Induction Of Remission In Patients Research Articles

Protocolo de diagnóstico y tratamiento de la enfermedad de Crohn refractaria a esteroides

IntroductionCorticosteroids have been considered the treatment of choice for induction of remission in patients with active Crohn's disease. However, a significant number of patients have an inadequate response or adverse events to these drugs. Therapeutic managementIn this setting, immunosuppressants, thiopurines and methotrexate, and biologic drugs, mainly anti-TNF, have achieved a long-term free steroid clinical remission. PrognosisIn addition, the early and combined use of these drugs has been associated with a better prognosis with lower rates of relapse, hospitalization and surgery.

Efficacy and safety of two pH-dependent-release mesalamine doses in moderately active ulcerative colitis: a multicenter, randomized, double-blind, parallel-group study.

Background/AimsThe therapeutic effect of mesalamine is considered to be dose-dependent; however, no consensus has been reached regarding the optimal doses for individual patients. This study aimed to provide new insight for dose optimization using two doses of pH-dependent release mesalamine for induction of remission of moderately active ulcerative colitis (UC).MethodsIn a multicenter, double-blind, randomized study, 110 patients with moderately active UC were assigned to two groups after treatment with a constant dose of mesalamine. Fifty-five patients were treated with a pH-dependent release formulation of 3.6 or 4.8 g/day for 8 weeks. The primary endpoint was a decrease in the UC disease activity index (UCDAI) adjusted by covariates.ResultsIn the full analysis set (n=110), the mean decrease in UCDAI was 3.1 in the 3.6 g/day group and 3.4 in the 4.8 g/day group (P>0.05). In a subgroup analysis, the effectiveness of the 4.8 g/day dose was greater in particular populations, such as those who had been previously treated with a lower dose of mesalamine and those with more severe disease. The safety was comparable between the two groups.ConclusionsThe results suggest that treatment with pH-dependent release mesalamine at either 3.6 or 4.8 g/day was effective and safe for the induction of remission in patients with moderately active UC. However, the patients receiving mesalamine at 2.4 g/day but in whom the therapeutic effect is not sufficient and having more severe symptoms (UCDAI 9-10), benefit from higher doses of mesalamine compared to others.

Tacrolimus or infliximab for severe ulcerative colitis: short-term and long-term data from a retrospective observational study

ObjectiveTreatment of severe ulcerative colitis (UC) is challenging. Although the efficacy of tacrolimus (TAC) and infliximab (IFX) have been evaluated in patients with severe UC, the safety and efficacy levels...

LONG-TERM EFFICACY OF SYSTEMIC INFLIXIMAB IN RECALCITRANT RETINAL VASCULITIS.

To evaluate the efficacy of systemic infliximab for the induction of remission in patients with retinal vasculitis, inadequately responsive to other immunomodulatory therapy, based on fluorescein angiography grading for retinal vasculitis evaluation. We analyzed 60 patients with retinal vasculitis, from the Massachusetts Eye Research and Surgery Institution in Cambridge, MA. Response to therapy was based on analysis of serial fluorescein angiography and fundus photography, including a baseline angiogram before initiation of infliximab. Sixty patients received infliximab therapy between July 2007 and July 2012 at Massachusetts Eye Research and Surgery Institution for a diagnosis of retinal vasculitis. All had previously showed a poor clinical response to other immunomodulatory regimens, or ceased therapy due to intolerable side effects. The initial dose of infliximab was 5 mg/kg in all patients and remained at this dose for the extent of treatment in 57 (95%) patients. At 6 months, 45 of 51 (88.23%) patients were maintaining remission with therapy, 5 (9.8%) were in partial remission, and 1 patient had failed. At 12 months, 39 of 39 (100%) patients were maintaining remission with therapy. Infliximab is effective for the treatment of recalcitrant noninfectious retinal vasculitis, refractory to conventional immunomodulatory therapy.

Efficacy of Empiric Antibiotic Therapy for Induction of Remission in Patients With an Acute Exacerbation of UC: A Cochrane Systematic Review and Meta-analysis

Efficacy of Empiric Antibiotic Therapy for Induction of Remission in Patients With an Acute Exacerbation of UC: A Cochrane Systematic Review and Meta-analysis

Unfractionated or low-molecular weight heparin for induction of remission in ulcerative colitis.

