [95% CI -56, 284]). Long-term work loss improved significantly in early RA patients randomized to infliximab plus methotrexate or conventional combination therapy. No difference was detected between strategies, and the level of work-loss days remained twice that observed in the general population. © 2016, American College of Rheumatology.

  5. Personer med fysiske handicap og psykiske lidelser

    DEFF Research Database (Denmark)

    Larsen, Malene Rode; Larsen, Mona

    2018-01-01

    Det er velkendt, at personer med fysiske handicap i større omfang er i beskæftigelse end personer med psykiske lidelser. Formålet med dette notat er at forøge den eksisterende viden om, hvorfor der er forskel på de to gruppers beskæftigelsesomfang. Vi undersøger, om forskelle mellem de to grupper......, hvad angår en række målbare personkarakteristika og deres sammenhæng med gruppernes beskæftigelsessandsynlighed, spiller en rolle i denne forbindelse. De undersøgte personkarakteristika er: a) personforhold som fx alder, etnisk oprindelse, uddannelse og sværhedsgrad af handicap, b) personlighedstræk...

  6. Effektelektronik - teknologi med energibesparelser og forbedret performance

    DEFF Research Database (Denmark)

    Blaabjerg, Frede

    2004-01-01

    Lige siden transistoren blev opfundet, har det altid været ønskeligt at kunne anvende en sådan til at styre store strømme/spændinger i elektriske systemer. Det er teknologisk også sket, først med tyristorer til styring af store effekter, men siden hen også med den bipolare transistor MOSFET, samt...

  7. Ud med Freud, Marx og Lacan

    DEFF Research Database (Denmark)

    Clasen, Mathias

    2009-01-01

    Det er på høje tid, at humanister løsriver sig fra deres forældede teorier. Freud, Marx og Lacan skal erstattes med evolutionspsykologi, biologi og kognitionsvidenskab.......Det er på høje tid, at humanister løsriver sig fra deres forældede teorier. Freud, Marx og Lacan skal erstattes med evolutionspsykologi, biologi og kognitionsvidenskab....

  8. Ukraine i fokus sammen med Georgien

    DEFF Research Database (Denmark)

    Fledelius, Karsten

    2017-01-01

    Der er god grund til at sammenligne Ukraine og Georgien, nu fokuslande for Danmark, og der er god grund til at støtte disse to eks-sovjetiske stater med i høj grad parallelle problemer.......Der er god grund til at sammenligne Ukraine og Georgien, nu fokuslande for Danmark, og der er god grund til at støtte disse to eks-sovjetiske stater med i høj grad parallelle problemer....

  9. Efeitos adversos durante a infusão de infliximabe em crianças e adolescentes: estudo multicêntrico Adverse reactions during infliximab infusion in children and adolescents: multicenter study

    Directory of Open Access Journals (Sweden)

    Cássia Maria Passarelli Lupoli Barbosa

    2008-10-01

    Full Text Available OBJETIVO: Avaliar a freqüência e a gravidade dos efeitos adversos durante a infusão de infliximabe. MATERIAL E MÉTODOS: Avaliação retrospectiva de prontuários de 58 pacientes acompanhados em cinco serviços de reumatologia pediátrica. Todos apresentavam doença refratária ou eram intolerantes ao uso de uma ou mais drogas modificadoras de doença e receberam uma ou mais infusões de infliximabe. A análise estatística foi descritiva, levando-se em conta a freqüência e o tipo dos efeitos adversos, assim como sua relação com o número de infusões, a dose de infliximabe e a indicação. RESULTADOS: A média da idade na época da introdução do infliximabe foi de 12 anos e 9 meses e a média do tempo de evolução da doença foi de 7 anos e 7 meses. A principal indicação da medicação foi artrite idiopática juvenil (43. Dos 58 pacientes avaliados, 25 (43,1% apresentaram efeitos adversos durante a infusão e em 17 (29,3%, a medicação teve de ser suspensa. As reações que ocorreram foram: dispnéia (dez, náuseas e vômitos (oito, rash cutâneo (sete, choque anafilático (seis, rubor facial (cinco, angioedema (quatro, dor torácica (quatro, urticária e hipertensão, entre outras. A reação anafilática foi mais freqüente entre a quarta e a sexta infusão. CONCLUSÃO: A freqüência e a gravidade dos efeitos adversos ao infliximabe devem ser levadas em conta, não apenas por ocasião da sua indicação, mas principalmente por ocasião da escolha do local para a sua aplicação, que deve contar com estrutura para atendimento de urgência.OBJECTIVE: To evaluate the frequency and the severity of the adverse reactions during the infusion of infliximab. METHODS: We performed a retrospective chart review of 58 patients, followed up at 5 paediatric rheumatology centers. All patients presented refractory disease or were intolerant to one or more disease modifying drugs and received one or more infliximab infusions. The data analysis

  10. Sociale indsatser til mennesker med ADHD

    DEFF Research Database (Denmark)

    Bengtsson, Steen; Alim, Winnie; Holmskov, Henriette

    Igennem de seneste år har flere og flere fået stillet diagnosen ADHD, som er en adfærdsmæssig forstyrrelse. Mennesker med ADHD har meget forskelligt støttebehov, og rapportens formål er at skabe overblik over de eksisterende sociale indsatser og tilbud til børn, unge og voksne med ADHD. Langt de...... ansvar for sociale end for terapeutiske tilbud i forhold til gruppen med ADHD. Mange voksne med ADHD beskriver, at det kræver mange ressourcer at få den fornødne støtte fra kommunen, mens forældre til børn med ADHD oplever det som nemmere at få adgang til de rette støttetilbud. Men begge grupper møder...... mange udfordringer som fx manglende koordinering og hyppige sagsbehandlerskift. Rapporten er udarbejdet i tilknytning til Servicestyrelsens projekt ’Ny og forstærket indsats til børn, unge og voksne med ADHD’ og er finansieret af Socialministeriet....

  11. Infliximab for inflammatory bowel disease in Denmark 1999-2005: clinical outcome and follow-up evaluation of malignancy and mortality

    DEFF Research Database (Denmark)

    Caspersen, S.; Elkjaer, M.; Riis, L.

    2008-01-01

    patients (14.6%). Four patients developed cancer versus 5.9 expected (standardized incidence ratio, 0.7; 95 confidence interval, 0.2-1.7) and 13 patients died versus 6.9 expected (standardized mortality ratio, 1.9; 95% confidence interval, 1.0-3.2). Two deaths caused by infections were possibly related...... to infliximab. CONCLUSIONS: Infliximab seemed effective in IBD and generally was well tolerated. However, rare but severe adverse events occurred, and patients receiving infliximab therefore should be selected carefully and monitored closely. No lymphomas and no increased risk of cancer were observed....

