Effectiveness of myocarditis therapy depending on the diagnosis approach (with or without myocardial biopsy) by O. V. Blagova, A. V. Nedostup, V. P. Sedov, A. Yu. Zaitsev, V. M. Novosadov, E. A. Kogan

“…The groups were completely comparable in age, baseline parameters (class III [2,25; 3] and III [2; 3] heart failure (HF); end-diastolic LV dimension, 6,7±0,7 and 6,4±0,7 cm; EF, 29,9±8,7 and 31,4±9,3%), the extent of cardiac therapy (excluding the administration rate of в-blockers — 94,4 and 78,7%, p<0,05) and 1ST (methylprednisolone in 91,7 and 89,4% of patients at a mean dose of 24 [16; 32] and 20 [15; 32] mg/day, azathioprine in 50,0 and 46,8% of patients at a mean dose of 150 mg/day or mycophenolate mofetil 2,0 g/day in 30,6% in group 1, hydroxychloroquine 0,2 g/day in 27,8 and 23,4%). …”
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Autoimmune hepatitis and primary biliary cholangitis overlap syndrome after COVID-19 by Marlone Cunha-Silva, Eloy Vianey Carvalho de França, Raquel Dias Greca, Daniel Ferraz de Campos Mazo, Larissa Bastos Eloy da Costa, Priscilla Brito Sena de Moraes, Clauber Teles Veiga, Guilherme Rossi Assis-Mendonça, Ilka de Fátima Santana Ferreira Boin, Raquel Silveira Bello Stucchi, Tiago Sevá-Pereira

“…According to the Paris Criteria, the patient was then diagnosed with an autoimmune hepatitis-primary biliary cholangitis overlap syndrome (AIH-PBC-OS). After adding azathioprine and ursodeoxycholic acid to the treatment, there was a satisfactory response. …”
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In-depth LC-MS and in-vitro studies of a triterpenoid saponin capilliposide-A metabolism modulation in gut microbiota of mice by Huan Zhao, Huan Zhao, Xueli Hu, Shenghong Guan, Jinhong Cai, Xiaohan Li, Jiaxi Fang, Bo Lin, Wei Zhu, Jingkui Tian, Juan Jin, Qiang He, Qiang He, Xiaoyong Zhang

“…CPS-A mainly involved in metabolic pathways such as azathioprine and mercaptopurine, which may also have beneficial or adverse effects.Discussion: This study on the interaction between CPS-A and microbiota provides a new idea for the study of traditional Chinese medicine with poor oral bioavailability. …”
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Case report: Discovery of a de novo FAM111B pathogenic variant in a patient with an APECED-like clinical phenotype by Elise M. N. Ferré, Yunting Yu, Vasileios Oikonomou, Anna Hilfanova, Chyi-Chia R. Lee, Lindsey B. Rosen, Peter D. Burbelo, Sara E. Vazquez, Mark S. Anderson, Amisha Barocha, Theo Heller, Ariane Soldatos, Steven M. Holland, Magdalena A. Walkiewicz, Michail S. Lionakis

“…We discuss the shared and distinct clinical, radiographic, and histological features between APECED and POIKTMP presented in our patient case and describe his treatment response to azathioprine for POIKTMP-associated hepatitis, myositis, and pneumonitis.MethodsThrough informed consent and enrollment onto IRB-approved protocols (NCT01386437, NCT03206099) the patient underwent a comprehensive clinical evaluation at the NIH Clinical Center alongside exome sequencing, copy number variation analysis, autoantibody surveys, peripheral blood immunophenotyping, and salivary cytokine analyses.ResultsWe report the presentation and evaluation of a 9-year-old boy who was referred to the NIH Clinical Center with an APECED-like clinical phenotype that included the classic APECED dyad of CMC and hypoparathyroidism. …”
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Efficacy of Switching to Adalimumab for Maintenance of Remission Following Induction Therapy with Tacrolimus in Patients with Ulcerative Colitis by Keijiro Numa, Kazuki Kakimoto, Yasuyoshi Tanaka, Noboru Mizuta, Naohiko Kinoshita, Kei Nakazawa, Ryoji Koshiba, Yuki Hirata, Kazuhiro Ota, Takako Miyazaki, Shiro Nakamura, Kazuhide Higuchi, Hiroki Nishikawa

