Systemic lupus erythematosus , treatment

Leave one out cross-validation for 3300 kinds of biological activity and 117 332 substances provides the estimate of PASS prediction accuracy during the training procedure. The average accuracy of prediction is about 94.7% according to the LOO CV estimation, while that for particular kinds of activity varies from 65% [System lupus erythematosus treatment, Immunomodulator (HIV)] to 99.9% (Allergic rhinitis treatment, histone acetylation inducer). The estimated accuracy of prediction for all kinds of biological activity predicted by PASS is presented at the web site. " ... 

Other studies describe similar beneficial effects for PUFA-enriched diets to treat Crohn s disease, other inflammatory bowel diseases such as ulcerative colitis, as well as psoriasis, asthma, systemic lupus erythematosus, and multiple sclerosis [57], Thus, immunomodulation by PUFAs appears to be a promising intervention for the treatment of many autoimmune and inflammatory diseases. 

Ronnblom, L.E., Aim, G.V., and Oberg, K.E., Possible induction of systemic lupus erythematosus by interferon-alpha treatment in a patient with a malignant carcinoid tumor, J Intern Med., 227, 207,1990. 

Azathioprine is used in the treatment of several rheumatic diseases, including systemic lupus erythematosus (SLE) and RA. About 10-30% of RA patients discontinue AZA because of side effects (40). AZA is a prodrug that after oral intake is... 

Lupus erythematosus Hydralazine may produce a clinical picture simulating systemic lupus erythematosus including glomerulonephritis. Symptoms usually regress when the drug is discontinued, but residual effects have been detected years later. Long-term treatment with steroids may be necessary. 

Lupus erythematosus For the treatment of chronic discoid and systemic lupus erythematosus (SLE) in patients who have not responded satisfactorily to drugs with less potential for serious side effects. 

Darmawan J. Treatment-free remission in systemic lupus erythematosus patieuts. APLAR J Rheumatol 1999 2 109-14. 

Of the DMARDs, methotrexate (Rheumatrex) is the most widely prescribed. It is indicated for the treatment of rheumatoid arthritis and psoriasis it is also used for psoriatic arthritis, systemic lupus erythematosus, and... 

Hydroxychloroquine Plaquenil) and chloroquine Ara-len) are 4-aminoquinoline antimalarial drugs that possess modest DMARD activity. They are indicated for the treatment of rheumatoid arthritis and systemic lupus erythematosus their use as antimalarials is detailed in Chapter 53. The onset of action of these drugs is longer than that of other DMARDs, and their side effects are relatively mild. Because of this, these agents show promise as ingredients of combination therapies for rheumatoid arthritis. 

Hydroxychloroquine (Plaquenil), like chloroquine, is a 4-aminoquinoline derivative used for the suppressive and acute treatment of malaria. It also has been used for rheumatoid arthritis and discoid and systemic lupus erythematosus. Hydroxychloroquine has not been proved to be more effective than chloroquine. Adverse reactions associated with its use are similar to those described for chloroquine. The drug should not be used in patients with psoriasis or porphyria, since it may exacerbate these conditions. 

Cyclosporine appears to have promise in the treatment of autoimmune diseases. It has a beneficial effect on the course of rheumatoid arthritis, uveitis, insulin-dependent diabetes, systemic lupus erythematosus, and psoriatic arthropathies in some patients. Toxicity is more of a problem in these conditions than during use in transplantation, since higher doses of cyclosporine are often required to suppress autoimmune disorders. 

Unlabeled Uses Treatment of biliary cirrhosis, chronic acfive hepatitis, glomerulonephritis, inflammatory bowel disease, inflammatory myopathy, multiple sclerosis, myasthenia gravis, nephrotic syndrome, pemphigoid, pemphigus, polymyositis, systemic lupus erythematosus... 

The main clinical uses of immunosuppressive drugs are suppression of organ and tissue rejection after transplant surgery and the treatment of diseases with an autoimmune component. Thses include renal diseases, e.g. glomerulonephritis, some nephrotic syndromes, connective tissue diseases, such as systemic lupus erythematosus rheumatoid arthritis, and systemic vasculitis. 

Although antimalarials improve symptoms, there is no evidence that these compounds alter bony damage in rheumatoid arthritis at their usual dosages (up to 6.4 mg/kg/d for hydroxychloroquine or 200 mg/d for chloroquine). It usually takes 3-6 months to obtain a response. Antimalarials are often used in the treatment of the skin manifestations, serositis, and joint pains of systemic lupus erythematosus, and they have been used in Sjogren s syndrome. 

MMF is effective for the treatment of renal disease due to systemic lupus erythematosus and may be useful in vasculitis and Wegener s granulomatosis. Although MMF is occasionally used at a dosage of 2 g/d to treat rheumatoid arthritis, there are no well-controlled data regarding its efficacy in this disease. 

The drug hydralazine is a vasodilator used for the treatment of hypertension. In a significant proportion of individuals, it causes a serious adverse effect, drug-induced systemic lupus erythematosus (SLE). This is a systemic kind of toxic effect, as there is no particular target organ or tissue. It is an example of immune-media ted toxicity that involves autoimmunity and shows a number of interesting features. 

Baler GR. Porphyria precipitated by hydroxychloroquine treatment of systemic lupus erythematosus. Cutis 1976 17(l) 96-8. 

Suzuki, K., The role of immunoadsorption using dextran-sulfate cellulose columns in the treatment of systemic lupus erythematosus. Ther. Apheresis 4, 239-243 (2000). 

Wang, X., W. Huang, L. E. Schiffer, M. Mihara, A. Akkerman, K. Hiromatsu, and A. Davidson. 2003. Effects of anti-CD154 treatment on B cells in murine systemic lupus erythematosus. Arthritis and rheumatism 48 495-506. 

Hiepe, F., Volk, H. D., Apostoloff, E., von Baehr, R., and Emmrich, F. (1991). Treatment of severe systemic lupus erythematosus with anti-CD4 monoclonal antibody (letter). Lancet338, 1529-1530. 

Certain collagen-like diseases are caused by hypersensitivity reactions to drugs. Hydralazine, and particularly procainamide, may produce a clinical picture similar to systemic lupus erythematosus (43). A number of cases of polyarteritis nodosa have developed during treatment with guanethidine and after repeated exposure to the sulfonamides, penicillin, and iodides (44). Nephropathy has been reported following high doses of methicillin and benzylpenicillin (45). 

Dong Y, Zhang X, Tang F, Tian X, Zhao Y, Zhang F (2001) Intrathecal injection with methotrexate plus dexamethasone in the treatment of central nervous system involvement in systemic lupus erythematosus. Chin Med J (Engl) 114 764—766. 

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