• Title/Summary/Keyword: Biologic therapy

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Psoriasis flares after COVID-19 vaccination: adherence to biologic therapy reduces psoriasis exacerbations: a case-control study

  • Martina Burlando;Astrid Herzum;Emanuele Cozzani;Aurora Parodi
    • Clinical and Experimental Vaccine Research
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    • v.12 no.1
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    • pp.80-81
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    • 2023
  • This study aimed to evaluate if patients under biologics have a lower risk of psoriasis flares after coronavirus disease 2019 (COVID-19) vaccination than other psoriatic patients. Of 322 recently vaccinated patients admitted for psoriasis at the Dermatological Psoriasis Unit during January and February 2022, 316 (98%) had no psoriasis flares after COVID-19 vaccination (79% under biologic treatment, 21% not biologically treated) and 6 (2%) presented psoriasis flares after COVID-19 vaccination (33.3% under biologic treatment, 66.6% not biologically treated). Overall, psoriasis patients under biologic treatment, developed fewer psoriasis flares after COVID-19 vaccination (33.3%), than patients not under biologic treatment (66.6%) (p=0.0207; Fisher's exact test).

Management of severe hidradenitis suppurativa with biologic therapy and wide excision

  • Lim, Shi Yu Derek;Cheong, Ee Cherk;Oon, Hazel H.
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.272-276
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    • 2019
  • Hidradenitis suppurativa (HS) is a chronic inflammatory follicular occlusive disease that involves the intertriginous areas. Treatment methods include conventional topical and systemic medication, radiotherapy, biologic agents, and surgical excision. Of late, there has been an increased focus on the use of biologic agents in patients with moderate to severe HS. Here, we present the case of a 46-year-old man with Hurley stage III HS for whom wide excision was ultimately curative, after aggressive medical therapy with the use of infliximab and adalimumab had succeeded in limiting the body surface area affected by the disease. This case demonstrates the effective treatment of severe HS with a combination of biologic therapy and surgery.

Cost-Minimization Analysis of Biologic Disease-Modifying Antirheumatic Drugs Administered by Subcutaneous Injections in Patients with Rheumatoid Arthritis (피하주사로 투여하는 생물학적 항류마티스 제제의 비용 최소화 연구)

  • Park, Seung-Hoo;Lee, Min-Young;Lee, Eui-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.1
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    • pp.59-69
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    • 2016
  • Background: The subcutaneous formulation of biologic disease-modifying antirheumatic drugs (DMARDs) was preferred due to favored self-administration and would be an economical treatment option for patients with rheumatoid arthritis. This study was to compare the economic impact of biologic DMARDs administered by subcutaneous injection in patients with rheumatoid arthritis who had inadequate response to conventional DMARDs. Methods: The cost-minimization analysis was conducted to estimate the lifetime health care costs of treatment sequences with subcutaneous biologic DMARDs as first-line therapy from a health care system perspective. The Markov model was developed to represent the transitions through treatment sequences based on American College of Rheumatology response rate and discontinuation rate. The health care costs comprised the cost of medications, administration, dispensing, outpatient visits, test/diagnostic examination, palliative therapy and treatment of serious infection. All costs were expressed in 2016 Korean Won (KRW) and discounted at 5%. Results: The mean lifetime health care cost per patient was lowest in the etanercept sequence, which was estimated at KRW 63,441,679. The incremental costs of the treatment sequence started with adalimumab, golimumab, abatacept, and tocilizumab were KRW 7,985,730, KRW 4,064,669, KRW 2,869,947, and KRW 4,282,833, respectively, relative to etanercept sequence. These differences in costs mainly were attributable to medication costs. One-way and probabilistic sensitivity analyses confirmed that etanercept represented the option with the lowest cost compared with comparators. Conclusion: This study found that etanercept is likely a cost-saving treatment option among subcutaneous biologic DMARDs in patients with rheumatoid arthritis.

