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Biomedical subjects

M Schattenkirchner

Publications and source records attributed to M Schattenkirchner.

At least 19 recordsLinked to original sources
PubMed1992

Carbamazepine-induced systemic lupus erythematosus.

A 21-year-old woman suffering from bipolar affective disorder developed systemic lupus erythematosus (SLE) with characteristic laboratory findings, 18 months after starting carbamazepine maintenance treatment. SLE receded after withdrawal of carbamazepine and treatment with anti-inflammatory drugs. Although both the spontaneous occurrence of SLE and the psychosis as a sign of CNS involvement of SLE cannot be excluded, SLE could be considered as an adverse effect of carbamazepine.

Adult↗
PubMed1991

Treatment of rheumatoid arthritis with monoclonal CD4 antibody M-T151. Clinical results and immunopharmacologic effects in an open study, including repeated administration.

Recent experimental and clinical data point to the T helper lymphocyte subset as playing a central role in the pathogenesis of rheumatoid arthritis (RA). Thus, a therapeutic strategy aimed specifically at the CD4 T cell subset is warranted. We treated patients with active RA for 7 days with a daily dose of 20 mg of CD4 monoclonal antibody M-T151, administered intravenously over 30 minutes. There were no negative side effects. According to changes in the combined parameters of Ritchie articular index, pain assessment, grip strength, and morning stiffness, 6 patients had a good response. Clinical improvement was greatest approximately 2 weeks after termination of the therapy and lasted from 4 weeks to 6 months. Of the serologic parameters of inflammation, only the C-reactive protein level improved in the patients with a favorable response. Close immunologic monitoring revealed a transient, selective depletion of CD4+ T cells after each infusion. During the entire treatment period, residual circulating CD4+ cells were found to be coated with CD4 antibody, whereas free antibody was detected in the serum only for approximately 8 hours after each infusion. Immediately after infusion, soluble CD4 antigen appeared in the serum. In addition to the cell-bound CD4 antibody, complement components could be detected on the surface of the remaining CD4+ cells. The proliferative response of peripheral blood mononuclear cells to purified protein derivative was significantly diminished 4 weeks after cessation of antibody treatment. Six patients showed a weak antibody response to mouse immunoglobulin. In 4 of the responders who received a second course of therapy (2 of them as outpatients), a therapeutic effect was noted that was similar to that after the first course. Only 1 patient, who had low titers of serum IgE anti-mouse Ig antibodies, showed a mild anaphylactic reaction at the end of the second course of therapy. Treatment of RA with the monoclonal CD4 antibody M-T151 seems to be a promising alternative, although the optimal dose and the regimen of administration are still to be defined.

Animals↗
PubMed1991

Double-blind comparison of etodolac and piroxicam in patients with rheumatoid arthritis.

A study was carried out to compare the efficacy and tolerability of etodolac and piroxicam in patients with rheumatoid arthritis. Sixty patients entered this double-blind, parallel study and after a wash-out period of up to 2 weeks were randomly assigned to receive 200 mg etodolac twice daily or 20 mg piroxicam once daily for 12 weeks. Efficacy and tolerability assessments were made after 2, 4, 6, 8 and 12 weeks. Patients in the etodolac group demonstrated statistically significant improvement in the number of tender joints and the duration of morning stiffness after 12 weeks, as did the piroxicam-treated patients. In addition, the etodolac-treated patients had significant improvement according to the patients' and physician's global evaluations, pain intensity, number of swollen joints, and grip strength. There were significant differences between therapies favouring etodolac for the assessments of the number of tender joints and the physician's global evaluation by the end of the study. Forty-seven percent (47%) of 15 etodolac-treated patients compared with 7% of 15 piroxicam-treated patients showed improvement according to the physician's global evaluation at Week 12. Similarly, the patients' global evaluation showed that 40% of etodolac-treated patients and 19% of piroxicam-treated patients had improved by the end of therapy. Both therapies were well tolerated. There were no significant differences between groups in the incidence of any adverse reactions or the frequency of withdrawals.

Adult↗
PubMed1991

Long-term safety of ketoprofen in an elderly population of arthritic patients.

