Renal amyloidosis medical therapy: Difference between revisions

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==Medical Therapy==
==Medical Therapy==
*Pharmacologic medical therapies for [[Renal amyloidosis]] include Colchicine   Dimethylsulfoxide   Azathioprine  Chlorambucil Methotrexate Cyclophosphamide TNF-alpha antagonists (ie, etanercept, infliximab, and adalimumab)
*Pharmacologic medical therapies for [[Renal amyloidosis]] include  
Colchicine <ref name="pmid1584316">{{cite journal |vauthors=Livneh A, Zemer D, Siegal B, Laor A, Sohar E, Pras M |title=Colchicine prevents kidney transplant amyloidosis in familial Mediterranean fever |journal=Nephron |volume=60 |issue=4 |pages=418–22 |date=1992 |pmid=1584316 |doi=10.1159/000186801 |url=}}</ref><ref name="pmid14978665">{{cite journal |vauthors=Lidar M, Scherrmann JM, Shinar Y, Chetrit A, Niel E, Gershoni-Baruch R, Langevitz P, Livneh A |title=Colchicine nonresponsiveness in familial Mediterranean fever: clinical, genetic, pharmacokinetic, and socioeconomic characterization |journal=Semin. Arthritis Rheum. |volume=33 |issue=4 |pages=273–82 |date=February 2004 |pmid=14978665 |doi= |url=}}</ref><ref name="pmid7780053">{{cite journal |vauthors=Tan AU, Cohen AH, Levine BS |title=Renal amyloidosis in a drug abuser |journal=J. Am. Soc. Nephrol. |volume=5 |issue=9 |pages=1653–8 |date=March 1995 |pmid=7780053 |doi= |url=}}</ref>
Azathioprine
Dimethylsulfoxide<ref name="pmid10576978">{{cite journal |vauthors=Iwakiri R, Sakemi T, Fujimoto K |title=Dimethylsulfoxide for renal dysfunction caused by systemic amyloidosis complicating Crohn's disease |journal=Gastroenterology |volume=117 |issue=4 |pages=1031–2 |date=October 1999 |pmid=10576978 |doi= |url=}}</ref><ref name="pmid16799886">{{cite journal |vauthors=Amemori S, Iwakiri R, Endo H, Ootani A, Ogata S, Noda T, Tsunada S, Sakata H, Matsunaga H, Mizuguchi M, Ikeda Y, Fujimoto K |title=Oral dimethyl sulfoxide for systemic amyloid A amyloidosis complication in chronic inflammatory disease: a retrospective patient chart review |journal=J. Gastroenterol. |volume=41 |issue=5 |pages=444–9 |date=May 2006 |pmid=16799886 |doi=10.1007/s00535-006-1792-3 |url=}}</ref>
Chlorambucil  
Methotrexate
Cyclophosphamide <ref name="pmid11477289">{{cite journal |vauthors=Chevrel G, Jenvrin C, McGregor B, Miossec P |title=Renal type AA amyloidosis associated with rheumatoid arthritis: a cohort study showing improved survival on treatment with pulse cyclophosphamide |journal=Rheumatology (Oxford) |volume=40 |issue=7 |pages=821–5 |date=July 2001 |pmid=11477289 |doi= |url=}}</ref><ref name="pmid14677008">{{cite journal |vauthors=Nakamura T, Yamamura Y, Tomoda K, Tsukano M, Shono M, Baba S |title=Efficacy of cyclophosphamide combined with prednisolone in patients with AA amyloidosis secondary to rheumatoid arthritis |journal=Clin. Rheumatol. |volume=22 |issue=6 |pages=371–5 |date=December 2003 |pmid=14677008 |doi=10.1007/s10067-003-0763-9 |url=}}</ref>
TNF-alpha antagonists (ie, etanercept, infliximab, and adalimumab)<ref name="pmid12847696">{{cite journal |vauthors=Gottenberg JE, Merle-Vincent F, Bentaberry F, Allanore Y, Berenbaum F, Fautrel B, Combe B, Durbach A, Sibilia J, Dougados M, Mariette X |title=Anti-tumor necrosis factor alpha therapy in fifteen patients with AA amyloidosis secondary to inflammatory arthritides: a followup report of tolerability and efficacy |journal=Arthritis Rheum. |volume=48 |issue=7 |pages=2019–24 |date=July 2003 |pmid=12847696 |doi=10.1002/art.11163 |url=}}</ref><ref name="pmid15866260">{{cite journal |vauthors=Fernández-Nebro A, Tomero E, Ortiz-Santamaría V, Castro MC, Olivé A, de Haro M, Portales RG, García-Vicuña R, González-Mari MV, Laffón A, García-Vicuña R |title=Treatment of rheumatic inflammatory disease in 25 patients with secondary amyloidosis using tumor necrosis factor alpha antagonists |journal=Am. J. Med. |volume=118 |issue=5 |pages=552–6 |date=May 2005 |pmid=15866260 |doi=10.1016/j.amjmed.2005.01.028 |url=}}</ref><ref name="pmid20440529">{{cite journal |vauthors=Nakamura T, Higashi S, Tomoda K, Tsukano M, Shono M |title=Etanercept can induce resolution of renal deterioration in patients with amyloid A amyloidosis secondary to rheumatoid arthritis |journal=Clin. Rheumatol. |volume=29 |issue=12 |pages=1395–401 |date=December 2010 |pmid=20440529 |doi=10.1007/s10067-010-1469-4 |url=}}</ref><ref name="pmid19366896">{{cite journal |vauthors=Keersmaekers T, Claes K, Kuypers DR, de Vlam K, Verschueren P, Westhovens R |title=Long-term efficacy of infliximab treatment for AA-amyloidosis secondary to chronic inflammatory arthritis |journal=Ann. Rheum. Dis. |volume=68 |issue=5 |pages=759–61 |date=May 2009 |pmid=19366896 |doi=10.1136/ard.2008.095505 |url=}}</ref>
*Proline for clearing amyloid
*Proline for clearing amyloid
===Disease Name===
===Disease Name===
* '''1 Stage 1 - Name of stage'''
** 1.1 '''Specific Organ system involved 1'''
*** 1.1.1 '''Adult'''
**** Preferred regimen (1): [[drug name]] 100 mg PO q12h for 10-21 days '''(Contraindications/specific instructions)''' 
**** Preferred regimen (2): [[drug name]] 500 mg PO q8h for 14-21 days
**** Preferred regimen (3): [[drug name]] 500 mg q12h for 14-21 days
**** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days 
**** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
**** Alternative regimen (3): [[drug name]] 500 mg PO q6h for 14–21 days
*** 1.1.2 '''Pediatric'''
**** 1.1.2.1 (Specific population e.g. '''children < 8 years of age''')
***** Preferred regimen (1): [[drug name]] 50 mg/kg PO per day q8h (maximum, 500 mg per dose) 
***** Preferred regimen (2): [[drug name]] 30 mg/kg PO per day in 2 divided doses (maximum, 500 mg per dose)
***** Alternative regimen (1): [[drug name]]10 mg/kg PO q6h (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
****1.1.2.2 (Specific population e.g. '<nowiki/>'''''children < 8 years of age'''''')
***** Preferred regimen (1): [[drug name]] 4 mg/kg/day PO q12h（maximum, 100 mg per dose）
***** Alternative regimen (1): [[drug name]] 10 mg/kg PO q6h (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose) 
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
** 1.2 '''Specific Organ system involved 2'''
*** 1.2.1 '''Adult'''
**** Preferred regimen (1): [[drug name]] 500 mg PO q8h
*** 1.2.2  '''Pediatric'''
**** Preferred regimen (1): [[drug name]] 50 mg/kg/day PO q8h (maximum, 500 mg per dose)
* 2 '''Stage 2 - Name of stage'''
** 2.1 '''Specific Organ system involved 1 '''
**: '''Note (1):'''
**: '''Note (2)''':
**: '''Note (3):'''
*** 2.1.1 '''Adult'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
**** Oral regimen
***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days 
***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
*** 2.1.2 '''Pediatric'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
***** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day) '<nowiki/>'''''(Contraindications/specific instructions)''''''
**** Oral regimen
***** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Preferred regimen (2): [[drug name]] '''(for children aged ≥ 8 years)''' 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days  (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)
** 2.2  '<nowiki/>'''''Other Organ system involved 2''''''
**: '''Note (1):'''
**: '''Note (2)''':
**: '''Note (3):'''
*** 2.2.1 '''Adult'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
**** Oral regimen
***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days 
***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
*** 2.2.2 '''Pediatric'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
***** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day)
**** Oral regimen
***** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Preferred regimen (2): [[drug name]] 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days  (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)