Atypical hemolytic uremic syndrome and eculizumab therapy in children

  • Kim, Seong Heon;Kim, Hye Young;Kim, Su Young
    • Clinical and Experimental Pediatrics
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    • v.61 no.2
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    • pp.37-42
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    • 2018
  • Hemolytic uremic syndrome (HUS) is often encountered in children with acute kidney injury. Besides the well-known shiga toxin-producing Escherichia coli-associated HUS, atypical HUS (aHUS) caused by genetic complement dysregulation has been studied recently. aHUS is a rare, chronic, and devastating disorder that progressively damages systemic organs, resulting in stroke, end-stage renal disease, and death. The traditional treatment for aHUS is mainly plasmapheresis or plasma infusion; however, many children with aHUS will progress to chronic kidney disease despite plasma therapy. Eculizumab is a newly developed biologic that blocks the terminal complement pathway and has been successfully used in the treatment of aHUS. Currently, several guidelines for aHUS, including the Korean guideline, recommend eculizumab as the first-line therapy in children with aHUS. Moreover, life-long eculizumab therapy is generally recommended. Further studies on discontinuation of eculizumab are needed.

Comparative Effectiveness of Biologic DMARDs in Rheumatoid Arthritis Patients with Inadequate Response to conventional DMARDs: Using a Bayesian Network Meta-analysis (Conventional DMARDs 치료에 실패한 류마티스 관절염 환자에서 Biologic DMARDs의 임상적 효과 비교: 베이지안 네트워크 메타분석)

  • Park, Sun-Kyeong;Kim, Hye-Lin;Lee, Min-Young;Kim, Anna;Lee, Eui-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.1
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    • pp.9-17
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    • 2015
  • Background: Biologic disease-modifying antirheumatic drugs (bDMARDs) extend the treatment choices for rheumatoid arthritis patients with insufficient response or intolerance to conventional DMARDs (cDMARDs). These agents have considerable efficacy compared with conventional DMARDs, but only a few head-to-head comparisons among these agents have been performed. The objective of this systematic review and network meta-analysis (NMA) was to compare the relative efficacy of Certolizumab with conventional DMARD to licensed bDMARD with cDMARD therapy for patients who failed to prior cDMARD treatment under the condition of the reimbursement coverage criteria in Korea. Methods: A systematic review was conducted using MEDLINE and Cochrane library. Key endpoints were the American College of Rheumatology (ACR) responses of 20/50/70 at six months. Bayesian outcomes were calculated as median of treatment effect, probability of the best, Odds Ratio (OR) and probability that OR was greater than one. Results: Compared with other bDMARDs, Certolizumab were associated with higher or comparable ACR response rates; in ACR20, the OR (probability of OR>1) was 2.08 (92.6%) for Adalimumab, 1.86 (85.7%) for Etanercept, 1.89 (79.5%) for Golimumab, 2.36 (92.1%) for Infliximab, 1.79 (87.0%) for Abatacept, 1.74 (80.8%) for Rituximab and 1.82 (86.8%) for Tocilizaumab. In ACR50 and ACR70, the ORs did not present significant differences. Conclusion: Certolizaumab with cDMARD was more effective or comparable than other bDMARDs in patients who failed prior cDMARD treatment.

Basics of particle therapy II: relative biological effectiveness

  • Choi, Jin-Hyun;Kang, Jin-Oh
    • Radiation Oncology Journal
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    • v.30 no.1
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    • pp.1-13
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    • 2012
  • In the previous review, the physical aspect of heavy particles, with a focus on the carbon beam was introduced. Particle beam therapy has many potential advantages for cancer treatment without increasing severe side effects in normal tissue, these kinds of radiation have different biologic characteristics and have advantages over using conventional photon beam radiation during treatment. The relative biological effectiveness (RBE) is used for many biological, clinical endpoints among different radiation types and is the only convenient way to transfer the clinical experience in radiotherapy with photons to another type of radiation therapy. However, the RBE varies dependent on the energy of the beam, the fractionation, cell types, oxygenation status, and the biological endpoint studied. Thus this review describes the concerns about RBE related to particle beam to increase interests of the Korean radiation oncologists' society.

Delayed radiation-induced inflammation accompanying a marked carbohydrate antigen 19-9 elevation in a patient with resected pancreatic cancer

  • Mattes, Malcolm D.;Cardinal, Jon S.;Jacobson, Geraldine M.
    • Radiation Oncology Journal
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    • v.34 no.2
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    • pp.156-159
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    • 2016
  • Although carbohydrate antigen (CA) 19-9 is a useful tumor marker for pancreatic cancer, it can also become elevated from a variety of benign and malignant conditions. Herein we describe an unusual presentation of elevated CA 19-9 in an asymptomatic patient who had previously undergone adjuvant chemotherapy and radiation therapy for resected early stage pancreatic cancer. The rise in CA 19-9 might be due to delayed radiation-induced inflammation related to previous intra-abdominal radiation therapy with or without radiation recall induced by gemcitabine. After treatment with corticosteroids the CA 19-9 level decreased to normal, and the patient has not developed any evidence of recurrent cancer to date.

