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Miguel TS, Souto ALM, Rocha FBDM, Rossett T, Rocha FBDM, Damasceno EDF. Retinopatia hipertensiva maligna secundária a lúpus eritematoso sistêmico em adolescente. REVISTA BRASILEIRA DE OFTALMOLOGIA 2022. [DOI: 10.37039/1982.8551.20220020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lin N, Zhang YQ, Jiang Q, Liu W, Liu J, Huang QC, Wu KY, Tu SH, Zhou ZS, Chen WH, Li XX, Ding Y, Fang YF, Liu JP, Li ZB, He DY, Chen YL, Lou YQ, Tao QW, Wang QW, Jin YH, Liao X, Li TX, Wang XY. Clinical Practice Guideline for Tripterygium Glycosides/ Tripterygium wilfordii Tablets in the Treatment of Rheumatoid Arthritis. Front Pharmacol 2021; 11:608703. [PMID: 33519474 PMCID: PMC7845140 DOI: 10.3389/fphar.2020.608703] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/16/2020] [Indexed: 11/13/2022] Open
Abstract
Tripterygium wilfordii Hook F (TwHF) is one of the most commonly used and effective traditional Chinese herbal medicines against rheumatoid arthritis (RA). Both Tripterygium Glycoside Tablets (TGT) and Tripterygium wilfordii Tablets (TWT) are the representative TwHF-based agents enrolled into the 2019 edition of Medicine Catalog for National Basic Medical Insurance, Injury Insurance, and Maternity Insurance. However, individual differences in TGT/TWT response across patients usually exist in the process of treating RA, implying that the clinical application of the two agents may not be standardized leading to the ineffective treatment and the risk of side effects. Growing evidence show that the bioactive constituents of TwHF may often have toxicity, the package insert of TGT and TWT may not be described in detail, and the therapeutic windows of the two agents are narrow. Thus, it is an urgent task to develop a standardized clinical practice guideline for TGT and TWT in the treatment of RA. In the current study, a group of clinical experts of traditional Chinese medicine and Western medicine in the research field of rheumatism diseases, pharmacists, and methodologists of evidence-based medicine were invited to select the clinical questions, to determine the levels of the evidence and the strength of the recommendations, and to develop the recommendations and good practice points. The guideline is formed based on the combination of clinical research evidence and expert experience (evidence-based, consensus, supplemented by experience). The clinical problems which are supported by clinical evidence may form recommendations, and the clinical problems without clinical evidence may form experts' suggestions. Both recommendations and experts' suggestions in this guideline summarized the clinical indications, usage, dosage, combined medication, and safety of TGT and TWT against RA systematically and comprehensively, which may offer a professional guidance in the context of the clinical application of the two TwHF-based agents.
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Affiliation(s)
- Na Lin
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yan-Qiong Zhang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Quan Jiang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wei Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jian Liu
- First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Qing-Chun Huang
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Kuan-Yu Wu
- Second People's Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Sheng-Hao Tu
- Tongji Hospital Affiliated to Tongji Medical School, Huazhong University of Science and Technology, Wuhan, China
| | - Zu-Shan Zhou
- Department of Honghu, Hubei Province Hospital of Traditional Chinese Medicine, Honghu, China
| | - Wei-Heng Chen
- Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-Xia Li
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ying Ding
- First Affiliated Hospital of the Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Yong-Fei Fang
- Southwest Hospital, Army Medical University, Chongqing, China
| | - Jian-Ping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Zhen-Bin Li
- Bethune International Peace Hospital, People's Liberation Army, Shijiazhuang, China
| | - Dong-Yi He
- Shanghai Guanghua Hospital of Integrated Traditional and Western Medicine, Shanghai, China
| | - Yao-Long Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | | | | | - Qing-Wen Wang
- Shenzhen Hospital, Peking University, Shenzhen, China
| | - Ying-Hui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xing Liao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tai-Xian Li
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiao-Yue Wang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
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Fanouriakis A, Tziolos N, Bertsias G, Boumpas DT. Update οn the diagnosis and management of systemic lupus erythematosus. Ann Rheum Dis 2020; 80:14-25. [PMID: 33051219 DOI: 10.1136/annrheumdis-2020-218272] [Citation(s) in RCA: 275] [Impact Index Per Article: 68.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 12/15/2022]
Abstract
Clinical heterogeneity, unpredictable course and flares are characteristics of systemic lupus erythematosus (SLE). Although SLE is-by and large-a systemic disease, occasionally it can be organ-dominant, posing diagnostic challenges. To date, diagnosis of SLE remains clinical with a few cases being negative for serologic tests. Diagnostic criteria are not available and classification criteria are often used for diagnosis, yet with significant caveats. Newer sets of criteria (European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) 2019) enable earlier and more accurate classification of SLE. Several disease endotypes have been recognised over the years. There is increased recognition of milder cases at presentation, but almost half of them progress overtime to more severe disease. Approximately 70% of patients follow a relapsing-remitting course, the remaining divided equally between a prolonged remission and a persistently active disease. Treatment goals include long-term patient survival, prevention of flares and organ damage, and optimisation of health-related quality of life. For organ-threatening or life-threatening SLE, treatment usually includes an initial period of high-intensity immunosuppressive therapy to control disease activity, followed by a longer period of less intensive therapy to consolidate response and prevent relapses. Management of disease-related and treatment-related comorbidities, especially infections and atherosclerosis, is of paramount importance. New disease-modifying conventional and biologic agents-used alone, in combination or sequentially-have improved rates of achieving both short-term and long-term treatment goals, including minimisation of glucocorticoid use.
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Affiliation(s)
| | - Nikolaos Tziolos
- 4th Department of Internal Medicine, "Attikon" University Hospital, Athens, Greece
| | - George Bertsias
- Rheumatology, Clinical Immunology and Allergy, University of Crete School of Medicine, Iraklio, Crete, Greece.,Laboratory of Autoimmunity-Inflammation, Institute of Molecular Biology and Biotechnology, Heraklion, Crete, Greece
| | - Dimitrios T Boumpas
- 4th Department of Internal Medicine, "Attikon" University Hospital, Athens, Greece .,Joint Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Medical School, University of Cyprus, Nicosia, Cyprus.,Laboratory of Autoimmunity and Inflammation, Biomedical Research Foundation of the Academy of Athens, Athens, Cyprus
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Ghozlani I, Mounach A, Ghazi M, Kherrab A, Niamane R. Targeting Acquired Hemophilia A with Rheumatoid Arthritis by a Rituximab Shot: A Case Report and Review of the Literature. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:582-588. [PMID: 29780157 PMCID: PMC5993004 DOI: 10.12659/ajcr.908854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Patient: Male, 66 Final Diagnosis: Acquired hemophilia A Symptoms: Polyarticular flare Medication: — Clinical Procedure: — Specialty: Rheumatology
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Affiliation(s)
- Imad Ghozlani
- Department of Rheumatology, 1st Military Medical-Surgical Center, Agadir, Morocco.,Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco
| | - Aziza Mounach
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco.,Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Mirieme Ghazi
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco.,Department of Rheumatology, Military Hospital Avicenne, Marrakesh, Morocco
| | - Anass Kherrab
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco.,Department of Rheumatology, Military Hospital Avicenne, Marrakesh, Morocco
| | - Radouane Niamane
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco.,Department of Rheumatology, Military Hospital Avicenne, Marrakesh, Morocco
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