Cyclophosphamide (CYC) has been a gold standard of treatment for severe progressive Systemic Sclerosis (SSc), especially in patients with concomitant interstitial lung disease (ILD). This approach was based on results of several interventional studies, including randomized control trials, which mainly addressed SSc-ILD as a primary end point and skin involvement as a second one. The use of CYC is time-limited due to significant adverse events. More recently, other immunosuppressive and biological agents showed efficacy but better safety profile in patients with SSc and SSc-ILD. With regards to other end-points, post-hoc analyses, systematic reviews and metalysis showed that CYC had limited influence on patients' quality of life, event-free survival and mortality. Comprehensive patient's stratification according to a molecular, cellular and phenotypic pattern may help in choosing of personalized medicine with more ambitious treatment effect and should be the future direction. According to the above available data and even if scientific evidence may be missing, experts' opinion has changed the attitude to CYC as an anchor drug in the management of severe SSc. Indeed, CYC has been pushed to the second and even third treatment option after mycophenolate mofetil, tocilizumab or rituximab. This position became obvious during debate on this topic at CORA meeting 2023.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.autrev.2023.103439 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Prolonged incubation time unwarranted for acute periprosthetic joint infections.
J Clin Microbiol
January 2025
Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Maastricht University Medical Centre, Maastricht, the Netherlands.
Unlabelled: Current laboratory protocols for periprosthetic joint infections (PJIs) involve a standard 10- to 14-day incubation period. However, recent evidence indicates considerable variability in the time to diagnosis (TTD) between acute and chronic PJIs. TTD is also influenced by the employed culture media and sample types.
View Article and Find Full Text PDFElectroconvulsive therapy in the treatment of catatonia in a patient with Budd Chiari syndrome: a case report.
Neurocase
January 2025
Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Catatonia may manifest as an independent entity or as a feature of a neuropsychiatric or medical illness. While electroconvulsive therapy (ECT) is the gold standard treatment for catatonia, it is typically administered if the patient's symptoms fail to respond to benzodiazepines. We describe the case of a 22-year-old male with Budd Chiari induced cirrhosis and no prior psychiatric history, who presented with symptoms of psychosis and hepatic encephalopathy, was treated in the ICU for multi-factorial delirium, developed symptoms of catatonia that failed to respond to lorazepam, ultimately requiring ECT with a favorable response.
View Article and Find Full Text PDFArtificial intelligence-powered solutions for automated aortic diameter measurement in computed tomography: a narrative review.
Ann Transl Med
December 2024
Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.
Background And Objective: Patients with thoracic aortic aneurysm and dissection (TAAD) are often asymptomatic but present acutely with life threatening complications that necessitate emergency intervention. Aortic diameter measurement using computed tomography (CT) is considered the gold standard for diagnosis, surgical planning, and monitoring. However, manual measurement can create challenges in clinical workflows due to its time-consuming, labour-intensive nature and susceptibility to human error.
View Article and Find Full Text PDFUsefulness of polymerase chain reaction tests in Chagas disease studies.
Front Parasitol
February 2024
National Reference Center for Parasitology, Research Institute of the McGill University Center, Montreal, QC, Canada.
The Polymerase Chain Reaction (PCR) test is a highly sensitive, specific, and rapid diagnostic tool for Chagas disease. Chagas disease is caused by the protozoan flagellate and is endemic to the Americas. While conventional serological methods are still used in the diagnosis of Chagas disease, they are being gradually replaced by molecular methods like PCR.
View Article and Find Full Text PDFFrom innovation to clinic: Emerging strategies harnessing electrically conductive polymers to enhance electrically stimulated peripheral nerve repair.
Mater Today Bio
February 2025
Discipline of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin 2, Ireland.
Peripheral nerve repair (PNR) is a major healthcare challenge due to the limited regenerative capacity of the nervous system, often leading to severe functional impairments. While nerve autografts are the gold standard, their implications are constrained by issues such as donor site morbidity and limited availability, necessitating innovative alternatives like nerve guidance conduits (NGCs). However, the inherently slow nerve growth rate (∼1 mm/day) and prolonged neuroinflammation, delay recovery even with the use of passive (no-conductive) NGCs, resulting in muscle atrophy and loss of locomotor function.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!