Abatacept as an alternative therapy for the treatment of drug-intolerant lupus nephritis: A case of underlying monosomy 1p36 deletion syndrome

Hosoda, Tatsuo; Hashimoto, Shun; Sato, Riko; Fujita, Masashi; Aizawa, Tomomi; Tsugawa, Koji; Tanaka, Hiroshi

doi:10.5414/cn110633

Cited by 3 publications

(1 citation statement)

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“…That was the theoretical background for the synthesis and introduction of Abatacept, a fusion protein composed of a soluble form of the extracellular domain of CTLA-4 linked to the immunoglobulin G1Fc part [ 60 ]. It showed its safety and efficacy in rheumatoid arthritis and is still intensively tested in various autoimmune diseases [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ]. In systemic sclerosis, which is characterised by the pivotal role of the T cell orchestrating the immune response [ 69 ], blocking T cell activation seems to be a reasonable approach.…”

Section: Immunocompetent Cells In Systemic Sclerosismentioning

confidence: 99%

Novel Therapeutic Strategies in the Treatment of Systemic Sclerosis

et al. 2023

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Systemic sclerosis is a connective tissue disease of unknown origin and with an unpredictable course, with both cutaneous and internal organ manifestations. Despite the enormous progress in rheumatology and clinical immunology, the background of this disease is largely unknown, and no specific therapy exists. The therapeutic approach aims to treat and preserve the function of internal organs, and this approach is commonly referred to as organ-based treatment. However, in modern times, data from other branches of medicine may offer insight into how to treat disease-related complications, making it possible to find new drugs to treat this disease. In this review, we present therapeutic options aiming to stop the progression of fibrotic processes, restore the aberrant immune response, stop improper signalling from proinflammatory cytokines, and halt the production of disease-related autoantibodies.

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Section: Immunocompetent Cells In Systemic Sclerosismentioning

confidence: 99%

Novel Therapeutic Strategies in the Treatment of Systemic Sclerosis

et al. 2023

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Experience with abatacept in refractory lupus nephritis

Calatayud,

Montomoli,

Ávila

et al. 2023

Rheumatol Int

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Lupus nephritis is a major cause of morbidity in patients with systemic lupus erythematosus. Responsiveness to treatment is crucial to avoid chronic kidney disease. New molecules have been developed in recent years to improve renal survival rates. Biological therapies as coadjutant to conventional induction treatment have been tested in randomized clinical trials with heterogeneous results. Like many others biologic therapies, Abatacept has not shown a clear benefit in the context of clinical trials. We present two cases of lupus nephritis patients in whom addition of abatacept resulted in complete remission of the renal disease. The first case described a 49-year-old male with class IV lupus nephritis with nephrotic range proteinuria and high immunological activity refractory to conventional treatment with cyclophosphamide and corticosteroids and multitarget therapy with tacrolimus, mycophenolate mofetil and prednisone. Several biological therapies (rituximab, belimumab and tocilizumab) were unsuccessfully tried, so that abatacept was added to his background multitarget therapy showing complete clinical response. The second case described a 52-year-old female with class IV lupus nephritis treated initially with conventional treatment with partial response. In successive renal flares with nephrotic proteinuria, she showed intolerance to rituximab and refractoriness to voclosporin. Finally, abatacept was added to her background therapy with MMF and PDN showing complete and maintained remission of the disease. In no case the use of abatacept was associated with serious adverse events. Based on our experience, abatacept should be considered as a safe rescue therapy in patients with refractory lupus nephritis and proteinuria with nephrotic range. In addition to this case, we reviewed the use of abatacept in lupus nephritis in the literature.

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Multiple drugs

2022

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Abatacept as an alternative therapy for the treatment of drug-intolerant lupus nephritis: A case of underlying monosomy 1p36 deletion syndrome

Cited by 3 publications

References 0 publications

Novel Therapeutic Strategies in the Treatment of Systemic Sclerosis

Novel Therapeutic Strategies in the Treatment of Systemic Sclerosis

Experience with abatacept in refractory lupus nephritis

Multiple drugs

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