“…However, TAC therapy usually lasts for 3 months. Although azathioprine (AZA) is often used in maintenance therapy, the relapse rate remains high. …”
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Consenso 2012 da Sociedade Brasileira de Reumatologia para o tratamento da artrite reumatoide 2012 Brazilian Society of Rheumatology Consensus for the treatment of rheumatoid arthr... by Licia Maria Henrique da Mota, Boris Afonso Cruz, Claiton Viegas Brenol, Ivanio Alves Pereira, Lucila Stange Rezende-Fronza, Manoel Barros Bertolo, Max Victor Carioca de Freitas, Nilzio Antonio da Silva, Paulo Louzada-Júnior, Rina Dalva Neubarth Giorgi, Rodrigo Aires Corrêa Lima, Geraldo da Rocha Castelar Pinheiro

“…RESULTS AND CONCLUSIONS: 1) The therapeutic decision should be shared with the patient; 2) immediately after the diagnosis, a disease-modifying antirheumatic drug (DMARD) should be prescribed, and the treatment adjusted to achieve remission; 3) treatment should be conducted by a rheumatologist; 4) the initial treatment includes synthetic DMARDs; 5) methotrexate is the drug of choice; 6) patients who fail to respond after two schedules of synthetic DMARDs should be assessed for the use of biologic DMARDs; 7) exceptionally, biologic DMARDs can be considered earlier; 8) anti-TNF agents are preferentially recommended as the initial biologic therapy; 9) after therapeutic failure of a first biologic DMARD, other biologics can be used; 10) cyclophosphamide and azathioprine can be used in severe extra-articular manifestations; 11) oral corticoid is recommended at low doses and for short periods of time; 12) non-steroidal anti-inflammatory drugs should always be prescribed in association with a DMARD; 13) clinical assessments should be performed on a monthly basis at the beginning of treatment; 14) physical therapy, rehabilitation, and occupational therapy are indicated; 15) surgical treatment is recommended to correct sequelae; 16) alternative therapy does not replace traditional therapy; 17) family planning is recommended; 18) the active search and management of comorbidities are recommended; 19) the patient's vaccination status should be recorded and updated; 20) endemic-epidemic transmissible diseases should be investigated and treated…”
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Journal Club Review of “Avacopan for the Treatment of ANCA‐Associated Vasculitis” by William Daniel Soulsby

“…All the patients received either cyclophosphamide (followed by azathioprine) or rituximab. The first primary endpoint was remission, defined as a Birmingham Vasculitis Activity Score (BVAS) of 0 (on a scale from 0 to 63, with higher scores indicating greater disease activity) at week 26 and no glucocorticoid use in the previous 4 weeks. …”
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Rituximab Biosimilar BCD020 Shows Superior Efficacy above Conventional Non-Biologics Treatment in Pediatric Lupus Nephritis: The Data of Retrospective Cohort Study by Mikhail Kostik, Elvira Kalashnikova, Raupov Rinat, Eugenia Isupova, Ekaterina Gaidar, Anton A. Soloviev, Vera Masalova, Ludmila Snegireva, Tatyana Kornishina, Natalia Abramova, Evgeny Suspitsin, Lubov Sorokina, Maria Kaneva, Margarita F. Dubko, Natalia Lubimova, Ekaterina Kuchuinskaya, Olga Kalashnikova, Vyacheslav Chasnyk

“…Results: The main patient’s characteristics were: Pre-rituximab non-biologic conventional treatment included: cyclophosphamide 15 (60%), MMF 8 (32%), azathioprine 3 (12%), hydroxychloroquine 12 (48%), and pulse therapy of methylprednisolone followed by oral methylprednisolone 25 (100%). …”
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Comparative effectiveness of various immunosuppressive therapy regimens for uveitis in patients with Behçet’s disease by T. A. Lisitsyna, G. A. Davydova, Z. S. Alekberova, R. G. Goloeva, L. A. Katargina, E. L. Nasonov

“…Glucocorticoids (GC) was systematically received by 68.7% patients with EU, including 51.5% in the form of pulse therapy. 88.9% patients with EU received cytotoxics: 33.5% – cyclosporine (CS), 20.7% – azathioprine (AZA), 11.4% – AZA+COL, 8.8% – AZA+CS, 7.5% – colchicine (COL), 3.9% – cyclophosphamide (CPh). 11.9% patients with EU were prescribe Biologics, mainly i-TNF-α (11,4%: 8,8% – adalimumab, 2.2% – infliximab, 0.4% – golimumab) and rituximab (0.4%). …”
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Three Myocardial Diseases in One Heart: Arrhythmogenic Right Ventricular Cardiomyopathy, Left Ventricular Noncompaction and Myocarditis by Yulia Lutokhina, Olga Blagova, Nadezhda Varionchik, Svetlana Alexandrova, Nina Gagarina, Eugenia Kogan, Vsevolod Sedov, Anna Shestak, Elena Zaklyazminskaya, Alexander Nedostup

