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Cyclosporine for treating rheumatoid arthritis

This review included three trials with a total of 318 patients. A statistically significant decrease in the number of tender and swollen joints was found for patients taking cyclosporine when compared to those taking placebo. Significant improvements in pain and function were also found for those patients taking cyclosporine. More side effects occurred in the cyclosporine group compared to the placebo group.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Treatment with cyclosporine raises blood pressure

Cyclosporine is an immunosuppressive agent discovered in 1972. It was first used to prevent rejection after organ transplantation and more recently, for management of autoimmune diseases. Common side effects associated with cyclosporine therapy are nephrotoxicity and hypertension. To observe the magnitude of elevated blood pressure caused by cyclosporine compared to placebo, we searched the available scientific literature. We identified 17 trials that met our inclusion criteria and had extractable data.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Cyclosporine for treatment of active Crohn's disease

The results of this review demonstrate that low dose oral cyclosporine is not effective for treatment of active Crohn's disease. Studies indicate that Crohn's patients treated with low dose (5 mg/kg/day) oral cyclosporine could experience side effects including kidney problems. Therefore the use of this medication for the treatment of chronic active Crohn's disease is not advisable. Higher oral doses and injections of cyclosporine have not been sufficiently evaluated. Larger doses of cyclosporine are not likely to be useful for the long‐term management of Crohn's disease due to the risk of kidney damage and the availability of other proven medications.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Cyclosporine A for induction of remission in severe ulcerative colitis

Ulcerative colitis (UC) is a chronic inflammation of the large bowel. Symptoms include bloody diarrhea and abdominal pain. The disease can also have manifestations outside the bowel with involvement of the joints, skin, eyes and liver. While the 'first line' treatment for a severe attack of UC is usually steroids (either as pills or intravenously) the options for patients not responding to steroids are limited and include surgical removal of the large bowel. Cyclosporine A (CsA), a drug effective in preventing transplant organ rejection by suppressing the immune system, was tried in severe UC with encouraging results in the early 1990's. The aim of this review was to assess the effectiveness of CsA for severe UC. The literature search identified 36 studies. Only 2 studies were of high methodological quality and both support the use of CsA in UC patients with a severe attack. However, both studies were small (involving only 50 patients altogether) and limited in the length of follow‐up (from a few weeks up to a year). There is limited evidence that cyclosporine is more effective than standard treatment for severe ulcerative colitis. The conclusion of the review is that while the data concerning the use of CsA in severe UC are encouraging, more studies are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Topical treatment with cyclosporine A eyedrops for inflammation of the surface of the eye

Atopic keratoconjunctivitis (AKC) is an inflammatory disorder of the ocular surface that can be suffered by 67.5% of atopic dermatitis patients. It is a chronic condition that often requires long‐term treatment in order to avoid ocular complications that may lead to visual loss. This condition is frequently treated with steroid eyedrops, but long‐term treatment with such drugs can produce severe side effects, such as the development of cataracts, glaucoma or severe infections of the eye. Topical treatment with cyclosporine A (CsA) eyedrops may be useful to control signs and symptoms of atopic keratoconjunctivitis, and to reduce the need for steroid eyedrops.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

After a kidney transplant: What advantages or disadvantages does belatacept (Nulojix) have?

Belatacept (trade name Nulojix) was approved in Germany in June 2011 for adult patients after a kidney transplant. When taken together with other medications, it is supposed to prevent the body from rejecting the new organ.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 25, 2012

A review of the use of drugs that suppress the immune system (immunosuppressants) in myasthenia gravis.

Myasthenia gravis (MG) is caused by antibodies produced by the immune system that impair the transmission of nerve impulses to muscles. This results in muscle weakness that characteristically fluctuates. About one person in every 10 000 ‐ 50 000 develops MG each year. The natural history of the disorder is typically a series of exacerbations and remissions. Severe attacks can be life‐threatening because of weakness of muscles involved in swallowing causing choking, and chest muscles causing difficulty with breathing. In MG, immunosuppressant drugs act mainly by reducing the production of antibodies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Calcineurin inhibitor minimisation, ie, reduction or withdrawal, versus continuation of calcineurin inhibitor treatment for liver transplant patients