  12. The effect of infliximab, a monoclonal antibody against TNF-alpha, on disc herniation resorption - A randomized controlled study

    NARCIS (Netherlands)

    Autio, Reijo A.; Karppinen, Jaro; Niinimaki, Jaakko; Ojala, Risto; Veeger, Nic; Korhonen, Timo; Hurri, Heikki; Tervonen, Osmo

    2006-01-01

    Study Design. Randomized, controlled study. Objective. To evaluate the effect of infliximab on herniated nucleus pulposus (HNP) resorption. Summary of Background Data. Although the effects of tumor necrosis factor alpha (TNF-alpha) on HNP resorption are not fully understood, TNF-alpha appears to be

  13. Pneumococcal polyarticular septic arthritis after a single infusion of infliximab in a rheumatoid arthritis patient: a case report

    Directory of Open Access Journals (Sweden)

    Hayashi Masatoshi

    2012-03-01

    Full Text Available Abstract Introduction We present a case of Streptococcus pneumoniae polyarticular septic arthritis in a patient with rheumatoid arthritis receiving a single infusion of infliximab. Case presentation A 38-year-old Japanese man with a 5-year history of seronegative rheumatoid arthritis had previously received sulphasalazine and methotrexate therapies and was on regular low-dose prednisolone therapy. Despite these treatments, his disease activity remained high and infliximab was introduced in addition to methotrexate, prednisolone, and folic acid. However, he was admitted to hospital with a fever of 40.6°C, chills, and polyarthralgia eight days after the first infusion of infliximab. His joints were swollen, painful, and warm. Laboratory data showed marked acute inflammation. He was diagnosed with bacterial septic polyarthritis, and emergency surgical joint lavage and drainage was performed at the knees along with needle aspiration and lavage of the ankles and right wrist. He was then given intravenous antibiotic therapy for 31 days. He made a good recovery and was discharged on day 37. Conclusions We believe this is the first reported case of severe pneumococcal septic arthritis requiring hospitalization in a patient treated with infliximab. S. pneumonia is now a well-recognized but uncommon cause of polyarticular septic arthritis that can lead to cessation of therapy, as in our patient's case.

  14. Circulating cytokines and cytokine receptors in infliximab treatment failure due to TNF-α independent Crohn disease

    DEFF Research Database (Denmark)

    Steenholdt, Casper; Coskun, Mehmet; Buhl, Sine

    2016-01-01

    The inflammatory response at infliximab (IFX) treatment failure due to tumor necrosis factor (TNF)-α-independent Crohn disease activity is unknown.This is an exploratory, hypothesis-generating study based on samples collected in a clinical trial among patients failing conventional IFX dosages...

  15. Infliximab therapy balances regulatory T cells, tumour necrosis factor receptor 2 (TNFR2) expression and soluble TNFR2 in sarcoidosis

    Science.gov (United States)

    Hijdra, D.; Vorselaars, A. D. M.; Crommelin, H. A.; van Moorsel, C. H. M.; Grutters, J. C.; Claessen, A. M. E.

    2016-01-01

    Summary Sarcoidosis is a systemic granulomatous disease of unknown aetiology that most commonly affects the lungs. Although elevated levels of regulatory T cells (Tregs) have been reported, the extent to which they play a role in sarcoidosis pathogenesis remains unclear. Tumour necrosis factor (TNF) is thought to be one of the driving forces behind granuloma formation, illustrated by the efficacy of infliximab in severe sarcoidosis. Tregs express TNF receptor 2 (TNFR2) highly. Here, we examined the influence of infliximab therapy on Tregs and (soluble) TNFR2 levels in sarcoidosis, and correlated these with response to therapy. We observed that relative frequencies of Tregs were significantly higher in patients (n = 54) compared to healthy controls (n = 26; median 6·73 versus 4·36%; P infliximab therapy, suggesting a pathophysiological role of this T cell subset. Interestingly, sTNFR2 levels at baseline differed significantly between responders and non‐responders, making it a potential marker in predicting which patients might benefit from infliximab. PMID:27158798

  16. Long-term outcome of patients with steroid-refractory acute severe UC treated with ciclosporin or infliximab.

    Science.gov (United States)

    Laharie, D; Bourreille, A; Branche, J; Allez, M; Bouhnik, Y; Filippi, J; Zerbib, F; Savoye, G; Vuitton, L; Moreau, J; Amiot, A; Cosnes, J; Ricart, E; Dewit, O; Lopez-Sanroman, A; Fumery, M; Carbonnel, F; Bommelaer, G; Coffin, B; Roblin, X; van Assche, G; Esteve, M; Farkkila, M; Gisbert, J P; Marteau, P; Nahon, S; de Vos, M; Lambert, J; Mary, J Y; Louis, E

    2018-02-01

    Ciclosporin and infliximab have demonstrated short-term similar efficacy as second-line therapies in patients with acute severe UC (ASUC) refractory to intravenous steroids. The aim of this study was to assess long-term outcome of patients included in a randomised trial comparing ciclosporin and infliximab. Between 2007 and 2010, 115 patients with steroid-refractory ASUC were randomised in 29 European centres to receive ciclosporin or infliximab in association with azathioprine. Patients were followed until death or last news up to January 2015. Colectomy-free survival rates at 1 and 5 years and changes in therapy were estimated through Kaplan-Meier method and compared between initial treatment groups through log-rank test. After a median follow-up of 5.4 years, colectomy-free survival rates (95% CI) at 1 and 5 years were, respectively, 70.9% (59.2% to 82.6%) and 61.5% (48.7% to 74.2%) in patients who received ciclosporin and 69.1% (56.9% to 81.3%) and 65.1% (52.4% to 77.8%) in those who received infliximab (p=0.97). Cumulative incidence of first infliximab use at 1 and 5 years in patients initially treated with ciclosporin was, respectively, 45.7% (32.6% to 57.9%) and 57.1% (43.0% to 69.0%). Only four patients from the infliximab group were subsequently switched to ciclosporin. Three patients died during the follow-up, none directly related to UC or its treatment. In this cohort of patients with steroid-refractory ASUC initially treated by ciclosporin or infliximab, long-term colectomy-free survival was independent from initial treatment. These long-term results further confirm a similar efficacy and good safety profiles of both drugs and do not favour one drug over the other. EudraCT: 2006-005299-42; ClinicalTrials.gouv number: NCT00542152; post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  17. The MED-SUV Multidisciplinary Interoperability Infrastructure

    Science.gov (United States)

    Mazzetti, Paolo; D'Auria, Luca; Reitano, Danilo; Papeschi, Fabrizio; Roncella, Roberto; Puglisi, Giuseppe; Nativi, Stefano

    2016-04-01

    In accordance with the international Supersite initiative concept, the MED-SUV (MEDiterranean SUpersite Volcanoes) European project (http://med-suv.eu/) aims to enable long-term monitoring experiment in two relevant geologically active regions of Europe prone to natural hazards: Mt. Vesuvio/Campi Flegrei and Mt. Etna. This objective requires the integration of existing components, such as monitoring systems and data bases and novel sensors for the measurements of volcanic parameters. Moreover, MED-SUV is also a direct contribution to the Global Earth Observation System of Systems (GEOSS) as one the volcano Supersites recognized by the Group on Earth Observation (GEO). To achieve its goal, MED-SUV set up an advanced e-infrastructure allowing the discovery of and access to heterogeneous data for multidisciplinary applications, and the integration with external systems like GEOSS. The MED-SUV overall infrastructure is conceived as a three layer architecture with the lower layer (Data level) including the identified relevant data sources, the mid-tier (Supersite level) including components for mediation and harmonization , and the upper tier (Global level) composed of the systems that MED-SUV must serve, such as GEOSS and possibly other global/community systems. The Data level is mostly composed of existing data sources, such as space agencies satellite data archives, the UNAVCO system, the INGV-Rome data service. They share data according to different specifications for metadata, data and service interfaces, and cannot be changed. Thus, the only relevant MED-SUV activity at this level was the creation of a MED-SUV local repository based on Web Accessible Folder (WAF) technology, deployed in the INGV site in Catania, and hosting in-situ data and products collected and generated during the project. The Supersite level is at the core of the MED-SUV architecture, since it must mediate between the disparate data sources in the layer below, and provide a harmonized view to