There are a limited number of treatment options for patients with ulcerative colitis (UC). An increased risk of thrombosis in UC coupled with an observation that UC patients being treated with anticoagulant therapy for thrombotic events had an improvement in their bowel symptoms led to trials examining the use of unfractionated heparin (UFH) and low molecular weight heparins (LMWH) in patients with active UC. To review randomized trials examining the efficacy of unfractionated heparin (UFH) or low molecular weight heparins (LMWH) for remission induction in patients with ulcerative colitis. We searched MEDLINE, EMBASE, CENTRAL, and the Cochrane IBD/FBD group specialized trials register up to June 2014. We also searched review papers on ulcerative colitis and references from identified papers in an effort to identify additional randomized trials studying UFH or LMWH use in patients with ulcerative colitis. We searched abstracts from major gastroenterological meetings to identify research published in abstract form. Randomized controlled trials comparing UFH or LMWH to placebo or a control therapy for induction of remission in ulcerative colitis were included. Studies published in abstract form only were included if the authors could be contacted for further information. A data extraction form was developed and used to extract data from included studies. Two authors independently extracted data. Any disagreements were resolved by consensus. The Cochrane Risk of Bias tool was used to assess study quality. Data were analyzed on an intention-to-treat basis. The primary outcome was induction of remission, as defined by the studies. Secondary outcomes measures included: endoscopic remission as defined by the authors; clinical, histological or endoscopic improvement as defined by the authors; the occurrence of adverse events; the occurrence of bleeding; and improvements in quality of life as measured by a validated instrument. We calculated the risk ratio (RR) and corresponding 95% confidence interval for dichotomous outcomes. Data were combined for analysis if they assessed the same treatments (UFH or LMWH versus placebo or other therapy). The overall quality of the evidence supporting the outcomes was evaluated using the GRADE criteria. Five studies were eligible for inclusion (329 patients). Three studies (270 patients) compared low molecular weight heparin to placebo, one study (34 patients) compared LMWH in addition to standard therapy, and one study (25 patients) compared UFH to corticosteroids. The study comparing UFH to corticosteroids was rated at high risk of bias due to a single-blind design. The study that compared the addition of LMWH to standard therapy to standard therapy alone was rated at high risk of bias due to open-label design. The other three studies were rated as low risk of bias. LMWH administered subcutaneously showed no benefit over placebo for any outcome, including clinical remission (very low quality of evidence), and clinical, endoscopic, or histological improvement. High dose LMWH administered via an extended colon-release tablet demonstrated benefit over placebo for clinical remission (RR 1.39; 95% CI 1.09 to 1.77 ; P = 0.008; very low quality of evidence), clinical improvement (RR 1.28; 95% CI 1.06 to 1.55; P = 0.01; very low quality of evidence), and endoscopic improvement (RR 1.21; 95% CI 1.00 to 1.47 ; P = 0.05) but not endoscopic remission or histologic improvement. LMWH was not beneficial when added to standard therapy for clinical remission, clinical improvement, endoscopic remission or endoscopic improvement. LMWH was well-tolerated but provided no significant benefit for quality of life. One study examining UFH versus corticosteroids for the treatment of severe UC demonstrated the inferiority of UFH for clinical improvement. More patients assigned to UFH had rectal hemorrhage as an adverse event. There is evidence to suggest that LMWH may be effective for the treatment of active UC. When administered by extended colon-release tablets, LMWH was more effective than placebo for treating outpatients with mild to moderate disease. This benefit needs to be confirmed by further randomized controlled studies. The same benefits were not seen when LMWH was administered subcutaneously at lower doses. There is no evidence to support the use of UFH for the treatment of active UC. A further trial of UFH in patients with mild disease may also be justified. Any benefit found would need to be weighed against a possible increased risk of rectal bleeding in patients with active UC.

Predictive factors for induction of remission in patients with active rheumatoid arthritis treated with tocilizumab in clinical practice.

