Document Detail

Effectiveness of etanercept vs cyclophosphamide as treatment for patients with amyloid A amyloidosis secondary to rheumatoid arthritis.
MedLine Citation:
PMID:  22879465     Owner:  NLM     Status:  Publisher    
Objectives. To compare the effectiveness of an alkylating agent with that of a biologic agent in the treatment of patients with amyloid A (AA) amyloidosis secondary to RA and to assess the association of the serum AA (SAA) 1.3 allele with treatment.Methods. CYC and etanercept (ETN) were administered to 62 and 24 RA patients, respectively, who were confirmed with biopsy as having AA amyloidosis. We evaluated whether the SAA1.3 allele, a factor indicating genetic risk and poor prognosis of Japanese RA patients with AA amyloidosis, influenced treatments and retrospectively analysed the effectiveness of both agents via statistical methods.Results. Two treatment groups were similar, except for the SAA1.3 genotype (P = 0.015) and duration of AA amyloidosis since diagnosis (P < 0.001). Also, patients given ETN had somewhat worse renal function, i.e. 24-h proteinuria (P = 0.02), at the initiation of treatment. ETN demonstrated greater effectiveness than CYC, as shown by significantly improved levels of serum CRP and serum albumin (both P < 0.01) and estimated glomerular filtration rate (eGFR; P = 0.032). ETN improved survival (P = 0.025), and the hazard ratios for the risk of death endpoint with eGFR and 24-h proteinuria were significant by P = 0.024 and P = 0.025, respectively. The SAA1.3 allele did not affect the response to medications in AA amyloidosis secondary to RA.Conclusion. ETN treatment was more effective than CYC treatment, and CRP, albumin and eGFR may be valuable biomarkers for analysis. The SAA1.3 allele was not a factor affecting treatment in Japanese patients with AA amyloidosis secondary to RA.
Tadashi Nakamura; Syu-Ichi Higashi; Kunihiko Tomoda; Michishi Tsukano; Masahiro Shono
Related Documents :
25459105 - Proficient motor impulse control in parkinson disease patients with impulsive and compu...
18591015 - Ballism not related to vascular disease: a report of 16 patients and review of the lite...
25246315 - Comparison of voluntary and reflex cough effectiveness in parkinson's disease.
4010865 - Clinical experience with nimodipine in the prophylaxis of neurological deficits after s...
18466605 - Adrenal insufficiency in prolonged critical illness.
20694845 - Clinical features associated with rem sleep behavior disorder symptoms in the early sta...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-9
Journal Detail:
Title:  Rheumatology (Oxford, England)     Volume:  -     ISSN:  1462-0332     ISO Abbreviation:  Rheumatology (Oxford)     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883501     Medline TA:  Rheumatology (Oxford)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Section of Internal Medicine and Rheumatology, Section of Orthopaedics and Rheumatology, Kumamoto Center for Arthritis and Rheumatology and Yuge Hospital, Kumamoto, Japan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  The early psoriatic arthritis screening questionnaire: a simple and fast method for the identificati...
Next Document:  Current evidence of methotrexate efficacy in childhood chronic uveitis: a systematic review and meta...