  18. Social indsats til borgere med erfaring fra salg af sex

    DEFF Research Database (Denmark)

    Mehlsen, Line; Amilon, Anna; Henriksen, Theresa Dyrvig

    2017-01-01

    Formålet med denne guide er at give endnu flere kommuner inspiration og vejledning til, hvordan man kan implementere og arbejde med CTI-forløb over for borgere med prostitutionserfaring. Manglende viden om borgere med prostitutionserfaringer gør det svært for kommunerne at hjælpe borgerne med de ...

  19. Long-term response rates to infliximab therapy for Crohn’s disease in an outpatient cohort

    Science.gov (United States)

    Teshima, Christopher W; Thompson, Adrienne; Dhanoa, LeRose; Dieleman, Levinus A; Fedorak, Richard N

    2009-01-01

    BACKGROUND: Infliximab’s efficacy in the induction and maintenance of remission in luminal Crohn’s disease has been confirmed by randomized, controlled trials. Less clearly described are long-term outcomes in the clinical practice setting since the establishment of regularly scheduled, every eight-week maintenance infliximab infusions. Existing reports describing clinical practice outcomes are limited by short durations of follow-up or by the use of episodic dosing, or focus on safety data rather than clinical outcomes. OBJECTIVE: To examine induction and maintenance responses to infliximab in an outpatient inflammatory bowel disease clinic. METHODS: A retrospective chart review was performed. Clinical outcomes were infliximab induction and maintenance responses, defined as the ability to stop and remain off corticosteroids while not requiring additional therapy for active disease. RESULTS: One hundred thirty-three patients were identified with records sufficiently detailed to be analyzed. Of these, 117 patients (88%) demonstrated a clinical response to induction; 104 of 117 (89%) were on concomitant immunosuppressive therapy; 80 of 104 on azathioprine/6-mercaptopurine (77%); and 24 of 104 on methotrexate (23%). The mean duration of clinical response was 94 weeks (95% CI 78.8 to 109.2). The proportion of patients who maintained response at 30 weeks was 83.2%, at 54 weeks was 63.6% and at 108 weeks was 44.9%. Adverse events occurred for 15 of 117 patients (12.8%), consisting of nine infusion reactions, four serum sickness-like reactions, one rash and one infection. CONCLUSION: Patients treated with infliximab therapy for luminal Crohn’s disease in our outpatient clinic achieved excellent induction and maintenance of response rates, confirming the real-life efficacy of maintenance infliximab established in clinical trials. PMID:19440565

  20. Hverdagslivet som uformel omsorgsudøver med en partner med Parkinsons sygdom, – en interviewundersøgelse af kvinders erfaringer med omsorg og livskvalitet

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Pedersen, B.; Wagner, L.

    2012-01-01

    Formål: At undersøge de levede erfaringer for kvindelige partnere til hjemmeboende patienter med Parkinsons sygdom. Baggrund: Det er kendt, at hverdagslivet med en partner med Parkinsons sygdom indebærer radikale omvæltninger i familien, især for den kvindelige partner. Metode: En fænomenologisk......-hermeneutisk metode blev anvendt. I 2008 gennemførtes interview med kvindelige partnere (N = 10) til hjemmeboende patienter med Parkinsons sygdom. Den franske filosof Ricoeurs teori om fortolkning blev anvendt i analysen af data. Konklusion: Undersøgelsen viste, at livet sammen med en partner med Parkinsons sygdom...

  1. A marvel of precision: MedAustron

    CERN Multimedia

    Anaïs Schaeffer

    2013-01-01

    MedAustron, which is currently being built in Austria, will be one of the most advanced centres for ion beam therapy and research in Europe. It is based on the same design as the Italian National Centre for Oncological Hadrontherapy (CNAO), which in turn is based on the CERN-led Proton Ion Medical Machine Study (PIMMS). MedAustron should welcome its first patient at the end of 2015.   Layout of the MedAustron accelerator complex.  With three ion-sources, a linac, a synchrotron and four irradiation rooms (see picture), MedAustron is a huge accelerator complex. Among other equipment, it comprises 300 magnets of 30 different types, all designed at CERN but produced at different sites: “We are working with five main suppliers from Europe and Russia,” explains Thomas Zickler, leader of the MedAustron magnet group. “All the magnets come to CERN to undergo a series of strict acceptance tests.” From the interfaces, to the electrical insulation, the co...

  2. PubMed Medical Publications From Libya

    Directory of Open Access Journals (Sweden)

    Bakoush O

    2007-01-01

    Full Text Available Medical research and publications are the back-bone for advancing the medical field. We identified the PubMed medical publications that are affiliated with Libya to shed some light on the contribution of this country’s medical community to the PubMed database. All publications affiliated with Libya in the PubMed were counted over a five year period ending December 2006. We also used the same method to obtain data on the PubMed medical publications from Tunisia, Morocco and Yemen. Tunisia had the largest number of PubMed publications among the studied countries: 20.4 publications per million population per year and 7.2 publications per year per one billion US$ GDP. Libya had much fewer publications: 2.4 publications per million population per year and 0.4 publications per one billion US$ GDP. The citation frequency for Libyan published research was very low compared to Tunisian and Moroccan related research. Conclusion: This preliminary analysis shows that medical research output in Libya is about twenty times less than in other countries with similar backgrounds, and that it needs to be enhanced.

  3. Måltidet på hospitalet - Behandling eller bespisning af ældre

    OpenAIRE

    Røjel, Terkel Søndergaard

    2016-01-01

    The purpose of this master thesis is to examine the field of research with relevance to the topic geriatric malnutrition in order to propose recommendations that can stimulate the appetite, increase food intake, and stabilize the nutritional status of the geriatric patient at risk of malnutrition. For this purpose searches were conducted in the bibliographical databases: PubMed, PsycINFO and Sociological Abstracts along with various other resources. Based on these searches an analysis of the ...

  4. Early diagnosis of bilateral sub-deltoid bursitis using clinic-based ultrasonography in a patient receiving infliximab therapy for ulcerative pouchitis.

    LENUS (Irish Health Repository)

    Veerappan, S G

    2010-12-01

    Infliximab, a monoclonal chimeric antibody to tumour necrosis factor (TNF)α, is a novel therapy used in the management of chronic refractory pouchitis that is unresponsive to conventional medical therapy.

