Secondary amyloidosis medical therapy: Difference between revisions
No edit summary |
No edit summary |
||
Line 8: | Line 8: | ||
==Medical Therapy== | ==Medical Therapy== | ||
* Medical or surgical treatment of the underlying chronic infection or inflammatory disease is recommended among all patients who develop AA amyloidosis. | * Medical or surgical treatment of the underlying chronic infection or inflammatory disease is recommended among all patients who develop AA amyloidosis.<ref name="pmid22909024">{{cite journal| author=Desport E, Bridoux F, Sirac C, Delbes S, Bender S, Fernandez B et al.| title=Al amyloidosis. | journal=Orphanet J Rare Dis | year= 2012 | volume= 7 | issue= | pages= 54 | pmid=22909024 | doi=10.1186/1750-1172-7-54 | pmc=3495844 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22909024 }}</ref> | ||
* Aggressively treating the disease that is causing the excess [[amyloid]] protein can improve [[symptoms]] and slow down or halt the progression of the disease. | * Aggressively treating the disease that is causing the excess [[amyloid]] protein can improve [[symptoms]] and slow down or halt the progression of the disease. | ||
* Complications such as [[heart failure]], [[renal failure]], and other problems can sometimes be treated, when needed. | * Complications such as [[heart failure]], [[renal failure]], and other problems can sometimes be treated, when needed. |
Revision as of 20:17, 1 November 2019
Secondary amyloidosis Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Secondary amyloidosis medical therapy On the Web |
American Roentgen Ray Society Images of Secondary amyloidosis medical therapy |
Risk calculators and risk factors for Secondary amyloidosis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Roukoz A. Karam, M.D.[2]
Overview
Medical or surgical treatment of the underlying chronic infection or inflammatory disease is recommended among all patients who develop AA amyloidosis.
Medical Therapy
- Medical or surgical treatment of the underlying chronic infection or inflammatory disease is recommended among all patients who develop AA amyloidosis.[1]
- Aggressively treating the disease that is causing the excess amyloid protein can improve symptoms and slow down or halt the progression of the disease.
- Complications such as heart failure, renal failure, and other problems can sometimes be treated, when needed.
- Although the choice of therapy depends on the underlying cause of chronic inflammation, the aim is always to suppress production of SAA to within the normal range.
- Examples of treatments for the commonest disorders underlying AA amyloidosis, adapted from Rheumatic Diseases Clinics of North America:[2]
Underlying Condition | Treatment Options | Examples |
---|---|---|
Inflammatory arthritis | Conventional disease-modifying agents | |
Other immunosuppressant agents |
||
Biologic agents |
||
Periodic fevers | On-demand agents | |
Colchicine (for familial mediterranean fever) |
||
Biologic agents |
||
Inflammatory bowel disease | Conventional disease-modifying agents | |
Biologic agents |
||
Antibiotics |
||
Biologic agents |
||
Surgery |
| |
Immunodeficiency | Immunoglobulins |
|
Antibiotics |
||
Chronic infections | Antibiotics and surgery |
|
Physiotherapy (in case of bronchiectasis) |
| |
Immunodeficiency | Immunoglobulins |
|
Antibiotics |
||
Neoplasia | Chemotherapy and surgery |
Varies according to type of cancer |
Biologic agents (in Castleman disease) |
- Long-term inflammatory control can be accompanied by gradual regression of amyloid deposits and improvement in renal function.
- Currently a second clinical trial is in progress in order to evaluate a targeted inhibitor molecule, Kiacta, in the management of secondary amyloidosis.
- Novel therapies aimed at promoting clearance of existing amyloid deposits soon may be an effective treatment approach.
References
- ↑ Desport E, Bridoux F, Sirac C, Delbes S, Bender S, Fernandez B; et al. (2012). "Al amyloidosis". Orphanet J Rare Dis. 7: 54. doi:10.1186/1750-1172-7-54. PMC 3495844. PMID 22909024.
- ↑ Papa R, Lachmann HJ (2018). "Secondary, AA, Amyloidosis". Rheum Dis Clin North Am. 44 (4): 585–603. doi:10.1016/j.rdc.2018.06.004. PMID 30274625.