To identify predictors of early response to tocilizumab (TCZ) in patients with active rheumatoid arthritis (RA) seen in daily routine clinical practice. A multicenter ambispective observational study of 126 RA patients treated with TCZ as a first- or second-line biological therapy. The variables associated to achieve the therapeutic goal (remission defined as a DAS28-ESR < 2.6) at 3 and 6 months were identified using regression analysis. TCZ was administered as the first biologic in 26% of patients. Overall, 34% of patients received TCZ as monotherapy. EULAR response and remission were obtained in 82% and 31% of patients at 3 months and in 86% and 40% at 6 months. In the multivariate analysis, the predictive factors increasing the likelihood of clinical remission at 3 months were baseline ESR > 30 mm/h (OR = 19.07, 95% CI: 2.720-133.716), baseline CRP > 10 mg/L (OR = 4.95; 95% CI: 1.464-13.826), and the presence of extra-articular manifestations of the disease (OR = 15.45, 95% CI: 2.334-102.319). The factors that decreased it were higher concentrations of hemoglobin (OR = 0.53, 95% CI: 0.319-0.910), higher baseline DAS28-ESR (OR = 0.30, 95% CI: 0.145-0.635) and the number of previous DMARDs (OR = 0.41, 95% CI: 0.221-0.779), and biological therapies used (OR = 0.33, 95% CI: 0.155-0.734). The only factor that remained statistically significant at 6 months was higher baseline DAS28-ESR (OR = 0.55, 95% CI: 0.347-0.877). No relationship was found with the neutrophil count or with the RF or ACPA positivity. In routine clinical practice, strong acute phase response, the presence of extra-articular manifestations, and the number of previous DMARDs and biological therapies used may help to identify patients who will have a rapid response to TCZ. However, it is likely that no parameter will predict response if taken separately.

Treatment of Severe Renal Disease in ANCA Positive and Negative Small Vessel Vasculitis with Rituximab

Background/Aims: Rituximab and glucocorticoids are a non-inferior alternative to cyclophosphamide and glucocorticoid therapy for induction of remission in antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) patients with moderate renal disease. The efficacy and safety of this approach in patients with severe renal impairment are unknown. We report the outcomes and safety profile of rituximab and glucocorticoid therapy for induction of remission in patients with AAV and ANCA-negative vasculitis presenting with severe renal disease. Methods: A multicenter, retrospective, cohort study was conducted between 2005 and 2014. Patients with new or relapsing disease with an estimated glomerular filtration rate (eGFR) of ≤20 ml/min/1.73 m² treated with rituximab and glucocorticoid induction with or without plasmapheresis were included. Fourteen patients met the inclusion criteria. The primary outcomes were rate of remission and dialysis independence at 6 months. The secondary outcomes were eGFR at 6 months, end-stage renal disease (ESRD), survival rates and adverse events. Results: All patients were Caucasian, and 57% were male. The mean eGFR was 12 ml/min/1.73 m² at diagnosis. All patients achieved remission with a median time to remission of 55 days. Seven patients required dialysis at presentation of which 5 patients recovered renal function and discontinued dialysis by 6-month follow-up. The mean eGFR for the 11 patients without ESRD who completed 6-month follow-up was 33 ml/min/1.73 m². Four patients ultimately developed ESRD, and one died during the follow-up period. Conclusion: Patients with AAV and severe renal disease achieve high rates of remission and dialysis independence when treated with rituximab and glucocorticoids without cyclophosphamide.

65-Year-Old Woman With Intermittent Fevers, Lower Extremity Paresthesia, Weight Loss, and Malaise

65-Year-Old Woman With Intermittent Fevers, Lower Extremity Paresthesia, Weight Loss, and Malaise

Budesonide MMX(®): a review of its use in patients with mild to moderate ulcerative colitis.

Budesonide MMX(®) (Cortiment(®); Uceris(®)) is a novel once-daily oral formulation of budesonide using Multi Matrix (MMX(®)) colonic delivery technology to permit the release of budesonide at a controlled rate throughout the colon. It is available in the USA for the induction of remission in patients with active, mild to moderate ulcerative colitis, and in various European countries for the induction of remission in patients with active, mild to moderate ulcerative colitis where 5-aminosalicylic acid (5-ASA) therapy is not sufficient. In three 8-week multinational, phase III studies in patients with active, mild to moderate ulcerative colitis, once-daily budesonide MMX(®) 9 mg, as monotherapy (CORE I and II studies) or add-on therapy to 5-ASAs (CONTRIBUTE), was significantly more effective than placebo in inducing combined clinical and endoscopic remission. In an 8-week extension of the CORE I study, the efficacy of budesonide MMX(®) 9 mg monotherapy was demonstrated among patients who completed the CORE I study, but did not achieve clinical remission. In phase III studies, the tolerability profile of budesonide MMX(®) 9 mg as monotherapy or add-on therapy to 5-ASAs was generally similar to that of placebo. Adverse events were generally mild or moderate in intensity, with exacerbation, relapse or worsening of ulcerative colitis, headache, nausea, abdominal pain and nasopharyngitis the most frequently reported following budesonide MMX(®) 9 mg monotherapy. Although final data from the CONTRIBUTE study are awaited, current evidence suggests budesonide MMX(®) 9 mg extends the treatment options currently available for patients with active, mild to moderate ulcerative colitis.