“…Immunosuppressive therapy (prednisone and azathioprine) was prescribed, LV ejection fraction stabilized at the level of 40%. …”
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Case report: Dupilumab treatment improved type 2 disorders in a patient with IPEX syndrome diagnosis by C. Caruso, L. Laterza, C. R. Settanni, S. Colantuono, C. Di Mario, B. Tolusso, F. Castrì, E. Gremese, E. Gremese, F. Scaldaferri, F. Scaldaferri, A. Armuzzi, A. Armuzzi, C. De Simone, K. Peris, A. Chiricozzi, A. Gasbarrini, A. Gasbarrini, A. Gasbarrini

“…Notwithstanding various therapies including azathioprine, sirolimus, tacrolimus, adalimumab, vedolizumab, the patient failed to achieve a good control of symptoms without steroids. …”
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Extra-articular manifestations of rheumatoid arthritis remain a major challenge: data from a large, multi-centric cohort by Karina Rossi Bonfiglioli, Ana Cristina de Medeiros Ribeiro, Ana Paula Carnieletto, Ivânio Pereira, Diogo Souza Domiciano, Henrique Carriço da Silva, Alisson Pugliesi, Leticia Rocha Pereira, Maria Fernanda Resende Guimarães, Rina Dalva Neubarth Giorgi, Ana Paula Monteiro Gomides Reis, Claiton Viegas Brenol, Paulo Louzada-Júnior, Maria de Fátima Lobato da Cunha Sauma, Sebastião Cezar Radominski, Licia Maria Henrique da Mota, Geraldo da Rocha Castelar-Pinheiro

“…The comparison among ExtRA and Non-ExtRA groups shows significant higher age (p < 0.001), disease duration (p < 0.001), RF high titers (p = 0.018), Clinical Disease Activity index (CDAI) (p < 0.001), Disease Activity Index 28 (DAS 28) (p < 0.001), and Health Assessment Questionnaire (HAQ) (p < 0.001) in ExtRA group. Treatment with Azathioprine (p = 0.002), Etanercept (p = 0.049) Glucocorticoids (GC) (‘p = 0.002), and non-steroidal anti-inflammatory drugs (NSAIDs) (p < 0.001) were more frequent in ExtRA group. …”
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Parkinsonian Syndrome with Frontal Lobe Involvement and Anti-Glycine Receptor Antibodies by Dominique Endres, Harald Prüss, Michel Rijntjes, Tina Schweizer, Rita Werden, Kathrin Nickel, Sophie Meixensberger, Kimon Runge, Horst Urbach, Katharina Domschke, Philipp T. Meyer, Ludger Tebartz van Elst

“…Therefore, an anti-inflammatory treatment with steroids and azathioprine was administered; this resulted in a decrease of antibody titers (to 1:80) but no detectable clinical improvement. …”
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The Outcome of Childhood Immunoglobulin A Nephropathy with Acute Kidney Injury at the Onset of the Disease—National Study by M. Mizerska-Wasiak, E. Płatos, J. Małdyk, M. Miklaszewska, D. Drożdż, A. Firszt-Adamczyk, R. Stankiewicz, B. Bieniaś, P. Sikora, A. Rybi-Szumińska, A. Wasilewska, M. Szczepańska, M. Drożynska-Duklas, A. Żurowska, A. Pukajło-Marczyk, D. Zwolińska, M. Tkaczyk, M. Pańczyk-Tomaszewska

“…All of them were analyzed for initial symptoms (GFR according to Schwartz formula, creatinine, proteinuria, IgA, C3), renal biopsy result with assessment by Oxford classification, treatment used (R—renoprotection, P—prednisone+R, Aza—azathioprine+P+R, Cyc—cyclophosphamide+P+R, CsA—cyclosporine+P+R, MMF—mycophenolate mofetil+P+R), and distant follow-up. …”
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Management of infliximab refractory immune checkpoint inhibitor gastrointestinal toxicity: a multicenter case series by Lisa Zimmer, Bastian Schilling, Yinghong Wang, Georgina V Long, Jennifer McQuade, Ana Arance, Douglas B Johnson, Nadia Yousaf, Kazi J Nahar, Matteo S Carlino, Kate Young, Joanna Lee, Liselotte Tas, Serigne N Lo, Christian Blank, Alexander Maxwell Menzies, Catriona Harvey, Janet McKeown, Sheima Farag, Aafke Meerveld-Eggink, Austin Thomas, Roberto Martín Huertas

