Efficacy and safety profile of intravenous tocilizumab versus intravenous abatacept in treating female Saudi Arabian patients with active moderate-to-severe rheumatoid arthritis

Elmedany, Samah Hamdy; Mohamed, Aly Elsayed; Galil, Sahar M. Abdel

doi:10.1007/s10067-019-04508-2

Cited by 10 publications

(13 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Three papers were identified reporting BP data with IL-6 antagonist tocilizumab, two used in combination with methotrexate. 172,173 SBP increase was demonstrated by Elmedany et al…”

Section: Anti-il-17mentioning

confidence: 86%

“…(116±16 vs 129 + /-17 mmHg, p=0.001), 172 the other two papers reporting no change in BP with IL6 blockade 173,174 , though the average baseline BP values were normal range. Overall, the minimally available evidence (detailed in Supplementary Table ) does not support an association with BP lowering.…”

Section: Anti-il-17mentioning

confidence: 88%

“…In five studies of RA patients reporting BP outcomes with abatacept, specific values were not available for two and none of the others reported a statistically significant effect on BP. 172,174,[198][199][200] Seven studies reporting BP outcomes using Belatacept, an alternative CTLA-Ig, were identified. All of these were in transplant recipients and were compared to patients receiving CNIs.…”

Section: Ctla-4-igmentioning

confidence: 99%

See 2 more Smart Citations

Therapeutic targeting of inflammation in hypertension: from novel mechanisms to translational perspective

Murray

Nosalski

MacRitchie

et al. 2021

Cardiovascular Research

View full text Add to dashboard Cite

Animal models, human observational and genetic studies have shown that immune and inflammatory mechanisms play a key role in hypertension and its complications. We review the effects of immunomodulatory interventions on blood pressure, target organ damage and cardiovascular risk in humans. In experimental and small clinical studies both non-specific immunomodulatory approaches, such as mycophenolate mofetil and methotrexate, and medications targeting T and B lymphocytes, such as tacrolimus, cyclosporine, everolimus, rituximab, lower blood pressure and reduce organ damage. Mechanistically targeted immune interventions include isolevuglandin (isoLG) scavengers to prevent neo-antigen formation, co-stimulation blockade (abatacept, belatacept), and anti-cytokine therapies (secukinumab, tocilizumab, canakinumab, TNF-α inhibitors). In many studies, trial designs have been complicated by a lack of blood pressure related endpoints, inclusion of largely normotensive study populations, polypharmacy, and established comorbidities. Among a wide range of interventions reviewed, TNF-α inhibitors have provided the most robust evidence of blood pressure lowering. Treatment of periodontitis also appears to deliver non-pharmacological antihypertensive effects. Evidence of immunomodulatory drugs influencing hypertension-mediated organ damage are discussed. Animal model, observational studies, and trial data in humans support the therapeutic potential of immune targeted therapies in blood pressure lowering and in hypertension-mediated organ damage. Targeted studies are now needed to address their effects on blood pressure in hypertensive individuals.

show abstract

“…Three papers were identified reporting BP data with IL-6 antagonist tocilizumab, two used in combination with methotrexate. 172,173 SBP increase was demonstrated by Elmedany et al…”

Section: Anti-il-17mentioning

confidence: 86%

Section: Anti-il-17mentioning

confidence: 88%

Section: Ctla-4-igmentioning

confidence: 99%

See 1 more Smart Citation

Therapeutic targeting of inflammation in hypertension: from novel mechanisms to translational perspective

Murray

Nosalski

MacRitchie

et al. 2021

Cardiovascular Research

View full text Add to dashboard Cite

show abstract

“…52 58-60 106 121 When directly comparing different non-TNFi bDMARDs, there was a numerical advantage of tocilizumab to be more effective than abatacept in patients who failed a TNFi in six of seven papers (statistically significant in at least one of the response criteria in 3 papers (1 SLR (of 4 studies), 1 RCT, 5 observational studies; 1 moderate RoB, 6 high RoB)). 63 83 84 89 91 97 101Additionally, there was a numerical advantage of tocilizumab to be more effective than abatacept in patients who failed rituximab in three of three papers (statistically significant in at least one of the response criteria in 2 papers (3 observational studies; 3 high RoB)). 62 114 117 Furthermore, there was some advantage of tocilizumab to be more effective than rituximab in patients who failed a TNFi (4 papers) or a non-TNFi (1 paper) in five of five papers (statistically significant in at least one of the response criteria in all papers (2 SLRs (of 24 and 4 studies (partly overlapping)), 1 RCT, 2 observational studies; 2 moderate RoB, 3 high RoB)).…”

