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Satisfaction Level of Rheumatoid Arthritis Patients Enrolled in the Treatment with Subcutaneous Tocilizumab
(Synergy Publishers, 2020)
Filip Gucev
;
Lj Damjanovska-Krstikj
;
Dubravka Antova
;
Bashim Osmani
;
Mimoza Nikolovska Kotevska
Abstract: Background: The introduction of biological-Disease Modifying Agents (bDMARDs) has allowed serious improvement in the treatment of patients with rheumatoid arthritis (RA) by providing a better quality of life (QoL). Such improvements have been shown in patients using subcutaneous form of Tocilizumab SC (TCZ-SC), a humanized monoclonal antibody against IL-6 receptor. Objective: To assess the subcutaneous treatment satisfaction level and to evaluate the epidemiological profile of RA patients treated with TCZ-SC in North Macedonian Patients with RA. Methods: An observational study was conducted at the University Rheumatology Clinic in Skopje between October 1st and December 15th 2018, including 48 patients who have received TCZ-SC. In order to obtain patient’s satisfaction level and to evaluate the epidemiological characteristics of the patients, a standardized questionnaire was developed. Results: The mean age of the patient’s cohort was 50.9 years and 88.5% of the patients were females. More than half of the patients (58%) had high disease activity with mean disease duration of 5.35 years. Eighty three percent of the patients were entitled to receive subcutaneous TCZ because of the insufficient efficacy of previous treatment, All patients enrolled in the treatment with TCZ-SC, reported to be satisfied or very satisfied with the subcutaneous application of TCZ. They were also very satisfied with the previous education and the opportunity to receive the treatment at home. Conclusions: Tocilizumab as an efficient and well tolerated bDMARD is becoming a standard of care in the treatment of patients suffering from RA, offering unprecedented benefits for QoL improvement and satisfying the patients’ needs for modern and effective treatment.
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ML28133 -A MULTICENTER, OPEN-LABEL, LONG-TERM EXTENSION STUDY OF WA 19926 TO DESCRIBE SAFETY DURING TREATMENT WITH TOCILIZUMAB IN PATIENTS WITH EARLY, MODERATE TO SEVERE RHEUMATOID ARTHRITIS
(Македонско лекарско друштво = Macedonian Medical Association, 2017)
;
Snezhana Mishevska-Percinkova
;
Dubravka Antova
;
Mimoza Kotevska Nikolova
;
Anzhelika Stojanovska
Introduction. Biologic DMARDs (Disease Modifying Anti Rheumatic Drugs) have shown to be effective in the treatment of rheumatoid arthritis (RA) resistant to the use of synthetic DMARDs. The primary goal of this study was to assess the long-term safety of the use of tocilizumab in patients with early rheumatoid arthritis, moderate to severe disease activity. The secondary goal was to assess the efficiency of tocilizumab in achieving and maintaining clinical remission of the disease. Methods. ML28133 is a long-term, extended study of 13 patients with rheumatoid arthritis treated with tocilizumab. Two patients were male (15.4%), 11(84.61%) female. The average age of patients was 53.27+/-10.68. Patients received 8mg/kg tocilizumab i.v. every four weeks, 104 weeks overall. Safety was assessed following side effects, blood tests, physical examination and vital signs. Efficiency was assessed by achieving and maintaining clinical remission according to DAS28 (Disease Activity Score 28), global assessment of disease activity, VAS score and HAQ-DI (Health Activity Score) questionnaire. Results. Incidence of side effects was 76.92%. Infections were of special interest and were most common (15.3%). Four patients had serious adverse events, three of which associated with tocilizumab, and therapy was stopped. In 11 (84.6%) of the 13 treated patients clinical remission was achieved at times. At the end of the study, 8 out of 9 patients were in remission. Conclusion. The results have shown significant therapeutic effect of tocilizumab even in the most severe forms of the disease, which gives hope for its use as a monotherapy
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Patient with Antineutrophil Cytoplasmic Antibody Associated Small Vessel Vasculitis, Acute Renal Failure, and Coronavirus Disease-19 Pneumonia: A Diagnostic and Therapeutic Challenge
(ID-Design/Scientific foundation SPIROSKI, 2020-11)
;
;
Zvezdana Petronijevik
;
Blagica Pecanova
;
Gjorgi Stojchev
BACKGROUND: Antineutrophil cytoplasmatic antibody (ANCA)-associated vasculitis (AAV) has a predilection for the kidney and more than three quarters of patients have renal involvement with rapidly progressive glomerulonephritis. Small-vessel systemic vasculitis may present as pulmonary-renal syndrome and is characterized by necrotizing glomerulonephritis and pulmonary hemorrhage. Diagnosis and therapy for AAV in coronavirus disease (COVID) COVID-19 pandemic require multi-disciplinary collaboration due to the affection of multiple systems and risks associated with immunosuppressive medications. CASE REPORT: A 69-year-old non-smoker, non-diabetic female presented in the outpatient unit at the department of pulmonology with dry cough, malaise, and sub-febrile temperature, lasting for 1 month. The patient had a high suspicion of severe pulmonary-renal syndrome, ANCA-AAV, and acute renal failure requiring hemodialysis. She was treated with corticosteroids, cyclophosphamide, and plasma exchange. The treatment led to temporary improvement. Infections with COVID-19, Enterococcus in the urine, and Acinetobacter in the tracheal aspirate further complicated the clinical picture and despite antibiotic treatment, use of tocilizumab and convalescent plasma, the outcome was lethal. CONCLUSION: It is important to establish the diagnosis and distinguish accurately between vasculitis and infection to provide adequate and timely therapy.

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