  5. The number needed to treat for adalimumab, etanercept, and infliximab based on ACR50 response in three randomized controlled trials on established rheumatoid arthritis

    DEFF Research Database (Denmark)

    Kristensen, L E; Christensen, R; Bliddal, H

    2011-01-01

    To compare the efficacy of adalimumab, etanercept, and infliximab in patients with established rheumatoid arthritis (RA) taking concomitant methotrexate (MTX) by calculating the number needed to treat (NNT) using three different methods....

  6. Association of Induction Infliximab Levels With Clinical Response in Perianal Crohn's Disease.

    Science.gov (United States)

    Davidov, Yana; Ungar, Bella; Bar-Yoseph, Haggai; Carter, Dan; Haj-Natour, Ola; Yavzori, Miri; Chowers, Yehuda; Eliakim, Rami; Ben-Horin, Shomron; Kopylov, Uri

    2017-05-01

    The association of infliximab [IFX] trough levels with clinical and endoscopic outcomes in inflammatory bowel disease is well established. However, there is scarce data regarding the association of perianal fistula response with IFX. The aim of this study was to establish whether early induction infliximab levels and anti-infliximab antibodies [ATIs] are associated with perianal fistula response. Consecutive CD patients with perianal fistulae that were treated with IFX between 2008 and 2016 were included in the study. Response was defined as cessation or significant improvement of fistula drainage. Patients with unavailable IFX level or ATI measurements and/or missing clinical follow-up at Week 14 were excluded. A total of 36 patients with perianal fistulae were included; 25/36 [69.4%] responded to treatment by Week 14. The median induction IFX levels at Weeks 2, 6 and 14 in the responders group at Week 14 were higher compared with those of the non-responders group [20/5.6 µg/mL, P = 0.0001; 13.3/2.55 µg/mL P = 0.0001; 4.1/0.14 µg/mL, P = 0.01]. On multivariate analysis, IFX leve at Weeks 2 and 6 were significantly associated with fistula response at Weeks 14 and 30. IFX drug levels of 9.25 µg/mL at Week 2 and 7.25 µg/mL at Week 6 were the best predictors of fistula response. High IFX trough levels during induction are associated with favorable fistula response to anti-TNF treatment. If validated in a larger prospective study, our findings may help guide anti-TNF treatment in patients with perianal CD, and suggest serum level-guided treatment escalation in non-responders or prompt changing of biologic treatment in non-responders. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

  7. Ti år med formidlingspligt

    DEFF Research Database (Denmark)

    Meyer, Gitte

    2014-01-01

    Jubilæet blev markeret ved et symposium - men hvor var journalisterne, og hvor var forskerne? For få uger siden lagde TV 2 hus til et symposium om videnskab, formidling, journalistik og spin. Danske Videnskabsjournalister og Akademiet for de Tekniske Videnskaber tog med arrangementet et behjertet...... initiativ. De ville gøre status efter ti år med lovfæstet formidlingspligt på universiteterne. Samtidig lagde de op til et kritisk blik på universitetsverdenens kommunikationsafdelinger...

  8. Forandringslæring med autismediagnoser?

    DEFF Research Database (Denmark)

    Gustafson, Kari Ingrid; Mørck, Line Lerche

    2013-01-01

    Rasmus’ ændringer i læring, selvforståelse og tilhørsforhold perspektiveres med andre ASF-diagnostiseredes læring udforsket bl.a. gennem gruppeinterviews i regi af Asperger-foreningen. Artiklen byder således på et alternativ i form af at forstå forandringslæring som overskridende læring, med langt større...... hvor fx Asperger-foreningen, lærere og skolebørns- og unges-fællesskaber, samt forældrene er vigtige aktører i overskridelsen af marginalisering....

  9. Hvad SKER der med drikkevandet i USA?

    DEFF Research Database (Denmark)

    Ramsay, Loren Mark

    2017-01-01

    Forskellige lande har forskellige traditioner indenfor drikkevandsbehandling. Denne beretning fra ”Water Quality Technology Conference” i USA er set med en særlig vinkel, da forfatteren er amerikansk statsborger, men har arbejdet i den danske vandbranche i mere end 25 år.......Forskellige lande har forskellige traditioner indenfor drikkevandsbehandling. Denne beretning fra ”Water Quality Technology Conference” i USA er set med en særlig vinkel, da forfatteren er amerikansk statsborger, men har arbejdet i den danske vandbranche i mere end 25 år....

  10. The number needed to treat for adalimumab, etanercept, and infliximab based on ACR50 response in three randomized controlled trials on established rheumatoid arthritis

    DEFF Research Database (Denmark)

    Kristensen, L E; Christensen, R; Bliddal, H

    2011-01-01

    To compare the efficacy of adalimumab, etanercept, and infliximab in patients with established rheumatoid arthritis (RA) taking concomitant methotrexate (MTX) by calculating the number needed to treat (NNT) using three different methods.......To compare the efficacy of adalimumab, etanercept, and infliximab in patients with established rheumatoid arthritis (RA) taking concomitant methotrexate (MTX) by calculating the number needed to treat (NNT) using three different methods....

  11. The number needed to treat for adalimumab, etanercept, and infliximab based on ACR50 response in three randomized controlled trials on established rheumatoid arthritis

    DEFF Research Database (Denmark)

    Kristensen, L E; Christensen, R; Bliddal, H

    2007-01-01

    To compare the efficacy of adalimumab, etanercept, and infliximab in patients with established rheumatoid arthritis (RA) taking concomitant methotrexate (MTX) by calculating the number needed to treat (NNT) using three different methods.......To compare the efficacy of adalimumab, etanercept, and infliximab in patients with established rheumatoid arthritis (RA) taking concomitant methotrexate (MTX) by calculating the number needed to treat (NNT) using three different methods....

  12. SAFETY PROFILE OF ANTI-TNF THERAPY IN CROHN'S DISEASE MANAGEMENT: A BRAZILIAN SINGLE-CENTER DIRECT RETROSPECTIVE COMPARISON BETWEEN INFLIXIMAB AND ADALIMUMAB.

    Science.gov (United States)

    Bau, Mariella; Zacharias, Patricia; Ribeiro, Diogo Araújo; Boaron, Larissa; Steckert Filho, Alvaro; Kotze, Paulo Gustavo

    2017-12-01

    Infliximab and adalimumab are considered effective drugs in the management of Crohn's disease. However, due to significant immunossupression, they can cause important adverse events, mostly infections. The aim of this study was to quantify and describe adverse events derived from adalimumab and infliximab use in Crohn's disease patients, and to compare the safety profile between these two agents. This was an observational, single-center, longitudinal, retrospective study with Crohn's disease patients under infliximab or adalimumab therapy. Variables analyzed: demographic characteristics (including the Montreal classification), type of agent used, concomitant immunomodulators, presence and types of adverse events observed. Patients were allocated in two groups (infliximab and adalimumab) and had their adverse events accessed and subsequently compared. A total of 130 patients were included (68 in infliximab and 62 in adalimumab groups, respectively). The groups were fully homogeneous in all baseline characteristics, with a median follow-up of 47.21±36.52 months in the infliximab group and 47.79±35.09 in the adalimumab group (P=0.512). Adverse events were found in 43/68 (63.2%) and 40/62 (64.5%) in each group, respectively (P=0.879). There were no differences between the groups regarding infections (P=0.094) or treatment interruption (P=0.091). There were higher rates of infusion reactions in the infliximab group (P=0.016). Cephalea and injection site reactions were more prevalent in adalimumab patients. Adverse events were found in approximately two thirds of Crohn's disease patients under anti-TNF therapy, and there were no significant differences between infliximab or adalimumab.

