Abstract:
BACKGROUND:Biological drugs, mainly interleukin (IL)-1 and IL-6 antagonists, but also tumor necrosis factor (TNF) inhibitors, have been used in the treatment of adult onset Still's disease patients (AOSD). METHODS:We summarised the available evidence for the effectiveness of biologic drugs in AOSD. A systematic review of the literature was performed in order to identify all the available data concerning the effectiveness of biologic drugs in AOSD. The proportion of patients achieving complete remission or any clinical response was calculated. The meta-analysis was thus performed using a random-effects model accounting for the expected high level of heterogeneity. RESULTS:Nineteen observational published studies were included in the meta-analysis. The pooled analysis under a random-effects model showed an overall rate of clinical response of 0.85 (95% CI: 0.77-0.91, p < 0.0001) and an overall rate of complete remission of 0.66 (95% CI: 0.54-0.77, p = 0.01). The heterogeneity across studies was high (Q = 59.82 with df = 19.0, p < 0.0001, I2 = 68.23%). CONCLUSIONS:Our meta-analysis suggests that AOSD patients may experience a clinical response and/or a complete remission when treated with biologic drugs. Specifically designed and powered studies are needed to fully investigate the role of such medications in the management of AOSD patients.
journal_name
Expert Rev Clin Immunoljournal_title
Expert review of clinical immunologyauthors
Ruscitti P,Ursini F,Cipriani P,De Sarro G,Giacomelli Rdoi
10.1080/1744666X.2017.1375853subject
Has Abstractpub_date
2017-11-01 00:00:00pages
1089-1097issue
11eissn
1744-666Xissn
1744-8409journal_volume
13pub_type
杂志文章,meta分析,评审abstract::Unbalanced immune cell populations or immune cell infiltration of the liver can disrupt the immune-privileged state of the liver, resulting in liver injury or fibrosis. Therefore, the treatment for liver diseases involves not only hepatic regeneration but also immunological regulation. Recent studies demonstrated that...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/1744666X.2014.930665
更新日期:2014-09-01 00:00:00
abstract::Hematopoietic stem cell transplantation (HSCT), both allogeneic and autologous, has become one of the hottest topics in clinical immunology. One of the main autoimmune diseases in which HSCT has been extensively tried during the last decade is multiple sclerosis (MS). A few original papers and many anecdotal reports h...
journal_title:Expert review of clinical immunology
pub_type:
doi:10.1586/eci.10.7
更新日期:2010-05-01 00:00:00
abstract::Type 1 diabetes (T1D) is caused by T-cell-mediated destruction of the insulin-producing beta-cells in the pancreas. Genetic and immunological evidence from humans and mouse models indicates that CD4(+) T cells play a crucial role in the development and prevention of T1D. The dichotomy between CD4(+) T regulatory and e...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1586/1744666X.3.4.557
更新日期:2007-07-01 00:00:00
abstract::Recent epidemiological studies estimated that more than 30% of European suffer from allergic rhinitis or conjunctivitis, while up to 20% suffer from asthma and 15% from allergic skin conditions, while for many other regions the prevalence is increasing. Allergen immunotherapy represents the only available treatment th...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/1744666X.2015.977260
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVES:Methylation pattern of gene modification is essential for the differentiation of T regulatory cells (Tregs) and 5-Aza-2'-deoxycytidine is a common inhibitor of methylation. This study aimed to investigate the potential effects of Treg polarizing conditions and 5-Aza-2'-deoxycytidine treatment in the differen...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1080/1744666X.2020.1866987
更新日期:2021-01-13 00:00:00
abstract::Obstructive lung diseases, in particular asthma and chronic obstructive pulmonary disease, are a worldwide health problem that is increasing in incidence. While significant progress has been made in the control of symptoms, further advances must be made in modifying the clinical situation in terms of disease progressi...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1586/1744666X.1.2.263
更新日期:2005-07-01 00:00:00
abstract::In adulthood, new or recurrent asthma is caused by work in approximately 10% of cases. The term occupational asthma is reserved for those cases arising from respiratory hypersensitivity to a specific workplace agent; in others (work-exacerbated asthma) the mechanism is of nonspecific airway irritation on a background ...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1586/1744666X.1.1.123
更新日期:2005-05-01 00:00:00
abstract::Rheumatoid arthritis (RA) is a chronic inflammatory systemic disease characterized by symmetric arthritis leading to progressive erosion of cartilage and bone. Psoriatic arthritis and ankylosing spondylitis are also inflammatory arthritides that belong to the spondyloarthritides. Disease-modifying anti-rheumatic drugs...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/eci.10.49
更新日期:2010-09-01 00:00:00
abstract::Treatment of idiopathic membranous nephropathy (IMN) is controversial. However, two randomized controlled trials (RCTs) reported that treatment with steroids alternated with an alkylating agent achieved significantly more remissions and better renal survival at 10 years in comparison with untreated controls. Short-ter...