Emerging Treatment in Metastatic Colorectal Cancer (전이성 대장암에서 표적치료와 면역치료)

  • Jae Hyun Kim;Seun Ja Park
    • Journal of Digestive Cancer Research
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    • v.6 no.2
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    • pp.45-49
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    • 2018
  • Colorectal cancer (CRC) is the third most common cause of cancer-related death in the world. Although the long-term outcome of patients with metastatic CRC is still poor, target therapy including anti EGFR agents and anti VEGF agents and immunotherapy including anti PD-1 antibody and anti CTLA-4 antibody have shown clinical benefits in the treatment of patient with metastatic CRC. In the future, the personalized treatment strategy based on the clinical characteristics and biologic features of patients with metastatic CRC will be necessary. In this review, we summarized the mechanisms and clinical evidences of target therapy and immunotherapy, and the guideline of clinical practice in patients with metastatic CRC.

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The Biologic Effect of Millimeter Wave Irradiation Followed to Photodynamic Therapy on the Tumor

  • Ahn, Jin-Chul;Lee, Chang-Sook;Chang, So-Young;Yoon, Sung-Chul
    • Biomedical Science Letters
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    • v.17 no.1
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    • pp.79-84
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    • 2011
  • Photodynamic therapy consists of a photosensitizer, suitable light source and oxygen. The excitation of the photosensitizer at a cancer mass results in oxidation which would ultimately reduce the mass via apoptosis. Millimeter wave (MMW) therapy has also been known to be effective on cancer cell mass reduction, human cell regeneration and immunity enhancement among the Russian clinicians and scientists. In the present study, the two modalities were combined to achieve synergistic effects while reducing the administration dosage of the photosensitizer, photogem, thus minimizing the side effects. The CT-26 adenocarcinoma cell mass was implanted on mice and the tumors were exposed to a simple MMW irradiation or a combined treatment of MMW and PDT. The treatments continued for 4 weeks and the size of the tumor was measured continuously. The significant therapeutic result of MMW was not found during 4 weeks, preferably more cancer recurrence possibility after MMW irradiation was observed. The results of this study suggest that the combination of MMW irradiation and photodynamic treatment should not be recommended. The result of the MMW treatment alone, however, displayed suppressive effect on cancer cell proliferation for both in vitro and in vivo. The results of the present study suggest that the millimeter wave therapy deserves a further study.

Experiential treatment of ankylosing spondylitis using Ortho-Cellular Nutrition Therapy (OCNT)

  • Baek, Kyungsin
    • CELLMED
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    • v.12 no.3
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    • pp.14.1-14.2
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    • 2022
  • Currently, a 70-year-old woman started suffering from S.I joint pain from 1973 and had severe pain in the S.I joint, wrist, and elbow from 1975 to 1977, and was diagnosed with spinal tuberculosis at a general hospital. From 1978 to 1987, she suffered from chronic fatigue and insomnia, and since January 1, 1988, she was unable to get up while lying down, suffering from whole body joint, muscle pain, and fibromyalgia. In May 1989, she was also diagnosed with ankylosing spondylitis through genetic testing at the Catholic St. Mary's Hospital Rheumatology Department in Korea, and was treated with sulfasalazine, analgesic, and immunosuppressant, methotrexate, for 12 years until 1999, but none of the drugs eliminated the pain. She was hospitalized and discharged repeatedly, and continued to receive salt water poultice and exercise therapy at home, but was unable to move at all. In 2000, after biologic treatment with Remicade injection (Remsima®), she was able to walk and move, and after that, she was continuously prescribed biologics. From 2015 to 2019, Enbrel® (Etanercept) injection was prescribed once a week, but the symptoms such as severe pain (joint and muscle, fibromyalgia), scleroderma, Sjogren's syndrome (dryness of eyes, nose and mouth), difficulty swallowing, chronic fatigue, and stiff body appeared. Around January 2018, hepatic indicators were high and lymphocytes became enlarged. However, most serious injuries were highly improved after the OCNT combination therapy using active phytonutrients, anthocyanin-fucoidan nanocomplex. Therefore, for patients with such experiences, OCNT treatment is proposed as an alternative.