P404. Calcineurin inhibitors are safe and effective for induction of remission in patients commencing vedolizumab for IBD

P404. Calcineurin inhibitors are safe and effective for induction of remission in patients commencing vedolizumab for IBD

Methotrexate for induction of remission in ulcerative colitis.

Ulcerative colitis (UC) is a chronic inflammatory bowel disease. Corticosteroids and 5-aminosalicylates are the most commonly used therapies. However, many patients require immunosuppressive therapy for steroid-refractory and steroid-dependent disease. Methotrexate is a medication that is effective for treating a variety of inflammatory diseases, including Crohn's disease. This review was performed to determine the effectiveness of methotrexate treatment in UC patients. This review is an update of a previously published Cochrane review. To assess the efficacy and safety of methotrexate for induction of remission in patients with UC. MEDLINE, EMBASE, CENTRAL and the Cochrane IBD/FBD group specialized trials register were searched from from inception to June 26, 2014. Study references and review papers were also searched for additional trials. Abstracts from major gastroenterological meetings were searched to identify research published in abstract form only. Randomized controlled trials comparing methotrexate with placebo or an active comparator in patients with active ulcerative colitis were considered for inclusion. Two authors independently reviewed studies for eligibility, extracted data and assessed study quality using the Cochrane risk of bias tool. The primary outcome measure was the proportion of patients who achieved clinical remission and withdrawal from steroids as defined by the studies and expressed as a percentage of the total number of patients randomized (intention-to-treat analysis). We calculated the risk ratio (RR) and corresponding 95% confidence intervals (95% CI) for dichotomous outcomes. The overall quality of the evidence supporting the primary outcome was assessed using the GRADE criteria. Two studies (n = 101 patients) were included in the review. One study (n = 67) compared oral methotrexate 12.5 mg/week) to placebo. The other study (n = 34) compared oral methotrexate (15 mg/week) to 6-mercaptopurine (1.5 mg/kg/day) and 5-aminosalicylic acid (3 g/day). The placebo-controlled study was judged to be at low risk of bias. The other study was judged to be at high risk of bias due to an open-label design. There was no statistically significant difference in clinical remission rates between methotrexate and placebo patients. Forty-seven per cent (14/30) of methotrexate patients achieved clinical remission and complete withdrawal from steroids during the study period compared to 49% (18/37) of placebo patients (RR 0.96, 95% CI 0.58 to 1.59. A GRADE analysis indicated that the overall quality of the evidence supporting this outcome was low due to very sparse data (32 events). There were no statistically significant differences in the proportion of patients who achieved clinical remission and withdrawal from steroids in the study comparing oral methotrexate to 6-mercaptopurine and 5-aminosalicylic acid. At 30 weeks, 58% (7/12) of methotrexate patients achieved clinical remission and withdrawal from steroids compared to 79% (11/14) of 6-mercaptopurine patients (RR 0.74, 95% CI 0.43 to 1.29) and 25% of 5-aminosalicylic acid patients (RR 2.33, 95% CI 0.64 to 8.49). GRADE analyses indicated that the overall quality of the evidence was very low due to very sparse data (18 and 9 events respectively) and and high risk of bias. In the placebo-controlled trial two patients (7%) were withdrawn from the methotrexate group due to adverse events (leucopenia, migraine) compared to one patient (3%) who had a rash in the placebo group (RR 2.47, 95% CI 0.23 to 25.91). Adverse events experienced by methotrexate patients in the active comparator study included nausea and dyspepsia, mild alopecia, mild increase in aspartate aminotransferase levels, peritoneal abscess, hypoalbuminemia, severe rash and atypical pneumonia. Although methotrexate was well-tolerated, the studies showed no benefit for methotrexate over placebo or active comparators. The results for efficacy outcomes between methotrexate and placebo, methotrexate and 6-mercaptopurine and methotrexate and 5-aminosalicylic acid were uncertain. Whether a higher dose or parenteral administration would be effective for induction therapy is unknown. At present there is no evidence supporting the use of methotrexate for induction of remission in active ulcerative colitis. A trial in which larger numbers of patients receive a higher dose of oral methotrexate should be considered. Currently there are two large ongoing placebo-controlled trials (METEOR and MERIT-UC) assessing the efficacy and safety of intramuscular or subcutaneous methotrexate in patients with active UC which may help resolve the evidence supporting the use of methotrexate as therapy for active of ulcerative colitis.