Almost every liver transplant recipient is treated with either the drug tacrolimus or the drug cyclosporine to prevent rejection of the transplanted liver. These drugs are part of a group of drugs called calcineurin inhibitors. Both tacrolimus and cyclosporine have serious and common adverse effects and, therefore, dose reduction or discontinuation of these drugs is frequently applied in clinical practice. The aim of the review was to compare reduction or withdrawal of tacrolimus or cyclosporine without substitution with another immunosuppressive agent with continuation of tacrolimus or cyclosporine. Through systematic searches of medical databases we found one ongoing randomised clinical trial investigating total withdrawal of immunosuppressive drugs but, at the time of conducting this review, no trial results on the outcome measures of interest to this review were published. Thus, we cannot reach any conclusion on beneficial or harmful effects of calcineurin inhibitor minimisation for liver transplant recipient patients.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Pharmacotherapy for Behcet's syndrome

Behcet's syndrome is a multisystemic disorder presenting with recurrent oral and genital ulcerations as well as ocular involvement. Treatment of Behcet's syndrome is symptomatic and empirical.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Stem cell transplantation of sibling donors compared with specific immunosuppressive therapy for acquired severe aplastic anemia

Acquired severe aplastic anemia is rare. Stem cells from the bone marrow usually replace naturally dying blood cells in the peripheral blood. Severe aplastic anemia is probably caused by an irregular, attacking immune response against these blood producing stem cells within the body. If supplies are not maintained, functional blood cells are lacking and infections, bleeding, and exhaustion will occur. Patients may experience paleness, weakness, fatigue, and shortness of breath. Disease progression is associated with severe infections, which are a major cause of death.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Balneotherapy or spa‐therapy for Rheumatoid Arthritis

This summary of a Cochrane review presents what we know from research about the effect of Balneotherapy for Rheumatoid Arthritis (RA).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Interventions for Rosacea

Rosacea is a common skin condition causing flushing, redness, red pimples, and pustules on the face, which should not be confused with acne. It can also cause inflammation of the eyes or eyelids, or both. Some people can develop a thickening of the skin, especially of the nose, which is called rhinophyma. Because rosacea is a chronic disease the effect of treatment on quality of life is very important to the individual. A range of treatment options are available which include several topical and oral antibiotics, azelaic cream, topical and systemic retinoids, and light‐based therapies, e.g. laser therapy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Treatments for nail psoriasis

Psoriasis is a common chronic skin disease with a prevalence in 2% to 3% of the population, according to European studies. Involvement of the nails occurs in about 50%. Nail psoriasis is difficult to treat, but may respond to some treatments. We aimed to review the efficacy and safety of the treatments used for nail psoriasis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Treatments for chronic palmoplantar pustulosis (a skin disease where repeated crops of painful yellow pus spots form on the palms and soles)

Chronic palmoplantar pustulosis is a skin disease where repeated crops of painful yellow pus spots form on the palms and soles, often over many years. Many different treatments have been used including topical creams and ointments, drugs by mouth and ultraviolet radiation. The review of trials found that several treatments improve the symptoms of chronic palmoplantar pustulosis, although no treatment was shown to suppress the condition completely. Oral retinoid therapy (acitretin) appears to be helpful at relieving symptoms, particularly if combined with PUVA. Ciclosporin and tetracycline antibiotics can also provide some relief. Topical treatments were generally less helpful. As yet there is no ideal treatment for chronic palmoplantar pustulosis, though oral retinoids, particularly when combined with psoralens and ultraviolet radiation (PUVA), may help

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Treatments for erosive lichen planus affecting mucosal sites

Erosive lichen planus (ELP) is a condition that affects the mouth, oesophagus (food pipe or gullet), and anogenital region. It is caused by an over‐active immune system. It is often more painful and debilitating than the non‐erosive types of lichen planus. Depending on the site involved, affected individuals may experience pain, and difficulty eating; passing urine; or having sexual intercourse. Treatment is difficult and aimed at controlling symptoms, rather than cure. Several creams and tablets have been used with varying results.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Interventions for pemphigus vulgaris and pemphigus foliaceus

This review of clinical trials aimed to find out which is the most effective and safest treatment option for pemphigus vulgaris and pemphigus foliaceus.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Mycophenolate mofetil versus methotrexate for prevention of graft‐versus‐host disease following allogeneic hematopoietic stem cell transplantation