“…Survival outcomes were examined based on immunosuppressive therapy received.Results 78 patients were identified: median age 60 years; 56% men; majority melanoma (N=70, 90%); 60 (77%) received anti-cytotoxic T-lymphocyte-associated protein 4 alone or in combination with anti-programmed cell death protein-1 and most had colitis (N=74, 95%). 106 post-infliximab treatments were given: 31 calcineurin inhibitors (CNIs); 27 antimetabolites (mycophenolate, azathioprine); 16 non-systemic immunomodulatory agents (eg, mesalazine or budesonide); 15 vedolizumab; 5 other biologics (anti-interleukin-12/23, 16, Janus kinase inhibitors) and 7 interventional procedures (including colectomy); 5 did not receive post-infliximab therapy. …”
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A randomised, double-blind, parallel-group trial to assess mercaptopurine versus placebo to prevent or delay recurrence of Crohn’s disease following surgical resection (TOPPIC) by Satsangi, J, Kennedy, N, Mowat, C, Arnott, I, Keerie, C, Lewis, S, Ennis, H

“…The primary analysis was adjusted for baseline values of previous treatment with MP and azathioprine, with the adjusted analysis considered to be the primary analysis.…”

Particularities regarding Clinical-biological and Evolutive Parameters of Immune-mediated Rheumatic Diseases in Patients with COVID-19 – systematic literature review by Andreea Iulia Trandafir, Gelu Onose, Constantin Munteanu, Mihai Băila, Ali-Osman Saglam, Mihaela Mandu, Ioana Săulescu, Elena Grădinaru, Violeta-Claudia Bojincă

“…Risk factors associated with severe outcomes and death are: age, comorbidities, un-derlying disease activity, therapies used (“the good” being anti-tumor necrosis factor α, “the bad” – Methotrexate, Sulfasalazine, Azathioprine and “the ugly” – anti CD20 mono-clonal antibodies). …”
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A randomised, double-blind, parallel-group trial to assess mercaptopurine versus placebo to prevent or delay recurrence of Crohn’s disease following surgical resection (TOPPIC) by Jack Satsangi, Nicholas A Kennedy, Craig Mowat, Ian Arnott, Catriona Keerie, Steff Lewis, Holly Ennis

“…The primary analysis was adjusted for baseline values of previous treatment with MP and azathioprine, with the adjusted analysis considered to be the primary analysis. …”
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ITPA polymorphisms do not predict additional risk beyond TPMT and NUDT15 for thiopurine-induced cytopenia in inflammatory bowel disease by A. Jena, N. Grover, P. Bhatia, M. Singh, D. Lad, K.K. Prasad, H. Singh, U. Dutta, V. Sharma

“…Material and methods: We enrolled consecutive IBD patients on thiopurines (azathioprine or 6-mercaptopurine) from January 2019–March 2020, at a tertiary care center in North India. …”
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An Italian multicentre distributed data research network to study the use, effectiveness, and safety of immunosuppressive drugs in transplant patients: Framework and perspectives o... by Valeria Belleudi, Alessandro C. Rosa, Marco Finocchietti, Francesca R. Poggi, Maria Lucia Marino, Marco Massari, Stefania Spila Alegiani, Lucia Masiero, Andrea Ricci, Gaia Bedeschi, Francesca Puoti, Massimo Cardillo, Silvia Pierobon, Maurizio Nordio, Eliana Ferroni, Martina Zanforlini, Giuseppe Piccolo, Olivia Leone, Stefano Ledda, Paolo Carta, Donatella Garau, Ersilia Lucenteforte, Marina Davoli, Antonio Addis, CESIT Study Group, Antonio Addis, Nera Agabiti, Stefania Spila Alegiani, Valeria Belleudi, Massimo Cardillo, Paolo Carta, Marina Davoli, Michele Ercolanoni, Eliana Ferroni, Pamela Fiaschetti, Marco Finocchietti, Bedeschi Gaia, Donatella Garau, Valentina Ientile, Ursula Kirchmayer, Luca L’Abbate, Stefano Ledda, Lorella Leoni, Olivia Lombardozzi, Ersilia Lucenteforte, Claudia Lucia Marino, Maria Marino, Lucia Masiero, Marco Massari, Arianna Mazzone, Ugo Moretti, Andrea Angelo Nisic, Maurizio Nordio, Alessandra Oliveti, Daniela Peritore, Giuseppe Piccolo, Silvia Pierobon, Francesca R. Poggi, Francesca Puoti, Andrea Rosa, Alessandro C. Ricci, Vito Sparacino, Matilde Tanaglia, Silvia Trapani, Gianluca Trifirò, Martina Zanforlini, Manuel Zorzi

“…In clinical practice, a multidrug approach is commonly used and involves drugs with different mechanisms of action, including calcineurin inhibitors (CNI) (tacrolimus or cyclosporine), antimetabolite (antimet) (mycophenolate or azathioprine), inhibitors of mechanistic target of rapamycin (mTOR) (sirolimus or everolimus), and/or steroids. …”
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