Methotrexate for induction of remission in refractory Crohn's disease.

Methotrexate for induction of remission in refractory Crohn's disease.

Corticosteroids are still the mainstay for treating relapses of Crohn’s disease, but should not be used for maintenance therapy

Irrespective of their local and systemic adverse effects, conventional corticosteroids remain the foundation of therapy for induction of clinical remission in patients with Crohn’s disease because of their prompt onset of action and effectiveness. However, they are not recommended as maintenance therapy because of their lack of efficacy in maintaining remission and potential to cause systemic adverse effects.

Is B-cell depletion first choice in antineutrophil cytoplasmic antibody-associated vasculitis?

To discuss in detail the efficacy and safety of rituximab (RTX) for induction and maintenance of remission in patients with antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) who are either treatment naive, relapsing or refractory to standard of care. In treatment naive AAV patients, RTX without maintenance treatment is as effective as cyclophosphamide (CYC) followed by azathioprine (AZA) for maintenance for up to 18 months. RTX is superior to CYC for induction of remission in patients with relapsing AAV. Nevertheless, long-term follow-up shows relapsing disease in up to 50% of patients with proteinase 3-ANCA, irrespective of the induction regimen. RTX is useful in patients with refractory AAV, but percentages of patients achieving complete remission differ between series. RTX seems more effective than AZA for maintaining remission, but detailed results from prospective studies are being awaited. Adverse events do not differ between RTX and classical induction regimens, but infections related to hypogammaglobulinemia and neutropenia could be items of concern with repeated administration of RTX. RTX is an alternative for CYC for induction of remission in generalized AAV and could be first choice for relapsing patients and patients refractory to CYC. RTX is promising for maintenance of remission, but long-term safety should be awaited.

A randomised controlled trial of etanercept and methotrexate to induce remission in early inflammatory arthritis: the EMPIRE trial

ObjectiveTo compare the efficacy of etanercept (ETN) and methotrexate (MTX) versus MTX monotherapy for remission induction in patients with early inflammatory arthritis.MethodsIn a 78-week multicentre randomised placebo-controlled superiority trial, 110...

Recent Advances in Pharmacotherapy of Ulcerative Colitis

Ulcerative colitis is a form of chronic inflammatory bowel disease (IBD) that produces inflammation and ulcers along the inside of the colon, which can interfere with the normal function of the colon. The disease typically starts to manifest in patients as young adults. Ulcerative colitis is an intermittent disease with periods of exacerbated symptoms, or flares, and periods that are relatively symptom-free. According to the Cohn’s and Colitis Foundation of America, several millions people suffer from ulcerative colitis worldwide. Current therapeutic approaches for ulcerative colitis are partially successful despites advances in GIT research. A significant proportion of patients with ulcerative colitis undergo colectomy. Nearly 50% patients do not achieve sustained remission, leading to impairment of physical and mental health, social life, employment issues and sexual activity. Budesonide is an oral, extended release synthetic corticosteroid that is recently approved for UC. Enteric-coated budesonide formulations resist gastric-acid degradation, delivering active drug to the small intestine and proximal colon. Budesonide is specifically indicated for the induction of remission in patients with active, mild to moderate ulcerative colitis. Budesonide has a high first-pass metabolism with minimal systemic absorption. This review describes recent advances in the pharmacotherapy of ulcerative colitis and outlines why future studies targeting sustained suppression of inflammation could have an enormous impact on the natural course of the disease. Ulcerative colitis needs intense therapy and it should be maintained until sustained remission and mucosal healing has been reached.