  13. PubMed, Internet Grateful Med, and Ovid: a comparison of three MEDLINE Internet interfaces.

    Science.gov (United States)

    De Groote, S L

    2000-01-01

    Three MEDLINE Internet interfaces are compared: PubMed, Internet Grateful Med, and Ovid MEDLINE. Although these interfaces all search MEDLINE, significant differences exist in terms of their search interfaces, presentation of results, and special features. This paper examines these variations and explores some of the advantages and disadvantages of the three interfaces.

  14. PubMedReco: A Real-Time Recommender System for PubMed Citations.

    Science.gov (United States)

    Samuel, Hamman W; Zaïane, Osmar R

    2017-01-01

    We present a recommender system, PubMedReco, for real-time suggestions of medical articles from PubMed, a database of over 23 million medical citations. PubMedReco can recommend medical article citations while users are conversing in a synchronous communication environment such as a chat room. Normally, users would have to leave their chat interface to open a new web browser window, and formulate an appropriate search query to retrieve relevant results. PubMedReco automatically generates the search query and shows relevant citations within the same integrated user interface. PubMedReco analyzes relevant keywords associated with the conversation and uses them to search for relevant citations using the PubMed E-utilities programming interface. Our contributions include improvements to the user experience for searching PubMed from within health forums and chat rooms, and a machine learning model for identifying relevant keywords. We demonstrate the feasibility of PubMedReco using BMJ's Doc2Doc forum discussions.

  15. A 53-year-old man with dyspnoea, respiratory failure, consistent with infliximab-induced acute interstitial pneumonitis after an accelerated induction dosing schedule.

    Science.gov (United States)

    Rofaiel, Rymon; Kohli, Sonny; Mura, Marco; Hosseini-Moghaddam, Seyed M

    2017-05-12

    A 53-year-old man with ulcerative colitis (UC) suffered fatal acute interstitial pneumonitis (AIP) post completing an accelerated infliximab induction course. This is the first case reported in this setting. A literature review found four similar cases of infliximab-induced interstitial lung disease in the setting of treating patients with UC using standard infliximab regimens had successful treatment of the subjects post infliximab discontinuation. Unfortunately, the patient we are presenting, who had an accelerated infliximab induction course, did not survive. Although a prior small trial along more recent new small studies continue to show a benefit in reducing the need for early colectomy with the accelerated infliximab induction regimen as salvage therapy, it should be used cautiously until more safety data are available. Further larger trials are required to investigate rare side effects that may be associated with this regimen such as rapidly progressive lung toxicity as seen in this patient. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. [Disseminated tuberculosis following infliximab therapy for Crohn disease: a case report].

    Science.gov (United States)

    Bouchentouf, R; Yasser, Z; Aitbenasser, M A

    2014-12-01

    Anti-tumor necrosis factor (TNF) therapy has been the major advance in the treatment of inflammatory bowel disease, especially Crohn's disease. But there is a higher risk of infections, especially tuberculosis (TB), in patients treated with anti-TNFα. The authors report a case of disseminated tuberculosis with the following features: pulmonary tuberculosis, left supra clavicular cervical and meditational lymphadenopathy, bilateral pleural effusion, peritoneal and splenic involvement. This disseminated tuberculosis was observed in a 39-year-old woman who was treated by infliximab for refractory Crohn's disease. The evolution with antituberculosis drugs was fatal, the death of the patient was due to hepatic encephalitis. The physicians should always be aware in the use of TNF-alpha blockers according to guidelines. Its recommended to realize a complete pretherapeutic assessment and it is necessary to follow-up the patients to detect possible reactivation of latent tuberculosis. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  17. Metabonomics uncovers a reversible proatherogenic lipid profile during infliximab therapy of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Bjerrum, Jacob Tveiten; Steenholdt, Casper; Ainsworth, Mark

    2017-01-01

    with principal components analysis and orthogonal projection to latent structures discriminant analysis using SIMCA-P+ v12 and MATLAB. Results: Metabolic profiles were significantly different between active ulcerative colitis and controls, active Crohn's disease and controls, and quiescent Crohn's disease...... changes taking place during induction treatment with IFX. Of distinct clinical relevance is the identification of a reversible proatherogenic lipid profile in IBD patients with active disease, which partially explains the increased risk of cardiovascular disease associated with IBD.......Background: One-third of inflammatory bowel disease (IBD) patients show no response to infliximab (IFX) induction therapy, and approximately half of patients responding become unresponsive over time. Thus, identification of potential treatment response biomarkers are of great clinical significance...

  18. Yes, We Are Still Talking about Cylosporin vs. Infliximab in Steroid Resistant Acute Severe Ulcerative Colitis.

    Science.gov (United States)

    Bernstein, Charles N; Kornbluth, Asher

    2017-11-01

    The Spanish IBD Registry (ENEIDA) is reporting in this issue of the Journal on a retrospective assessment of outcomes of cyclosporine use and infliximab use to treat steroid refractory acute severe ulcerative colitis (SR-ASUC) between 1989 and 2013. Overall, they found similar outcomes in terms of 3 month and 1 year colectomy rates. Serious adverse events were lower in cyclosporine users. While this study does not meet the standard of a prospective randomized controlled trial, it does remind us that cyclosporine can be effective in (SR-ASUC) and should be considered in those who have already failed antibody to tumor necrosis factor therapy or as a bridge to immunomodulators that have a slower onset of action.

  19. A scientific update on biosimilar infliximab (CT-P13) in rheumatic diseases.

    Science.gov (United States)

    Taylor, Peter

    2015-01-01

    The development of biologic drugs has undoubtedly enhanced the spectrum of treatments available for immune-mediated inflammatory rheumatic diseases such as rheumatoid arthritis. However, despite their clear clinical benifits, use of biologics is often hindered by their high costs. The manufacture and subsequent approval of more cost-effective 'biosimilar' versions of these drugs may address this issue and improve patient access. CT-P13 (Remsima(®), Inflectra(®)), a biosimilar of infliximab (Remicade(®)), has shown comparable efficacy, safety and pharmacokinetics to its originator drug in clinical studies. The articles in this supplement present a scientific update on the development and use of biosimilars in rheumatic disorders, with specific focus on CT-P13. The information discussed highlights the predicted positive clinical and economic impact of biosimilars on the management of rheumatic diseases.

  20. Fatal miliary Coccidioidomycosis in a patient receiving infliximab therapy: a case report

    Directory of Open Access Journals (Sweden)

    Rogan Mark P

    2007-09-01

    Full Text Available Abstract A 78-year-old white male from Iowa in the United States of America receiving the anti- tumor necrois factor (TNF agent infliximab therapy for rheumatoid arthritis developed a cheek ulcer which failed to respond to empiric antibiotic therapy. He subsequently presented with progressive respiratory failure from miliary coccidioidomycosis which proved fatal. The patient vacationed in Arizona 6 months previously and likely contracted the organism there as Iowa is not an endemic area for coccidioidomycosis. Respiratory failure from miliary infiltration is an uncommon presentation of coccidioidomycosis. Physicians should be aware of the importance of travel history and potential for life-threatening coccidioidomycosis in patients receiving tumor necrosis factor inhibitors.