Section: Study Characteristicsmentioning

confidence: 99%

Pharmacological and non-pharmacological therapeutic strategies in difficult-to-treat rheumatoid arthritis: a systematic literature review informing the EULAR recommendations for the management of difficult-to-treat rheumatoid arthritis

et al. 2021

View full text Add to dashboard Cite

ObjectivesTo summarise, by a systematic literature review (SLR), the evidence regarding pharmacological and non-pharmacological therapeutic strategies in difficult-to-treat rheumatoid arthritis (D2T RA), informing the EULAR recommendations for the management of D2T RA.MethodsPubMed, Embase and Cochrane databases were searched up to December 2019. Relevant papers were selected and appraised.ResultsTwo hundred seven (207) papers studied therapeutic strategies. Limited evidence was found on effective and safe disease-modifying antirheumatic drugs (DMARDs) in patients with comorbidities and other contraindications that limit DMARD options (patients with obesity, hepatitis B and C, risk of venous thromboembolisms, pregnancy and lactation). In patients who previously failed biological (b-)DMARDs, all currently used b/targeted synthetic (ts-)DMARDs were found to be more effective than placebo. In patients who previously failed a tumour necrosis factor inhibitor (TNFi), there was a tendency of non-TNFi bDMARDs to be more effective than TNFis. Generally, effectiveness decreased in patients who previously failed a higher number of bDMARDs. Additionally, exercise, psychological, educational and self-management interventions were found to improve non-inflammatory complaints (mainly functional disability, pain, fatigue), education to improve goal setting, and self-management programmes, educational and psychological interventions to improve self-management.The identified evidence had several limitations: (1) no studies were found in patients with D2T RA specifically, (2) heterogeneous outcome criteria were used and (3) most studies had a moderate or high risk of bias.ConclusionsThis SLR underscores the scarcity of high-quality evidence on the pharmacological and non-pharmacological treatment of patients with D2T RA. Effectiveness of b/tsDMARDs decreased in RA patients who had failed a higher number of bDMARDs and a subsequent b/tsDMARD of a previously not targeted mechanism of action was somewhat more effective. Additionally, a beneficial effect of non-pharmacological interventions was found for improvement of non-inflammatory complaints, goal setting and self-management.

show abstract

“…Hence, according to this scenario, anti-inflammatory drugs should be given before the presentation of Stage II symptoms (Sheppard et al, 2017). To this end, however, tocilizumab and corticosteroids are questioned, or not recommended in earlier stages because of the cost and sub-optimal safety issues (Elmedany et al, 2019), and because of immunosuppressive activity (Veronese et al, 2020), respectively.…”

mentioning

confidence: 99%

Repositioning Chromones for Early Anti-inflammatory Treatment of COVID-19

Sestili

Stocchi

2020

Front. Pharmacol.

View full text Add to dashboard Cite

The COVID-19 pandemic is posing an unprecedented sanitary threat. In the absence of specific vaccines and anti-SARS-CoV-2 drugs, medicines that may assist in tackling the emergency and limiting the high number of fatalities are urgently needed. The repositioning of available drugs to treat COVID-19 is the only and rapid option in the face of the lack of direct antiviral agents and vaccines available. In this light it is important to focus on available drugs, which, based on their pharmacodynamics, could plausibly attenuate viral growth as well as COVID-19's worst complications. This is the case of chloroquine and tocilizumab which seem to limit virus replication and the severity of interstitial pneumonia, respectively. However, these treatments, particularly those aimed at containing inflammation, are still reserved for the most severe cases. This commentary elaborates on the pharmacological rationale of repositioning the mast cell stabilizer chromones as an adjunctive treatment for SARS-CoV-2 infection, and proposes their practical clinical testing as an early, safe, and cost-effective anti-inflammatory intervention in COVID-19 to limit the eventual secondary progression toward life-threatening respiratory complications.

show abstract

Efficacy and safety profile of intravenous tocilizumab versus intravenous abatacept in treating female Saudi Arabian patients with active moderate-to-severe rheumatoid arthritis

Cited by 10 publications

References 31 publications

Therapeutic targeting of inflammation in hypertension: from novel mechanisms to translational perspective

Therapeutic targeting of inflammation in hypertension: from novel mechanisms to translational perspective

Pharmacological and non-pharmacological therapeutic strategies in difficult-to-treat rheumatoid arthritis: a systematic literature review informing the EULAR recommendations for the management of difficult-to-treat rheumatoid arthritis

Repositioning Chromones for Early Anti-inflammatory Treatment of COVID-19

Contact Info

Product

Resources

About