Deoxyspergualin in relapsing and refractory Wegener's granulomatosis

Floßmann, Oliver; Baslund, Bo; Bruchfeld, Annette; Tervaert, Jwc; Hall, Cindy; Heinzel, P; Hellmich, Bernhard; Luqmani, Raashid; Nemoto, Kyuichi; Tesař, Vladimı́r; Jayne, David

doi:10.1136/ard.2008.092429

Cited by 80 publications

(46 citation statements)

References 34 publications

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“…Massive alveolar haemorrhage is associated with a poorer prognosis in induction-refractory disease. Rituximab (25), intravenous immunoglobulin (55), deoxyspergualin (56), infliximab (57), alemtuzumab (58), and anti-thymocyte globulin have been used with success to treat AAV refractory to cyclophosphamide and glucocorticoids.…”

Section: Treatmentmentioning

confidence: 99%

Diffuse Alveolar Haemorrhage in ANCA-associated Vasculitis

et al. 2013

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Diffuse alveolar haemorrhage (DAH) is a serious complication of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). A literature review was performed to ascertain the diagnostic features, treatment, and outcome of this rare but serious condition. Haemoptysis and dyspnoea are common but nonspecific features. Chest radiography is usually abnormal, and high-resolution computerised tomographic scanning is more sensitive. Increased uptake of inhaled carbon monoxide and reduced clearance of C 15 O on lung function testing is suggestive of intra-alveolar blood. Fiberoptic bronchoscopy and bronchoalveolar lavage are useful when a super-added infection is suspected. Concurrent renal disease is common and contributes to the morbidity and mortality. Treatment should be individualised, and it is based on glucocorticoid and cyclophosphamide induction with azathioprine maintenance. The role of plasmapheresis is unclear, and is currently being evaluated. Patients are at risk of disease and treatment-related long-term complications. Ongoing research into the most efficacious therapeutic regimens associated with the least side effects is especially important.

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Section: Treatmentmentioning

confidence: 99%

Diffuse Alveolar Haemorrhage in ANCA-associated Vasculitis

et al. 2013

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“…The combination of cyclophosphamide and corticosteroids is still commonly used for induction therapy of orbital GPA. Although not specifically evaluated for orbital GPA, methotrexate, azathtioprine, mycophenolate mofetil, and 15-deoxyspergualin (an immunomodulatory synthetic analog of bacteria-derived spergualin) have also been shown to assist in inducing remission [72][73][74][75][76].…”

Section: Granulomatosis With Polyangitismentioning

confidence: 99%

Orbital inflammatory disease management

Moore

Rootman

2016

Expert Review of Ophthalmology

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“…Rituximab has been successful in CyP-refractory disease in observational studies (Smith et al 2006;Keogh et al 2006;Jones et al 2009;Keogh et al 2005). Deoxyspergualin (0.5 mg/Kg/day subcutaneously in 6 cycles of 21 days with 7-day intervals), an antiproliferative agent licensed in Japan for acute renal transplant rejection, showed promise in phase II study (Flossmann et al 2009). Infliximab was beneficial in refractory disease in observational studies (Josselin et al 2008) but when added to standard induction treatment did not make any difference ).…”

Section: Refractory Diseasementioning

confidence: 99%