  1. Global klimaovervågning med GNSS

    DEFF Research Database (Denmark)

    Madsen, Finn Bo; Khan, Shfaqat Abbas; Nielsen, Jens Emil

    2010-01-01

    Hvornår bliver de folkerige floddeltaer i Asien ubeboelige, hvornår forsvinder Maldiverne eller som merhuset på Danmarks Vestkyst. Verdenshavene stiger i takt med at ismasserne ved polerne smelter og ledes ud i oceanerne. Et centralt spørgsmål for hele verdenssamfundet er: hvor hurtigt sker det o...

  2. Historien med stort H endte i '89

    DEFF Research Database (Denmark)

    Østergaard, Uffe

    2015-01-01

    Revolution. Uffe Østergaard, Jean Monnet professor i europæisk historie på Copenhagen Business School, tager os med op, og betragter debatten om årsagerne til, og betydningen af, Murens fald i fugleperspektiv. Hvorfor var der ingen, der havde forudset begivenhederne?...

  3. MedAustron - Austrian Hadron Therapy Centre

    CERN Document Server

    Benedikt, M; 10.1109/NSSMIC.2008.4774090

    2009-01-01

    MedAustron is a synchrotron based accelerator facility for cancer treatment with proton and carbon ion beams. In addition to the clinical application, the accelerator will also provide beams for non-clinical research, in the fields of medical radiation physics, radiation biology and experimental physics.

  4. Kørsel med spiritus og stoffer

    DEFF Research Database (Denmark)

    Bernhoft, Inger Marie; Hels, Tove; Janstrup, Kira

    2012-01-01

    Alkohol er væsentlig hyppigere til stede hos alvorligt tilskadekomne bilister end misbrugs- og lægemiddelstoffer, hvorimod forekomsten hos bilister i trafikken er ligeligt delt mellem alkohol og andre stoffer. Højeste risiko for alvorlige personskadeuheld findes hos bilister, der kører med ulovli...

  5. Frequency, predictors, and consequences of maintenance infliximab therapy intensification in ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Luis Fernández-Salazar

    2015-09-01

    Full Text Available Introduction: Infliximab (IFX therapy intensification in ulcerative colitis (UC is more common than established in pivotal studies. Objectives: To establish the frequency and form of intensification for UC in clinical practice, as well as predictors, and to compare outcomes between intensified and non-intensified treatment. Methods: A retrospective study of 10 hospitals and 144 patients with response to infliximab (IFX induction. Predictive variables for intensification were analyzed using a Cox regression analysis. Outcome, loss of response to IFX, and colectomy were compared between intensified and non-intensified therapy. Results: Follow-up time from induction to data collection: 38 months [interquartile range (IQR, 20-62]. Time on IFX therapy: 24 months (IQR, 10-44. In all, 37% of patients required intensification. Interval was shortened for 36 patients, dose was increased for 7, and 10 subjects received both. Concurrent thiopurine immunosuppressants (IMM and IFX initiation was an independent predictor of intensification [Hazard ratio, 0.034; p, 0.006; CI, 0.003-0.371]. In patients on intensified therapy IFX discontinuation for loss of response (30.4% vs. 10.2%; p, 0.002, steroid reintroduction (35% vs. 18%; p, 0.018, and colectomy (22% vs. 6.4%; p, 0.011 were more common. Of patients on intensification, 17% returned to receiving 5 mg/kg every 8 weeks. Conclusions: Intensification is common and occasionally reversible. IMM initiation at the time of induction with IFX predicts non-intensification. Intensification, while effective, is associated with poorer outcome.

  6. A systematic review of infliximab in the treatment of early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Sophie Martin Du Pan

    2007-11-01

    Full Text Available Sophie Martin Du Pan, Cem Gabay, Axel FinckhDivision of Rheumatology, Department of Internal Medicine, University of GenevaBackground: Several health authorities have recently revised the indication of infliximab (IFX to include the treatment of early rheumatoid arthritis (RA. The aim of this systematic review of the literature was to appraise the efficacy, safety, and cost-effectiveness of early therapy with IFX.Methods: We identified published clinical trials from 1966 to May 2006. We included randomized clinical trials (RCTs in RA with disease duration of less than 3 years comparing the treatment of methotrexate-IFX (MTX-IFX with methotrexate-placebo (MTX-placebo.Results: A total of 8 studies met inclusion criteria. Three studies reported redundant data regarding the vdH Sharp Score. Out of the 5 remaining studies, 4 analyzed structural joint destruction (vdH Sharp Score and demonstrated a significant reduction in radiographic damage progression in favor of the combination of MTX-IFX compared with MTX-placebo (–4.1 vdH Sharp Score units (95% CI: 3.5; 4.6. Three studies also displayed a benefit of MTX-IFX on functional outcomes of RA (HAQ score and disease activity measures (DAS, ACR response criteria, although less markedly.Conclusions: Although data might be skewed because of only 2 existing large studies with concordant data, results from RCTs demonstrate improved efficacy of the combination MTXIFX compared with MTX-placebo in early RA. However, many early RA patients probably do not require the addition of IFX to achieve a satisfying clinical and radiological course. So far, no evidence has established the superiority of MTX-IFX over MTX-prednisone or other combinations of traditional disease-modifying anti-rheumatic agents.Keywords: rheumatoid arthritis, antirheumatic agents, infliximab

  7. Musikterapi med børn med svær autisme - en litteraturgennemgang

    Directory of Open Access Journals (Sweden)

    Ulla Holck

    2003-03-01

    Full Text Available Faglitteratur om musikterapi med børn med autisme er omfattende og indeholder såvel kvalitative case-beskrivelser som kvantitative forskningsundersøgelser. I artiklen gennemgås faglitteraturen systematisk med henblik på at specifi cere musikterapiens effekt og virkemåder i forhold til denne målgruppe. Vægten ligger på børn med svær autisme, men litteratur om voksne højtfungerende personer med autisme inddrages også. Forskningslitteraturen viser, at det især er inden for områderne koncentration, visuel opmærksomhed, respons og initiativ, samt brug af stemme og tur-tagning, at musikterapi har en effekt. Case-litteraturen begrunder denne effekt med musikkens evne til at være redundant, anvendelse af imitation og responsfremmende teknikker (overraskelse etc., fælles opbyggede samspilsformer, samt det temporale-interaktive element i improvisatorisk musikterapi. Ud fra en interaktionsteoretisk indfaldsvinkel sammenkobles effekten endvidere med, at den musikalske interaktion hjælper musikterapeuten til at fastholde et dynamisk udtryk, hvilket er afgørende i forhold til en klientgruppe, der ofte giver ´flad´ eller stærkt afvigende feedback.