A total of 823 patients (620 women and 203 men) aged greater than or equal to 65 years (mean age: 72 years) with osteoarthritis (n = 642) or rheumatoid arthritis (n = 181) were enrolled in an international prospective study designed to assess the safety profile of ketoprofen, a propionic acid derivative, over a 12-month treatment period. The patients received a 200-mg, sustained-release tablet of ketoprofen once daily. At the end of the study, 521 patients (63.3%) remained on the drug regimen, whereas 302 patients (36.7%) had withdrawn from treatment for various reasons, including adverse reactions, inefficacy and improvement, or had been lost to follow-up. A total of 314 patients (38.2%) experienced at least one adverse event during the study. Most side effects involved the digestive system (232 patients [28.2%]), the central nervous system (33 patients [4.0%]) or the cardiovascular system (26 patients [3.2%]). Fourteen patients (1.7%) experienced gastrointestinal adverse events (e.g., ulceration and bleeding). Most of these events occurred during the first 3 months of the study. Thus, it may be concluded that sustained-release ketoprofen, 200 mg once daily, is safe for the long-term treatment of elderly arthritic patients.

Age Factors↗
PubMed1991

Magnetic resonance imaging of the parotid gland in patients with Sjögren's syndrome.

To detect structure and size abnormalities, magnetic resonance imaging (MRI) of the parotid gland was performed on 36 patients with sicca complaints. Twenty-four patients had primary Sjögren's syndrome (SS) without rheumatoid arthritis (RA) or connective tissue disease; 6 had secondary SS associated with RA, whereas in another 6 cases the related disease could not be classified. Characteristic gland size and structural abnormalities were identified in patients with SS and various stages could be established, compared to patients with other parotid gland disorders, as well as healthy persons. MRI provides an accurate noninvasive technique for assessment of xerostomia in patients with SS.

Arthritis, Rheumatoid↗
PubMed1990

A three year comparative study of auranofin and gold sodium thiomalate in rheumatoid arthritis.

UNLABELLED: One hundred twenty-one patients with active RA were randomly assigned to receive 6 mg auranofin (AF)/day (60 patients) or 50 mg gold sodium thiomalate (GST)/week (62 patients) in a double-blind fashion. There were no intergroup differences with respect to sex, age, duration (median 2 years), stage and activity of the disease. In the case of "striking improvement" after 24 weeks a dose reduction to 50 mg GST/month or 4 mg AF/day was allowed and carried out in all GST patients and no AF patient. The serum gold levels were 5 times higher with weekly GST, they approached those of the AF group with monthly GST injections. The clinical parameters--number of swollen joints, activity index, articular index, grip strength, ESR--improved significantly in both groups, but grip strength, articular index and ESR improved more pronounced in the GST group. The X-ray progression (hands and forefeet) was significantly greater in the AF group. Forty-eight AF patients (80%) and 39 GST patients (36%) completed the first year. Thereafter the study was continued as an open study but the patients were allowed to switch from GST to AF. After the first and second year 14/7 GST patients switched to AF. The second/third year was completed by 37/22 AF pat. (62%/37%) and by 15/8 GST pat. (24%/13%). Skin reactions were more common with GST (41.9%/26.7%), diarrhoea was more common with AF (36.7%/19.4%), proteinuria occurred in 10% in both groups, leucopenia and thrombocytopenia were rare in both groups (1.7%). The withdrawal rate due to adverse events was 10%/26% in the AF/GST group during the first year (p less than 0.05) and 25%/32% over the three year period (n.s.). CONCLUSION: Both AF and GST are effective in the long-term treatment of RA, but GST is more so in radiological progression and ESR.

Arthritis, Rheumatoid↗
PubMed1990

[Immuno-diagnostic findings in "secondary" Sjögren syndrome in chronic polyarthritis].

