Golimumab and immunogenicity? 2010 and beyond.

Immunogenicity is a frequent adverse event observed with biological agents' therapy. Challenges of management in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis treated with golimumab, an anti-TNF-alpha blocker, include limited generation of antibodies like anti-nuclear, anti-golimumab, and anti-double stranded DNA antibodies. We conducted here a meta-analysis study in order to evaluate and compare the newly generated antibody levels after golimumab therapy. The examination of original clinical trials revealed that their levels were neither higher nor significant. Moreover, no evident associations between the induced-antibodies and lupus-like syndromes and/or infusion site reaction were reported. The reduced patients cohort and the absence of systematic newly generated antibodies follow-up might be implicated in the difficulty to evaluate their risk in delaying diseases therapy, and/or predicting for their worse prognosis. Hence, further studies are required to ascertain the real impact of the induced antibodies after golimumab's therapy.

Dermatologic adverse events: golimumab, friend or foe?

Golimumab is a fully human anti-TNF-alpha blocker that has demonstrated its efficacy in the treatment of numerous kinds of diseases. Although it is generally safe and well tolerated, various adverse events have been reported. The present aim is to improve the understanding of dermatologic adverse events associated with golimumab following a search of various scientific databases. This systematic review and meta-analysis shows that golimumab is associated neither with severe injection-site reactions nor with injection-site erythema. We found no significant lupus-like syndromes, and no significant skin squamous cell carcinoma. We further suggest systematic dermatologic monitoring in clinical practice during golimumab therapy. Subsequent research should employ a larger cohort of patients to ensure clear and significant future conclusions.

Percutaneous treatment of hydatid cysts (Echinococcus granulosus).

A new method called PAIR (Puncture-Aspiration of cyst contents--Injection of hypertonic saline solution--Reaspiration) was used as a percutaneous treatment of hydatid cysts. In 37 patients, 120 cysts were punctured. All patients had not been considered surgical candidates. The cysts were localized in the liver, peritoneum, spleen, kidneys, muscles, and bones. In 70% of patients, good results were obtained. Recurrence occurred in 5 of 120 cysts, all at the beginning of our experience when a low concentration of sodium chloride solution was injected. Moderate allergic reactions occurred during seven cyst aspirations. No anaphylactic shock, sudden deaths or dissemination of cyst contents were observed.

[Trial therapy of inoperable abdominal hydatid cysts by puncture]. / Essai de traitement par ponctio des kystes hydatiques abdominaux inopérables.

Hydatidosis is a major public health problem in Tunisia. The infection rate in the normal population is over a 100 times higher than in the generally accepted hyperendemicity level (1,720 in 100,000 as against 13 in 100,000!). The use of drugs of benzimidazole derivates prevents the development of scolices into hydatic cysts and allows to try a non-surgical cure by the punction of hydatid cyst of the sheep liver, i.e. aspiration of the cyst fluid and injection of hypertonic salt solution into the drug treated animal. The good results obtained in a group of 16 animals permitted us to apply this method to two patients whose conditions made surgical intervention dangerous. The results although excellent in the case of a secondary peritoneal cyst were less spectacular in the case of secondary liver cyst of whose wall showed signs of involution.