  8. B-lymfocytdepletring og andre biologiske behandlingsmuligheder ved Graves' oftalmopatiTumor necrosis factor-alpha binding capacity and anti-infliximab antibodies measured by fluid-phase radioimmunoassays as predictors of clinical efficacy of infliximab in Crohn's disease

    DEFF Research Database (Denmark)

    El, Fassi D.; Hegedus, L.; Nielsen, Claus Henrik

    2008-01-01

    The current medical treatment options for Graves' ophthalmopathy (GO) are unsatisfactory. Recent treatment of GO patients with the B-lymphocyte depleting monoclonal antibody rituximab or with the anti-tumor necrosis factor-alpha agents etanercept and infliximab has shown promising results. We...... discuss the use of these and other biological agents targeting B lymphocytes, T-lymphocyte interaction with antigen-presenting cells, or cytokines in the future treatment of GO Udgivelsesdato: 2008/6/9...

  9. Udvendig efterisolering af gavle med præfabrikerede komponenter

    DEFF Research Database (Denmark)

    Nørregaard, M.; Stampe, M.; Kjær, A.

    Rapporten bringer resultaterne af et demonstrationsprojekt, hvor en fritliggende gavl på hver af to ældre etageejendomme blev efterisoleret med præfabrikerede komponenter. Den ene gavl blev beklædt med komponenter af fiberbeton monteret fra stillads, den anden med store stålkassetter monteret med...... kran og lift....

  10. Oclusão de ramo venoso da retina associado ao uso de infliximabe: relato de caso

    Directory of Open Access Journals (Sweden)

    Bruno Diniz

    2011-06-01

    Full Text Available Descrevemos o caso de uma paciente, de 53 anos, com quadro de oclusão de ramo venoso da retina após receber seis infusões de infliximabe (3 mg/kg/dose, para tratamento de artrite reumatóide. A investigação clínica e laboratorial sobre distúrbios de coagulação, cardiopatias e sinais de hipertensão arterial crônica foi negativa. A relação temporal do uso de infliximabe e o desenvolvimento do quadro de oclusão de ramo pode indicar um possível efeito adverso da medicação.

  11. Early treatment with infliximab in bilateral occlusive vasculitis as a presenting manifestation of Behçet' disease.

    Science.gov (United States)

    Bañeros-Rojas, P; Berrozpe-Villabona, C; Peraza-Nieves, J E; Díaz-Valle, D

    2015-06-01

    A 24 year old woman who complained of maculo-papulo rash, genital and bucal aphthous ulcers, abdominal pain, minor dyspnea and visual loss in both eyes. Funduscopy revealed a bilateral occlusive vasculitis including central vessels. Treatment was initiated with a methylprednisolone bolus (1 g/24h) and infliximab 5mg/kg/day (0-2-6 weeks and every 8 weeks). The treatment prescribed induced a fast remission. Visual acuity improved. The patient did not suffer any other relapse after one year of follow-up. An initial treatment with Infliximab should be considered in Behçet disease for serious outbreaks, such as macular occlusive vasculitis with ischemia. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  12. IgE antibodies and skin tests in immediate hypersensitivity reactions to infliximab in inflammatory bowel disease: impact on infliximab retreatment.

    Science.gov (United States)

    Fréling, Estelle; Peyrin-Biroulet, Laurent; Poreaux, Claire; Morali, Alain; Waton, Julie; Schmutz, Jean-Luc; Guéant, Jean-Louis; Barbaud, Annick

    2015-10-01

    Infliximab (IFX) is used for the treatment of inflammatory bowel diseases (IBD). Immediate hypersensitivity reactions (HR) to IFX are frequently reported. We investigated immunoglobulin E (IgE)-mediated mechanisms underlying immediate HR to IFX. We also evaluated the clinical utility of allergological tests as well as the tolerability of IFX retreatment in these patients. This was a prospective single-center study including IBD patients with previous immediate HR to IFX. Skin tests to IFX, including prick tests and intradermal tests, and measurement of anti-IFX IgE antibodies were performed at least 4 weeks after HR. In case of negative skin tests and absence of IgE antibodies, readministration of IFX was performed with a twice-reduced infusion rate. In case of positive tests or recurrence of HR during readministration of IFX, a 12-step desensitization or induction of tolerance protocol was proposed. A total of 24 IBD patients were included (Crohn's disease: n=20). Prick tests to IFX were all negative. Intradermal test was positive in one patient. Anti-IFX IgE antibodies were not detected in 21 patients and were detected in three patients (significant level in one patient and intermediate level in two patients). No relationship was observed between positive skin tests and the presence of anti-IFX IgE antibodies. Switch to adalimumab was well tolerated in 10/11 patients. The readministration of IFX was well tolerated in 4/11 patients. Desensitization to IFX was successful in three out of four patients. The vast majority of immediate HR to IFX is not IgE-mediated. Allergological tests are of poor clinical utility. Desensitization or induction of tolerance protocol may allow continuation of IFX therapy in IBD patients with a history of immediate HR.

  13. Comparisons of Serum Infliximab and Antibodies-to-Infliximab Tests Used in Inflammatory Bowel Disease Clinical Trials of Remicade®.

    Science.gov (United States)

    Marini, Joseph C; Sendecki, Jocelyn; Cornillie, Freddy; Popp, John W; Black, Shawn; Blank, Marion; Gils, Ann; Van Stappen, Thomas; Hamann, Dörte; Rispens, Theo; Thérien, Lina; Chun, Kelly; Shankar, Gopi

    2017-01-01

    Monitoring infliximab (IFX) concentrations and antibodies-to-IFX (ATI) titers during inflammatory bowel disease treatment may allow more informed decisions in assessing exposure/response and determining appropriate dosing. To aid in interpreting results from different commercial tests in the context of Janssen's published Remicade® results, the reliability of Janssen's IFX and ATI assays was compared with commercial assays from KU Leuven, Sanquin, Dynacare, and LabCorp. Test results were independently reported to Janssen. All assays were tested for specificity, selectivity, and precision. ATI assays were evaluated for sensitivity, drug interference, and potential interference of tumor necrosis factor-alpha (TNF-α). IFX assays were specific, accurate, and reproducible. Intra-class correlation of Janssen IFX assay results with those from KU Leuven, Sanquin, Dynacare, and LabCorp were 0.960, 0.895, 0.931, and 0.971, respectively. ATI titers >10 interfered with IFX assessment in all IFX assays, whereas TNF-α (≤50 ng/mL) did not interfere with IFX detection in any assay. ATI assays specifically and reproducibly detected ATI. Janssen, Sanquin, and LabCorp ATI methods were more resistant to IFX interference than Dynacare and KU Leuven, which were affected by IFX concentrations at ≥2 μg/mL. TNF-α (<5 ng/mL) did not interfere with ATI detection. Strong agreement was observed between Janssen's IFX and ATI assays and the diagnostic service provider assays. Our study results indicate that all four commercially available assays are suitable for therapeutic drug monitoring of IFX. The substantial agreement reported here between the comparator assays and the Janssen drug-tolerant assay provides support to clinicians in their use of these commercial assays, and for understanding their patients' IFX and ATI results relative to published data from clinical studies of Remicade.