journal_title:Expert review of clinical immunology
pub_type: 评论,杂志文章
doi:10.1586/eci.12.89
更新日期:2013-01-01 00:00:00
abstract:INTRODUCTION:Prediction of treatment outcome and clinical relapse in patients with inflammatory bowel disease (IBD), either ulcerative colitis (UC) or Crohn's disease (CD), is particularly important because therapeutics for IBD are not always effective and patients in remission could frequently relapse. Because undergo...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1080/1744666X.2019.1593140
更新日期:2019-06-01 00:00:00
abstract::Although a large part of the population suffers from allergies, a cure is not yet available. Allergen-specific immunotherapy (AIT) offers promise for these patients. AIT has proven successful in insect and venom allergies; however, for food allergy this is still unclear. In this editorial we focus on the recent advanc...
journal_title:Expert review of clinical immunology
pub_type: 社论,评审
doi:10.1586/1744666X.2016.1103182
更新日期:2016-01-01 00:00:00
abstract:INTRODUCTION:Highly sensitized patients awaiting a kidney transplant accrue on the transplant waiting list. The breadth of HLA antibodies in this subpopulation of patients precludes receiving a compatible organ offer through regular allocation within an acceptable time-frame. Areas covered: Several alternative options ...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1080/1744666X.2018.1498335
更新日期:2018-08-01 00:00:00
abstract:INTRODUCTION:New generations of small molecules are being developed for the treatment of ulcerative colitis. Among them, tofatinib (a Janus kinase (JAK) inhibitor) has demonstrated efficacy for inducing and maintaining remission and achieving mucosal healing with a reasonable safety profile. Oral administration is attr...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1080/1744666X.2018.1532291
更新日期:2018-11-01 00:00:00
abstract::Antiphospholipid antibodies (aPL Abs) are associated with thrombosis in patients with the antiphospholipid syndrome (APS). There is strong evidence that aPL Abs are pathogenic in vivo from studies in animal models. Furthermore, there are now convincing data indicating that activation of complement is involved in those...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1586/1744666X.4.2.193
更新日期:2008-03-01 00:00:00
abstract:INTRODUCTION:Patients with features of both asthma and chronic obstructive pulmonary disease (COPD) ('asthma-COPD overlap') experience greater symptom burden and higher risk of adverse health outcomes than those with asthma or COPD alone. However, virtually no pharmacotherapy studies have been performed in this overlap...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1080/1744666X.2017.1273109
更新日期:2017-05-01 00:00:00
abstract::Graft-versus-host disease (GVHD) remains a significant complication that greatly enhances morbidity and mortality associated with hematopoietic stem cell transplantation. Key immunoregulatory molecules have been implicated in the pathogenesis of GVHD, but the mechanisms by which these molecules affect the incidence an...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1586/eci.09.44
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVES:Impairment in early B-cell development can cause a predominantly antibody deficiency with severe depletion of peripheral B-cells. Mutations in the gene encoding for Bruton's-tyrosine-kinase (BTK) and the components of the pre-B-cell receptor complex or downstream signaling molecules have been related to this...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1586/1744666X.2016.1139451
更新日期:2016-01-01 00:00:00
abstract::The 12/15-lipoxygenase (LO) cascade governs the generation of 12-hydroperoxy-eicosatetraenoic acid (HPETE) and 15-HPETE from arachidonic acid. The 5-LO pathway plays a fundamental role in the biosynthesis of leukotrienes, essential inflammatory lipid mediators. Cyclooxygenase (COX)-1 and -2 biosynthetic pathways are r...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1586/1744666X.2.4.649
更新日期:2006-07-01 00:00:00
abstract::Psoriatic arthritis (PsA) is a chronic inflammatory joint disease occurring in 6-39% of patients with psoriasis. Standard therapy of PsA includes nonsteroidal anti-inflammatory drugs, intra-articular steroids and disease-modifying antirheumatic drugs. Failure of standard therapy is an indication for anti-TNF-alpha the...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1586/eci.09.50
更新日期:2009-11-01 00:00:00
