Rheumatology

Rituxan for leukocytoclastic vasculitis – pro

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 various subsets of vasculitis patients, particularly those with antineutrophil cytoplasmic antibody

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Rituxumab for lung involvement of scleroderma – pro

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 interstitial lung disease associated with connective tissue disease (CTD-ILD), progressing despite maximal conventional 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

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Cytoxan for scleroderma – pro

Immunosuppressive agents such as cyclophosphamide have long been used to treat autoimmune disease, but the dose is often limited by bone marrow suppression. In a randomized placebo-controlled trial, those with scleroderma-related alveolitis and interstitial lung disease who received Cytoxan for one year had better forced vital capacity than patients on placebo, a difference still seen at two-year follow-up. In addition, patients who had taken Cytoxan

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Fibromyalgia and cancer – pro

There is no reported causal association between cancer and fibromyalgia to my knowledge and that I could fing in a literature search. However there is an association between chronic fatigue syndrome and cancer (an association does not establish a causal connection). A recent report analyzed 1361 patient records. While they found no association between fibromyalgia and cancer in patients whose fibromyalgia diagnosis was confirmed, they found that

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Rituximab for rheumatoid artritis – pro

Rituximab in combination with methotrexate is recommended as an option for the treatment of adults with severe active rheumatoid arthritis who have had an inadequate response to or intolerance of other disease-modifying anti-rheumatic drugs (DMARDs), including treatment with at least one tumour necrosis factor alpha (TNF-alpha) inhibitor therapy. This combination treatment is FDA indicated. However, in a situation in which ,methotrexate is contraindicated,

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MRA for temporal arteritis – pro

Temporal arteritis, or giant cell arteritis, is a common systemic vasculitis of unknown etiology. Ttemporal artery biopsy, a fairly easy procedure, is standard for the diagnosis of temporal arteritis. Angiography can be used when biopsy results are negative, or it can be used to help guide biopsy by demonstrating areas of abnormality. Magnetic resonance angiography (MRA) has results comparable to those of angiography in evaluating medium to large

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Metanx for scleroderma – pro

  Nutritional deficiencies in scleroderma and related disorders often include folate and Vit. B12, and as 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

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Sacroiliac Injection – pro

Sacroiliac 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 confounders of outcome, and the potential for a placebo effect. In general, the literature regarding injection therapy on joints in the back is of poor quality.

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Nutritional Deficiencies in Scleroderma and Related Disorders – pro

Nutritional deficiencies in scleroderma and related disorders often include folate and Vit. B12, and as 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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