Membrane Tyrosine Kinase Receptors Kit and FLT3 are an Important Targets for the Therapy of Acute Myeloid Leukemia

KIT and FLT3 are class III trans membrane tyrosine kinases playing key roles in the control of hematopoietic stem cell survival and proliferation. KIT is mutated in about 2.5-3% of acute myeloid leukemia (AML) patients mainly by point mutations occurring at the level of tyrosine kinase domains. FLT3 is mutated in about 30% of AML patients, either by internal tandem duplication of the juxtamembrane domain or by point mutations occurring at the level of tyrosine kinase domains. All these types of mutations lead to the constitutive activation of KIT and FLT3 receptors, respectively. In some AML subsets, the occurrence of FLT3/ITD mutation is associated with a poor prognosis. These observations have represented the basis for the development of a large number of Tyrosine Kinase Inhibitors (TKIs) with activity against KIT and FLT3. Some of these inhibitors are still in the preclinical phase, but many have been tested in phase I/II/III clinical studies. Although these inhibitors when used as single agents have lead to a significant reduction of the number of leukemic blasts, they have produced only transient and limited clinical responses. This efficacy may be related to the limited inhibitory caefficacy of these inhibitors, occurrence of resistance and to the complexity of the genetic abnormalities occurring in AMLs. However, recently Quizartinib, a potent FLT3 inhibitor, showed an impressive rate of remission induction in patients with chemotherapy-refractory FLT3-ITD-positive AMLs, but most remissions do not meet classical criteria of complete remissions and instead represent clearance of bone marrow blasts with incomplete recovery of blood cell counts. However, the majority of these patients after an initial sustained response exhibit a leukemic relapse due to the rare pre-exisisting or new FLT3-ITD-TKD mutants surviving to the treatment with this drug and becaming driver leukemic clones. The combination of various types of FLT3 TKIs, including a type II TKI like Quizartinib with a type I FLT3 inhibitor efficiently targeting TKD mutants, such as Crenolanib, or the combination of FLT3 inhibitors with other molecularly targeted agents inhibiting other pathways activated in leukemic cells would determine a major progress in leukemia therapy. The efficacy of FLT3 TKIs in combination with standard anti-leukemic chemotherapeutics is also under evaluation in several combination clinical trials. It is expected that these trials could determine an improvement in the negative prognosis of AML patients with FLT3/ITD mutations. Keywords: Membrane tyrosine kinase receptors, leukemia, cytogenetic.

Biological therapy for systemic vasculitis: A systematic review

ObjectiveRelapses and failure are frequent in systemic vasculitis (SV) patients. Biological agents have been prescribed as rescue therapies. The aim of this systematic review is to analyze the current evidence on the therapeutic use of biological agents for SV. MethodsMEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched up to the end of April 2013. Systematic reviews and meta-analysis, clinical trials, cohort studies, and case series with >3 patients were included. Independent article review and study quality assessment was done by 2 investigators with consensus resolution of discrepancies. ResultsOf 3447 citations, abstracts, and hand-searched studies screened, 90 were included. Most of the studies included ANCA-associated vasculitis (AAV) patients and only a few included large vessel vasculitis (LVV) patients. Rituximab was the most used agent, having demonstrated efficacy for remission induction in patients with AAV. A number of studies used different anti-TNFα agents with contrasting results. A few uncontrolled studies on the use of abatacept, alemtuzumab, mepolizumab, and tocilizumab were found. ConclusionCurrent evidence on the use of biological therapies for SV is mainly based on uncontrolled, observational data. Rituximab is not inferior to cyclophosphamide for remission induction in AAV and might be superior in relapsing disease. Infliximab and adalimumab are effective as steroid-sparing agents. Etanercept is not effective to maintain remission in patients with granulomatosis with polyangiitis, and serious adverse events have been reported. For LVV, both infliximab and etanercept had a role as steroid-sparing agents, and tocilizumab might be effective also for remission induction in LVV.

OP0204 Characterization of the novel C5AR antagonist CCX168, a potential therapeutic for ANCA-vasculitis, rheumatoid arthritis, and other autoimmune disorders

BackgroundThe C5a receptor (C5aR) is expressed by cells of the innate immune system and is thought to play a key role in numerous autoimmune diseases, such as anti-neutrophil cytoplasmic antibody...