==References==
==References==

Revision as of 18:55, 26 July 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2] Omer Kamal, M.D. [2]

Overview

The mainstay of treatment for Renal amyloidosis is to decrease the production of amyloid.

Medical Therapy

Colchicine [1][2][3] Azathioprine Dimethylsulfoxide[4][5] Chlorambucil Methotrexate Cyclophosphamide [6][7] TNF-alpha antagonists (ie, etanercept, infliximab, and adalimumab)[8][9][10][11]

  • Proline for clearing amyloid

Disease Name

References

  1. ↑ Livneh A, Zemer D, Siegal B, Laor A, Sohar E, Pras M (1992). "Colchicine prevents kidney transplant amyloidosis in familial Mediterranean fever". Nephron. 60 (4): 418–22. doi:10.1159/000186801. PMID 1584316.
  2. ↑ Lidar M, Scherrmann JM, Shinar Y, Chetrit A, Niel E, Gershoni-Baruch R, Langevitz P, Livneh A (February 2004). "Colchicine nonresponsiveness in familial Mediterranean fever: clinical, genetic, pharmacokinetic, and socioeconomic characterization". Semin. Arthritis Rheum. 33 (4): 273–82. PMID 14978665.
  3. ↑ Tan AU, Cohen AH, Levine BS (March 1995). "Renal amyloidosis in a drug abuser". J. Am. Soc. Nephrol. 5 (9): 1653–8. PMID 7780053.
  4. ↑ Iwakiri R, Sakemi T, Fujimoto K (October 1999). "Dimethylsulfoxide for renal dysfunction caused by systemic amyloidosis complicating Crohn's disease". Gastroenterology. 117 (4): 1031–2. PMID 10576978.
  5. ↑ Amemori S, Iwakiri R, Endo H, Ootani A, Ogata S, Noda T, Tsunada S, Sakata H, Matsunaga H, Mizuguchi M, Ikeda Y, Fujimoto K (May 2006). "Oral dimethyl sulfoxide for systemic amyloid A amyloidosis complication in chronic inflammatory disease: a retrospective patient chart review". J. Gastroenterol. 41 (5): 444–9. doi:10.1007/s00535-006-1792-3. PMID 16799886.
  6. ↑ Chevrel G, Jenvrin C, McGregor B, Miossec P (July 2001). "Renal type AA amyloidosis associated with rheumatoid arthritis: a cohort study showing improved survival on treatment with pulse cyclophosphamide". Rheumatology (Oxford). 40 (7): 821–5. PMID 11477289.
  7. ↑ Nakamura T, Yamamura Y, Tomoda K, Tsukano M, Shono M, Baba S (December 2003). "Efficacy of cyclophosphamide combined with prednisolone in patients with AA amyloidosis secondary to rheumatoid arthritis". Clin. Rheumatol. 22 (6): 371–5. doi:10.1007/s10067-003-0763-9. PMID 14677008.
  8. ↑ Gottenberg JE, Merle-Vincent F, Bentaberry F, Allanore Y, Berenbaum F, Fautrel B, Combe B, Durbach A, Sibilia J, Dougados M, Mariette X (July 2003). "Anti-tumor necrosis factor alpha therapy in fifteen patients with AA amyloidosis secondary to inflammatory arthritides: a followup report of tolerability and efficacy". Arthritis Rheum. 48 (7): 2019–24. doi:10.1002/art.11163. PMID 12847696.
  9. ↑ Fernández-Nebro A, Tomero E, Ortiz-Santamaría V, Castro MC, Olivé A, de Haro M, Portales RG, García-Vicuña R, González-Mari MV, Laffón A, García-Vicuña R (May 2005). "Treatment of rheumatic inflammatory disease in 25 patients with secondary amyloidosis using tumor necrosis factor alpha antagonists". Am. J. Med. 118 (5): 552–6. doi:10.1016/j.amjmed.2005.01.028. PMID 15866260.
  10. ↑ Nakamura T, Higashi S, Tomoda K, Tsukano M, Shono M (December 2010). "Etanercept can induce resolution of renal deterioration in patients with amyloid A amyloidosis secondary to rheumatoid arthritis". Clin. Rheumatol. 29 (12): 1395–401. doi:10.1007/s10067-010-1469-4. PMID 20440529.
  11. ↑ Keersmaekers T, Claes K, Kuypers DR, de Vlam K, Verschueren P, Westhovens R (May 2009). "Long-term efficacy of infliximab treatment for AA-amyloidosis secondary to chronic inflammatory arthritis". Ann. Rheum. Dis. 68 (5): 759–61. doi:10.1136/ard.2008.095505. PMID 19366896.

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