  14. Infliximab Biosimilars: A Promising but Unusual Treatment for Mycobacterial Immune Reconstitution Inflammatory Syndrome in Human Immunodeficiency Virus-Infected Patients

    Science.gov (United States)

    Cuevas, Guillermo; Ryan, Pablo; Díez, Victorino; Izquierdo, Elsa; Escobar, Ismael; Solís, Javier

    2017-01-01

    Abstract Immune reconstitution inflammatory syndrome can present as a paradoxical reaction after initiation of antiretroviral treatment in patients with severe immunosuppression and underlying infections. Immune reconstitution inflammatory syndrome has often been associated with mycobacteria, and the clinical response to traditional treatment with corticosteroids is not always satisfactory. Consequently, administration of an infliximab biosimilar could lead to an improvement in the clinical status of these patients. PMID:28948183

  15. Comparison of acute effect of systemic versus intravitreal infliximab treatment in an experimental model of endotoxin-induced uveitis.

    Science.gov (United States)

    Yuksel, Erdem; Hasanreisoglu, Berati; Yuksel, Nilay; Yilmaz, Guldal; Ercin, Ugur; Bilgihan, Ayse

    2014-02-01

    In this study, we investigated the efficacy of systemic and intravitreal (IV) infliximab treatments and compared these 2 different treatment modalities in an experimental model of endotoxin-induced uveitis (EIU). Twenty-four white New Zealand rabbits were equally divided into 4 groups. Group 1 received IV injection of lipopolysaccharide (LPS), group 2 received IV injections of LPS and saline, group 3 received IV LPS and IV 2 mg/0.1 cc infliximab, and group 4 received IV LPS and 5 mg/kg intravenous infliximab. Inflammation was determined with objective and subjective tests. The subjective test was clinical determination of uveitis, the objective tests were determination of protein concentrations and tumor necrosis factor alpha (TNF-α) levels and histopathology. Clinical examination score was lower in group 3 and group 4 (4±0.6 and 3.5±1.6, respectively) when compared with group 1 (P=0.02; P=0.04, respectively) and group 2. In group 3 and 4, the aqueous and vitreous protein and TNF-α concentration measured significantly lower than group 1 and 2. In histopathologic examination, there was no statistically significant difference between group 1, 2, and 3 (3.5±0.5, 3.6±0.5, 3.6±0.5, respectively). However, the lowest histopathologic inflammation was determined in group 4 (2.5±0.5) (compared with group 1 and group 3, respectively; P=0.03; P=0.014). In a rabbit model of experimental EIU, intravenous administration of infliximab was more effective than IV route in an acute period.

  16. Changes in Body Mass Index and Lipid Profile in Psoriatic Patients After Treatment With Standard Protocol of Infliximab.

    Science.gov (United States)

    Ehsani, Amir Houshang; Mortazavi, Hossein; Balighi, Kamran; Hosseini, Mahboubeh Sadat; Azizpour, Arghavan; Hejazi, Seyyedeh Pardis; Goodarzi, Azadeh; Darvari, Seyyedeh Bahareh

    2016-09-01

    Psoriasis is a chronic and inflammatory dermatologic disease. Psoriasis may predispose to cardiovascular disease and diabetes. However, the role of tumor necrosis factor (TNF) inhibitor in mediating this risk is controversial. Regarding frequent use of infliximab in psoriasis, and the hypothesis that anti TNF-α treatment may increase Body Mass Index (BMI) and alter lipid profile in these patients, the aim of this study was to assess changes in BMI and Lipid Profile and level of leptin in Psoriatic Patients under Treatment of Standard Protocol of Infliximab in a 24 week period. This study was accomplished as a before-after study. Twenty-seven psoriatic patients were included, and standard infliximab therapy was applied. All patients underwent 3 times of blood collection and in each session; LDL, HDL, Total Cholesterol, Triglycerides, Leptin, and PASI score were measured at the start of the study and at the 12th and 24th week of follow-up. Twenty-five patients consisted of 18 (72%) male and 7 (28%) female subjects were evaluated. The mean age of the patients was 36.91±13.31 years. PASI score demonstrated significant decrease after 24 weeks; however, BMI and HDL and leptin showed a significant increase during treatment. Significant negative correlation was seen between Leptin and PASI score changes (r=0.331, P=0.042). HDL and BMI had the most correlations with leptin (positive correlation) and PASI score (negative correlation). Results demonstrated a dramatic decrease in PASI, increase in BMI and HDL and increased in leptin; somewhat correlated to each other. These results suggest that patients taking infliximab should take more care of their weight and lipid profile, while on treatment.

  17. Om computerberegnede tommelfingerregler i forbindelse med pensionsopsparing

    DEFF Research Database (Denmark)

    Møller, Michael; Waldstrøm, Stephan

    2013-01-01

    Beslutninger i forbindelse med pension er mange og komplicerede: Hvornår og hvor meget skal spares op, hvordan skal pengene investeres, og hvilke forsikringsydelser skal købes. Obligatoriske pensionsordninger er en ”one size fits all” model, som for mange vil ramme i underkanten af det forventede...... behov. Der er behov for tommelfingerregler, der kan hjælpe alle dem, der på den ene side ikke vil nøjes med deres obligatoriske ordning men på den anden side finder beslutninger om pension of forsikring vanskelige. Modellerne kan aldrig blive perfekte. Det lader sig ikke gøre i en usikker verden. Men de...

  18. Hvad skal vi med Trump-satire?

    DEFF Research Database (Denmark)

    Møller, Mette

    2017-01-01

    Trump-satire er et stort hit, og særligt en lang række satiriske videohilsner til Trump fra lande verden over får folk til at trække på smilebåndet. Men hvorfor er det så sjovt at gøre grin med Trump, og hvad kan vi bruge den politiske humor til?......Trump-satire er et stort hit, og særligt en lang række satiriske videohilsner til Trump fra lande verden over får folk til at trække på smilebåndet. Men hvorfor er det så sjovt at gøre grin med Trump, og hvad kan vi bruge den politiske humor til?...

  19. Analys av nickel med ICP-MS

    OpenAIRE

    Wallman, Karin; Löfgren, Stefan; Sonesten, Lars; Demandt, Christian

    2009-01-01

    Vid en granskning av nickelhalter för perioden 1985-2007 upptäcktes ett nivåskifte i tidsserierna på flera stationer mellan 2001 och 2002. Skiftet visade sig bero på att prover innan 2002 inte korrigerades för kalciuminterferens, medan prover under åren 2002-2007 korrigerades. Syftet med denna rapport är att utreda om resultaten före 2002 i efterhand kan korrigeras för kalciuminterferensen. Från 2002 finns ett antal prover (N=347) med resultat som både är kalciumkorrigerade och som inte är de...

  20. Bøger med QR-lyd

    DEFF Research Database (Denmark)

    Hellensberg, Christina

    2015-01-01

    Anmeldelse af DigiRead engelsk supplerende læsning med QR-lyd. Lyd på QR-koder til bøger kræver smartphone eller tablet; devices, kun nogle elever i indskolingen har adgang til, men som er lige ved hånden for en stor del af mellemtrinnets elever. Men kvaliteten af lyden er god; rigtig god...