Long-term safety and efficacy of a tamoxifen-based treatment strategy for idiopathic retroperitoneal fibrosis

Bommel, E. F. H. van; Pelkmans, Lindsey G.; Damme, Hendrik Van; Hendriksz, Tadek R

doi:10.1016/j.ejim.2012.11.010

Cited by 62 publications

(47 citation statements)

References 39 publications

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“…Tamoxifen, an anti-oestrogen agent developed for the treatment of gynaecological tumours, has proven to be effi cient in patients with RF [70]. In more than 80 %, substantial symptom resolution was seen within 3 weeks of a monotherapy with 2 × 20 mg tamoxifen/d which was continued over two years.…”

Section: Infl Ammatory Abdominal Aneurysm (Iaa)mentioning

confidence: 99%

Inflammatory diseases of the aorta

Caspary

2016

Vasa

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Summary:Infl ammatory aortic diseases may occur with and without dilatation and are complicated by obstruction, rupture and dissection. Infections originate from periaortic foci or septicaemia and tend to result in the rapid development of aneurysms. Large vessel vasculitis due to Takayasu arteritis in younger and giant cell arteritis (GCA) in older patients is located in all layers of the aortic wall and prevails in the thoracic section. GCA patients are prone to developing aortic complications in the late course of disease. In Behçet's disease, aneurysms may have an unusual morphology and localisation. The diagnosis of aortitis is usually obtained by vascular imaging, but partly made only by biopsy on occasion of an operation, especially in case of isolated aortitis of the ascending aorta which mostly remains inapparent until dissection or large aneurysms have developed. Periaortitis typically occurs in the abdominal aorta and may lead to infl ammatory aortic aneurysm (IAA). It is looked upon as a special form of vasculitis, with an overlap to primary retroperitoneal fi brosis (RF). An identical pathology is discussed for the three diseases. On the other hand, about 50 % of isolated aortitides and periaortitides as well as retroperitoneal fi broses can be classed among IgG4-related diseases. Periaortitis also is observed after treatment of aortic aneurysms by stent-graft implantation. Special attention should be paid to ureteral obstruction along with RF or IAA. Once infection is ruled out, immunosuppression is applied to all forms of infl ammatory aortic diseases, primarily with glucocorticoids. However, after successful surgery for isolated thoracic aortitis or infl ammatory aortic aneurysm immunosuppression may be dispensable and it is not required if periaortic tissue enlargement persists in chronic inactive disease. For some patients with periaortitis and RF, tamoxifen may be a valuable alternative.

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Section: Infl Ammatory Abdominal Aneurysm (Iaa)mentioning

confidence: 99%

Inflammatory diseases of the aorta

Caspary

2016

Vasa

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“…From that time until the most recent follow-up in October 2015, the patient has been clinically, analytically, and radiographically stable, with tamoxifen 20 mg daily and no associated corticosteroids [3].…”

Section: Case Reportmentioning

confidence: 96%

Efficacy of Tamoxifen for Treating Idiopathic Retroperitoneal Fibrosis

López-Serrano¹,

Vega²,

Bernabeu³

et al. 2017

Arch Med

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The term retroperitoneal fibrosis (Ormond's disease) encompasses a group of diseases characterized by fibrosis and inflammation of the tissue in the retroperitoneal space, which may surround abdominal and pelvic structures including the aorta, iliac arteries, and ureters. The origin is idiopathic in about 70% of the cases.There is controversy regarding the best treatment and management for idiopathic retroperitoneal fibrosis (IRPF), and clinical strategies vary widely, from treatment with corticosteroids and immunosuppressant's to surgery. We present the case of a patient with IRPF associated with bilateral ureteral obstruction and periaortitis, receiving treatment with tamoxifen.

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“…Some authors have used Tamoxifene for its antifibrotic properties in the treatment of RPF and have demonstrated the clinical benefit of this molecule in addition to its good tolerance and the absence of major adverse effects [4,42,43]. Surgery, the historical treatment of RPF, has become an adjuvant treatment, since the use of corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal Fibrosis: Case Series of 20 Patients

Said¹,

Ghoundale²,

Zakaria³

et al. 2017

SJPH

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Abstract:Retroperitoneal fibrosis (RPF) is a rare disease. The objective of this paper is to study the prevalence, clinical, biological and radiological aspects of the RPFand to specify its therapeutic modalities. This study provides descriptive evidence for a series of 20 patients with RPF. We conducted a retrospective study of cases of RPF diagnosed in the Urology and Internal Medicine departments of the Ibn Sina Military Hospital in Marrakech over a five-year period from July 2010 to December 2015. The positive diagnosis of RPF was retained either on the basis of a histological analysis from a biopsy fragment or, in the absence of histological evidence, by the detection on a scan of an infiltrate or "sleeve" Regular and homogeneous tissue density, perivascular topography, surrounding the abdominal aorta, more or less extended to the iliac vessels and able to take the contrast after injection. They were 15 men and 5 women with an average age of 53 years with extremes of 41 to 74 years. Almost all patients had mainly lumbar and abdominal pain. An inflammatory syndrome existed in all cases and renal insufficiency in 15 cases. Radiological investigations showed unilateral or bilateral hydronephrosis in 16 cases. RPF was idiopathic in 14 patients. Secondary forms were present in 6 patients (three atheromatous diseases, one gastric tumor, one case associated with Riedel's thyroiditis and one case of systemic fibrosis associating RPF, Riedel's thyroiditis and liver fibrosis). The treatment consisted of corticosteroids in 19 cases, surgery in 17 cases associated with corticosteroid therapy or even immunosuppressant in the case of steroid-dependence. Two deaths were observed in this series; one of these two patients had developed cervix carcinoma with pleural and peritoneal metastases after 5 years of immunosuppressive therapy. The second died due to the complications of his gastric neoplasm. The general characteristics of patients included are similar to the other series of the literature. The frequency of secondary forms seems to be underestimated, hence the value of a rigorous etiological investigation. The therapeutic strategy and the use of the cortisone saving treatments should be specified by randomized therapeutic trials. The prognosis is generally good; however, the possibility of recurrences, the incidence of which is greater during the first five years, requires prolonged clinical, biological and radiological monitoring.

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Long-term safety and efficacy of a tamoxifen-based treatment strategy for idiopathic retroperitoneal fibrosis

Cited by 62 publications

References 39 publications

Inflammatory diseases of the aorta

Inflammatory diseases of the aorta

Efficacy of Tamoxifen for Treating Idiopathic Retroperitoneal Fibrosis

Retroperitoneal Fibrosis: Case Series of 20 Patients

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