abstract::Hashimoto's thyroiditis (HT) is the most prevalent thyroid autoimmune disorder, characterized by the presence of specific thyroid autoantibodies (TAb). The development of autoimmunity, including TAb production and clinical presentation of HT, is determined by a complex interplay of genetic susceptibility and several e...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1586/1744666X.3.2.217
更新日期:2007-03-01 00:00:00
abstract::Epigenetic modifications of gene expression comprise modifications of DNA by DNA methylation and modifications of the histone proteins by acetylation, methylation, SUMOylation or phosphorylation. DNA methylation in the promoter region of genes represses gene transcription. Histone modifications influence the structure...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/eci.11.37
更新日期:2011-07-01 00:00:00
abstract:INTRODUCTION:Hypersensitivity pneumonitis (HP) is an immunologically induced lung disease that develops after inhalation of certain environmental antigens only in subjects with susceptibility to antigens. Therefore, both environmental and host immunological factors play important roles in the aetiology and pathogenesis...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1080/1744666X.2016.1182426
更新日期:2016-09-01 00:00:00
abstract:INTRODUCTION:Common variable immunodeficiency (CVID) comprises a large heterogeneous group of patients with primary antibody deficiency. Areas covered: The affected patients are characterized by increased susceptibility to infections and low levels of serum immunoglobulin. However, enteropathy, granulomatous organ infi...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1080/1744666X.2016.1224664
更新日期:2017-02-01 00:00:00
abstract::Severe active refractory ulcerative colitis is a potentially life-threatening disease. The introduction of intensive steroid treatment and early surgery has reduced mortality in recent years. Ciclosporin and infliximab are effective rescue therapies in steroid refractory colitis. A head-to-head study proposed by Lahar...
journal_title:Expert review of clinical immunology
pub_type: 评论,杂志文章
doi:10.1586/eci.13.34
更新日期:2013-06-01 00:00:00
abstract:INTRODUCTION:Rheumatoid arthritis (RA) is a complex disease in which different mechanisms are involved. Studies suggest a key role for aberrant pathways of T-cell activation in the initiation and perpetuation of disease. Abatacept is a fusion protein composed of the Fc region of the immunoglobulin G1 (IgG1) fused to th...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1080/1744666X.2019.1579642
更新日期:2019-04-01 00:00:00
abstract:INTRODUCTION:HAE is a very debilitating disease that causes significant distress for patients not only during an acute attack but also constant fear for a subsequent attack. It is important to address long-term prophylactic (LTP) therapy to prevent attacks, decrease morbidity and increase the quality of life. When disc...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1080/1744666X.2020.1750953
更新日期:2020-05-01 00:00:00
abstract::Thymic stromal lymphopoietin (TSLP) is an IL-7-related cytokine expressed predominantly by barrier epithelial cells. TSLP is a potent activator of several cell types, including myeloid-derived dendritic cells, monocytes/macrophages and mast cells. Recent studies have revealed an important role for TSLP in the initiati...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1586/eci.09.45
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:X-linked agammaglobulinemia (XLA) is characterized by the absence of immunoglobulin and B cells. Patients suffer from recurrent bacterial infections from early childhood, and require lifelong immunoglobulin replacement therapy. Mutations in BTK (Bruton's Tyrosine Kinase) are associated with this phenotype. S...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1080/1744666X.2018.1413349
更新日期:2018-01-01 00:00:00
abstract::Systemic lupus erythematosus is an autoimmune disorder that can affect every organ system and cause a wide range of signs and symptoms. The precise pathogenic mechanism of disease remains uncertain, but it is clearly complex and involves the activation and deregulation of many components of the immune system. Certain ...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章,评审
doi:10.1586/1744666X.2015.1078237
更新日期:2015-01-01 00:00:00
abstract::Beclomethasone dipropionate is a corticosteroid with topical activity for inflammatory disorders at mucosal surfaces. Oral beclomethasone dipropionate (orBec) has demonstrated activity in gastrointestinal acute graft-versus-host disease (aGVHD) associated with hematopoietic cell transplantation. Since the GI tract is ...
journal_title:Expert review of clinical immunology
pub_type: 杂志文章
doi:10.1586/1744666X.3.5.695
更新日期:2007-09-01 00:00:00