Rituxan and vasculitis

The U.S. Food and Drug Administration in April 2011approved Rituxan (rituximab), in combination with glucocorticoids (steroids), to treat patients with Wegener’s granulomatosis (WG) and microscopic polyangiitis (MPA), two rare disorders that cause blood vessel inflammation (vasculitis). Case reports and sereis suggest that it may also be effective in otehr types of vasculitis, particularly those with antineutrophil cytoplasmic antibody (ANCA)–associated

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Rituxan for scleroderma lung disease

Rituximab is an agent with a variety of immunologic effects mediated thorugh its effects on B-lymphocytes. Unfortunately, there is no effective therapy for severe lung disease caused by scleroderma that is not responding to immunosuppression. Two observational studies, one with 8 and one with 15 patients revealed conflicting results. One very small prospective study with 8 patients who received rituximab and six who had not had been performed and

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Cyclophosphamide(Cytoxan) in the treatment of Pulmonary Vasculitis – pro

Pulmonary vasculitis describes a number of distinct disorders that are pathologically characterized by the destruction of blood vessels. Before the institution of immunosuppressive therapy, the mortality rate of patients with a systemic vasculitis was 75%, with a median survival of 5 mo. The addition of corticosteroid therapy improved mortality at 1 yr but had no impact at 3 yr (there was significant steroid-associated mortality and morbidity). The

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Nutritional Deficiencies in Scleroderma and Related Disorders

Nutritional deficiencies in scleroderma and related disorders often include folate and Vit. B12, and more recently reported, Vit. D and E, due to bacterial overgrowth in the gut. Metanx is sometimes prescribed for these conditions. Metanx is a food which is formulated to be consumed or administered by mouth under the supervision of a physician and which is intended for the specific dietary management of a disease or condition for which distinctive

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Sacroiliac Injection

Sacroiliac steroid injection can be used diagnostically or therapeutically. There are no prospective a controlled trials to support this procedure. Most support comes from case reports or case series. Case series are unreliable evidence due to the variable natural history of back pain, the presence of factors that can influence outcome and mislead the investigators, and the potential for a placebo effect. In general, the literature regarding injection

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