Azathioprine. An effective, corticosteroid-sparing therapy for patients with recalcitrant cutaneous lupus erythematosus or with recalcitrant cutaneous leukocytoclastic vasculitis

Callen, Jeffrey P.

doi:10.1001/archderm.127.4.515

Cited by 83 publications

(62 citation statements)

References 12 publications

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“…For example, azathioprine was reported to be effective for cutaneous lupus erythematosus [16]. However, according to another report, azathioprine was not effective for arthritis, serositis, or cutaneous manifestations of SLE [17].…”

Section: Discussionmentioning

confidence: 99%

Tacrolimus therapy for systemic lupus erythematosus without renal involvement: a preliminary retrospective study

et al. 2009

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We conducted a pilot study to investigate whether tacrolimus was effective for treating patients with systemic lupus erythematosus (SLE) without renal involvement. Ten SLE patients with symptoms such as arthritis and erythema, but no active nephritis, were treated with tacrolimus. They included 8 women and 2 men aged from 24 to 62 years [mean +/- standard deviation (SD): 42.1 +/- 11.3 years]. Tacrolimus was administered at doses of 1-3 mg daily, and efficacy was assessed from the SLE Disease Activity Index (SLEDAI) after 1 year. Two patients ceased treatment due to adverse reactions (after 4 days for chest pain and 7 months for recurrent infections). The other 8 patients completed 1 year of treatment, and significant improvement of disease activity was observed in 6 of them. The mean (+/-SD) SLEDAI showed a significant decrease after 1 year of tacrolimus therapy, from 6.8 +/- 3.1 to 3.4 +/- 0.9; p < 0.05 by Student's paired t test. The mean (+/-SD) dose of prednisolone also decreased significantly, from 16.8 +/- 8.6 to 9.3 +/- 4.6 mg/day; p < 0.05. Although a prospective controlled study will be necessary to confirm, tacrolimus might be a treatment option for active SLE without renal involvement.

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Section: Discussionmentioning

confidence: 99%

Tacrolimus therapy for systemic lupus erythematosus without renal involvement: a preliminary retrospective study

et al. 2009

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“…Standard pharmacological treatment of CLE includes topical or systemic corticosteroids and anti-malarial agents, but these options may be of limited effectiveness and may result in burdensome local and systemic side effects [7]. Some patients with CLE or DLE resistant to standard therapies may respond to immunomodulators such as azathioprine [8], methotrexate [9] and mycophenolate mofetil [10], although the benefits of the latter agents must also be weighed against the potential for toxicity.…”

Section: Introductionmentioning

confidence: 99%

Monoclonal antibody against macrophage colony-stimulating factor suppresses circulating monocytes and tissue macrophage function but does not alter cell infiltration/activation in cutaneous lesions or clinical outcomes in patients with cutaneous lupus erythematosus

Masek-Hammerman

Peeva

Ahmad

et al. 2015

Clinical and Experimental Immunology

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Summary This study's objective was to assess the effects of PD‐0360324, a fully human immunoglobulin G2 monoclonal antibody against macrophage colony‐stimulating factor in cutaneous lupus erythematosus (CLE). Patients with active subacute CLE or discoid lupus erythematosus were randomized to receive 100 or 150 mg PD‐0360324 or placebo via intravenous infusion every 2 weeks for 3 months. Blood and urine samples were obtained pre‐ and post‐treatment to analyse pharmacokinetics and pharmacodynamic changes in CD14+ CD16+ monocytes, urinary N‐terminal telopeptide (uNTX), alanine/aspartate aminotransferases (ALT/AST) and creatine kinase (CK); tissue biopsy samples were taken to evaluate macrophage populations and T cells using immunohistochemistry. Clinical efficacy assessments included the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI). Among 28 randomized/analysed patients, peak/trough plasma concentrations increased in a greater‐than‐dose‐proportional manner with dose increases from 100 to 150 mg. Statistically significant differences were observed between active treatment and placebo groups in changes from baseline in CD14+ CD16+ cells, uNTX, ALT, AST and CK levels at most time‐points. The numbers, density and activation states of tissue macrophages and T cells did not change from baseline to treatment end. No between‐group differences were seen in CLASI. Patients receiving PD‐0360324 reported significantly more adverse events than those receiving placebo, but no serious adverse events. In patients with CLE, 100 and 150 mg PD‐0360324 every 2 weeks for 3 months suppressed a subset of circulating monocytes and altered activity of some tissue macrophages without affecting cell populations in CLE skin lesions or improving clinical end‐points.

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“…Dapson is an anti-inflammatory drug that is used in various neutrophilic dermatoses and vasculitic diseases with its anti-neutrophilic effect [12]. Immunosuppressive agents (azathiopurine, mycophenolate mofetil, cyclosporin) that reduce steroid side effects in recurrent or chronic disease may also be treated [8][9][10]13]. Methotrexate is recommended especially in cases associated with connective tissue diseases.…”

Section: Discussionmentioning

confidence: 99%

Vildagliptin induced cutaneous leukocytoclastic vasculitis: A case report

Sayin¹,

Ömeroğlu²,

Bilgin³

2017

Med-Science

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Vildagliptin is a new generation theurapeutic agent of diabetes mellitus which belongs to dipeptidyl peptidase-IV inhibitor class acting via the incretin hormone system. It has moderate glycemic efficacy, a low propensity of causing hypoglycaemia and it is weight neutral. Overall, Dipeptidyl peptidase-4 (DPP-4) inhibitors are well tolerated. The use of DPP-4 inhibitors has been associated with a slightly increased risk of upper respiratory tract infections. In this article, we report a case of cutaneous leukocytoclastic vasculitis due to probable vildagliptin usage. Vildagliptin which is associated with cutaneous leukocytoclastic vasculitis was not described in the literature before. Physical examination revealed skin rash in the abdomen and thigh region in our patients due to use of the drug. Discontinuation of the drug eliminated the skin rash immediately.

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Azathioprine. An effective, corticosteroid-sparing therapy for patients with recalcitrant cutaneous lupus erythematosus or with recalcitrant cutaneous leukocytoclastic vasculitis

Cited by 83 publications

References 12 publications

Tacrolimus therapy for systemic lupus erythematosus without renal involvement: a preliminary retrospective study

Tacrolimus therapy for systemic lupus erythematosus without renal involvement: a preliminary retrospective study

Monoclonal antibody against macrophage colony-stimulating factor suppresses circulating monocytes and tissue macrophage function but does not alter cell infiltration/activation in cutaneous lesions or clinical outcomes in patients with cutaneous lupus erythematosus

Vildagliptin induced cutaneous leukocytoclastic vasculitis: A case report

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