Allogeneic hematopoietic stem cell transplantation is a procedure in which a portion of a healthy donor's stem cells (cells that can develop into various types of blood cells) or bone marrow is obtained and prepared for intravenous infusion. Hematopoietic stem cells are taken from a healthy donor and transplanted into the patient (recipient). People undergoing allogeneic hematopoietic stem cell transplantation are at risk of developing graft‐versus‐host disease (GVHD). GVHD results when the transplanted cells from the donor (graft) attack the recipient's (host) body cells because they perceive the recipient's body as foreign. Mycophenolate mofetil and methotrexate are two drugs often used to suppress the human body's reaction against the graft (immune response) and prevent GVHD. We conducted a systematic review of three randomized controlled trials (RCTs, which are clinical studies where people are randomly put into one of two or more treatment groups) that compared mycophenolate mofetil versus methotrexate for use in preventing GVHD among 174 participants. We searched for the relevant studies in March 2014.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Drugs that suppress or modify the immune system for dermatomyositis and polymyositis

Dermatomyositis and polymyositis are long‐term inflammatory muscle diseases, causing muscle weakness and disability. For some reason, the body's immune system turns against its own muscles in an autoimmune response. Corticosteroids are the principal treatment but due to side effects, there is a need for additional treatment with drugs that suppress the immune system (immunosuppressants) or modify it (immunomodulatory therapies) to improve patient outcomes. For this review, an update of a review first published in 2005, we found ten randomised trials available, involving 258 participants.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Bile acids for liver‐transplanted patients

Liver transplantation is a major surgical procedure that has been practiced for more than forty years and has nowadays become a generally accepted treatment option in patients with end‐stage liver disease. The most common cause for liver transplantation in adults is cirrhosis caused by various types of liver injuries such as infections (hepatitis B and C), alcohol, autoimmune liver diseases, early‐stage liver cancer, metabolic and hereditary disorders, but also diseases of unknown aetiology. All transplant recipients need lifetime immunosuppressive therapy to prevent transplant rejection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Immunomodulatory treatment other than corticosteroids, immunoglobulin and plasma exchange for CIDP

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an uncommon disease that causes weakness and numbness of the arms and legs, which can be progressive or have a relapsing and remitting course. It is due to inflammation which damages the insulating sheaths (myelin) around individual nerve fibres. In severe cases the actual nerve fibres themselves are affected. The underlying cause is thought to be an autoimmune response in which immune cells are misdirected against the myelin components. Cochrane systematic reviews have presented evidence that some treatments do help. These are corticosteroids, plasma exchange (in which the abnormal plasma portion of the blood is replaced with a substitute) and intravenous infusions of human immunoglobulin (antibodies). However, benefit from these treatments is often absent, inadequate, or short‐lived, lasting only a few weeks. Other treatment options include cytotoxic 'chemotherapy‐like' drugs, which kill the harmful immune cells, and drugs that regulate the immune system, such as interferons. High quality evidence that these treatments work is sparse and there have only been four randomised trials that we have been able to identify. One tested the cytotoxic drug azathioprine for nine months involving 27 participants. The second tested the immune regulating drug interferon beta‐1a involving 10 participants, with each treatment period lasting 12 weeks. Neither trial showed a significant result but neither was large enough to detect even moderate benefit. The third trial was a double‐blind randomised trial of interferon beta‐1a including 67 participants for 32 weeks. The fourth was a double‐blind placebo controlled trial of methotrexate involving 60 participants for 40 weeks. These latter two trials again did not show significant benefit from methotrexate or interferon beta‐1a and were still not large enough to detect or rule out minor or moderate benefit. Not all of the studies reported outcomes that might be considered relevant to drug response or patients. There was no significant bias in the conduct and reporting of the two trials of interferon beta‐1a and the trial of methotrexate but there was high risk of bias in the trial of azathioprine. Observational studies of these and other drugs, including the cytotoxic drugs cyclophosphamide, ciclosporin, mycophenolate, rituximab, and alemtuzumab, peripheral blood stem cell transplantation and the immune regulating drug interferon alfa, have been performed but are of insufficient quality to determine whether any of these drugs are beneficial.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Medical Encyclopedia

  • Hypomagnesemia
    Hypomagnesemia is a condition in which the amount of magnesium in the blood is lower than normal.
  • Minimal change disease
    Minimal change disease is a kidney disorder that can lead to nephrotic syndrome, although the nephrons of the kidney look normal under a regular microscope.
  • Pseudotumor cerebri
    Pseudotumor cerebri is a condition in which the pressure inside the skull is increased. The brain is affected in a way that the condition appears to be -- but is not -- a tumor.
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Systematic Reviews in PubMed

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