In order to characterize typical findings in patients (pts.) with secondary Sjögren's Syndrome (SS) associated with rheumatoid arthritis (RA), 173 patients with RA were studied. Pathological screening-test results (Schirmer- and Saxon-test) were followed by ENT- and ophthalmological investigations and examinations in the field of internal medicine. Secondary SS associated with RA was diagnosed in 34 pts. (20%). Immuno-serological SS-A and/or SS-B-antibodies were found in 11 (32%) of 34 patients. 9 pts. (27%) had antinuclear antibodies. Abnormal titers of circulating immune complexes were present in the sera of 24 pts. (71%), salivary gland-antibodies in 3 pts. (9%). In 16 of 34 pts. (47%) minor salivary gland biopsy was performed. Lympho-plasma cell sialadenitis could be verified in all pts. Immuno-histological reactions to anti-IgG and/or anti-IgM and/or anti-IgA were detected in 10 (62%) of 16 pts. We could not find a single criterion to ascertain the diagnosis SS which still has to be made by considering all clinical and serological findings. Immunological findings may provide helpful and interesting diagnostic aspects which by long term observation may even gain importance; however, no differential therapeutic consequences can be seen at the moment.

Antibodies, Antinuclear↗
PubMed1990

Polymorphisms in the VK gene patterns of rheumatoid arthritis patients and control individuals.

Restriction nuclease digests of DNAs from rheumatoid arthritis patients and control persons were studied by blot hybridization using immunoglobulin VK gene probes of subgroups I-III. Two restriction fragment length polymorphisms (RFLP) were detected in Bg1II digests with a VKI gene probe. One of the RFLPs is linked to rheumatoid arthritis with a relative risk of 5 (p less than 0.01). The observation may be of pathogenetic interest.

Arthritis, Rheumatoid↗
PubMed1990

An updated safety profile of etodolac in several thousand patients.

The safety of etodolac, a new nonsteroidal anti-inflammatory drug (NSAID), was reviewed by examining data from 3,302 patients enrolled in double-blind and open-label clinical trials and from 8,334 patients taking etodolac in post-marketing surveillance studies. The review determined that gastrointestinal disturbances are the most frequently reported side effects, followed by headache, dizziness, rash, and pruritus. The rate of abdominal pain and dyspepsia is similar to that observed with several other NSAIDs but is lower than that seen with aspirin. Gastrointestinal ulceration occurs in less than 0.3% of patients taking etodolac, and drug-related hepatic, renal, and hematologic dysfunctions are rare. The elderly appear to be no more at risk of experiencing adverse effects than the general population. Overall, the review confirmed the excellent safety profile of etodolac reported previously.

Adult↗
PubMed1988

Auranofin and gold sodium thiomalate in the treatment of rheumatoid arthritis: a one-year, double-blind, comparative multicenter study.

In a 48-week, double-blind trial, 122 patients were randomly assigned to treatment with auranofin (60) and gold sodium thiomalate (GST) (62) at five centers. Both groups showed significant improvement (P less than 0.05) from baseline in parameters of disease activity. Results of the covariance analysis for all patients who completed the trial showed no significant differences (P less than 0.05) in efficacy between the two groups. The proportions of patients showing 50% or greater improvement in tender joints, swollen joints, activity index, severity of pain, general health rating, and erythrocyte sedimentation rate (ESR) were similar for both auranofin-treated and GST-treated patients who completed the 48-week trial. When all patients who entered the trial were evaluated, a slightly greater proportion of patients on auranofin had improved. Diarrhea occurred more frequently with auranofin (32%) compared to GST (19%), whereas rash and pruritus were twice as common in those patients treated with GST compared to those treated with auranofin. The withdrawal rate due to adverse reactions was 10% for auranofin vs 26% for GST. It was concluded that the efficacy of auranofin was comparable to that of injectable gold and was better tolerated, as evidenced by the lower withdrawal rate from adverse events for the auranofin patients.

Adult↗
PubMed1988

Molecular biology of the HLA-B27 locus.

The molecular biology of the HLA-B27 locus is reviewed. The HLA-B27 gene itself does not differ between healthy individuals and ankylosing spondylitis patients. Several unique features of the HLA-B27 molecule have been identified and one epitope was proposed to cross-react with bacterial proteins.

Amino Acid Sequence↗