Expert opinion on biological therapy
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Hitherto, some of the most severe forms of arthritis with onset in the neonatal period and early childhood have been resistant to conventional and anti-tumour necrosis factor agents. Recent results from drug trials of novel monoclonal antibodies will significantly alter the treatment of two of these diseases. This review is for canakinumab, a new monoclonal antibody to interleukin 1β that has been shown to be specifically efficacious in two groups of arthritis with systemic features. ⋯ The last decade has seen a major advance in treatment leading to remission while on therapy for many children with CAPS and sJIA. The outcomes of the anti-IL-1β and the anti-IL-6 trials for sJIA are quite similar and do not enable preferential use of either biological in a given patient.
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Expert Opin Biol Ther · Apr 2013
ReviewStem cell therapy for chronic heart failure: an updated appraisal.
Significant advances have been made to understand the mechanisms involved in cardiac cell-based therapies. The early translational application of basic science knowledge has led to several animal and human clinical trials. The initial promising beneficial effect of stem cells on cardiac function restoration has been eclipsed by the inability of animal studies to translate into sustained clinical improvements in human clinical trials. ⋯ Several questions remain unanswered, and this limits our ability to understand basic mechanisms involved in stem cell therapeutics. Human studies have revealed critical unresolved issues. Further elucidation of the proper timing, mode delivery and prosurvival factors is imperative, if the field is to advance. The limited benefits seen to date are simply not enough if the potential for substantial recovery of nonfunctioning myocardium is to be realized.