Long-term efficacy of infliximab treatment for AA-amyloidosis secondary to chronic inflammatory arthritis

T Keersmaekers¹, K Claes¹, D R Kuypers¹, K de Vlam², P Verschueren², R Westhovens²

¹ Department of Nephrology, University Hospitals KU Leuven, Leuven, Belgium
² Department of Rheumatology, University Hospitals KU Leuven, Leuven, Belgium

Correspondence to:
Dr R Westhovens, Department of Rheumatology, University Hospitals KU Leuven, Herestraat 49, B-3000 Leuven, Belgium; rene.westhovens@uz.kuleuven.ac.be

Accepted 26 July 2008

The first 150 words of the full text of this article appear below.

Secondary AA-amyloidosis is sometimes associated with chronic inflammatory arthritis, such as rheumatoid arthritis (RA) and spondylarthropathies (SpA), with an extracellular accumulation of amyloid proteins in the tissues of various organs. This amyloid is composed of serum amyloid P-component (SAP), serum amyloid A (SAA), an acute phase protein, and proteoglycans. Renal involvement is the most frequent manifestation of secondary amyloidosis, usually presenting with asymptomatic proteinuria.

According to earlier literature, the prognosis of AA-amyloidosis was considered very poor. Treatment with corticosteroids and immunosuppressive drugs, mainly alkylating agents, consisted of adequate suppression of the underlying inflammatory process. Recently, eprodisate was shown to slow the decline in renal function by inhibition of the production of SAA.¹ In recent years we² and others^3–9 reported the short-term efficacy of infliximab or etanercept in a few case series of approximately 30 patients with secondary amyloidosis. Here we present the long-term follow-up data (up to 8 years) of . . . [Full text of this article]

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