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Article ; Online: Efficacy and cytokine modulating effects of tacrolimus in systemic lupus erythematosus: a review.

Yoon, Kam Hon

2010 Volume 2010, Page(s) 686480

Abstract: Systemic lupus erythematosus (SLE) is a complex systemic autoimmune disease with involvement of both B cells and cytotoxic T lymphocytes and several cytokines aberrations. Standard therapy for SLE has its limitations. Tacrolimus, a novel calcineurin ... ...

Abstract	Systemic lupus erythematosus (SLE) is a complex systemic autoimmune disease with involvement of both B cells and cytotoxic T lymphocytes and several cytokines aberrations. Standard therapy for SLE has its limitations. Tacrolimus, a novel calcineurin inhibitor with potent immunosuppressive effects, has been shown in the recent years to be effective in SLE therapy. This paper serves to collate the experimental and clinical data on the efficacy of tacrolimus in the treatment of SLE and lupus nephritis. Tacrolimus as a key component of multitarget therapy in SLE is also discussed. The immunocytokine modulatory effects of tacrolimus are also reviewed with reference to SLE. It can be concluded that tacrolimus has an established role in the management of SLE.
MeSH term(s)	Cytokines/immunology ; Estrogens/metabolism ; Humans ; Immunosuppressive Agents/pharmacology ; Immunosuppressive Agents/therapeutic use ; Lupus Erythematosus, Systemic/drug therapy ; Lupus Erythematosus, Systemic/genetics ; Lupus Erythematosus, Systemic/immunology ; Tacrolimus/pharmacology ; Tacrolimus/therapeutic use ; Treatment Outcome
Chemical Substances	Cytokines ; Estrogens ; Immunosuppressive Agents ; Tacrolimus (WM0HAQ4WNM)
Language	English
Publishing date	2010-06-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2052552-7
ISSN	1110-7251 ; 1110-7243
ISSN (online)	1110-7251
ISSN	1110-7243
DOI	10.1155/2010/686480
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Article ; Online: Proliferation signal inhibitors for the treatment of refractory autoimmune rheumatic diseases: a new therapeutic option.

Yoon, Kam Hon

Annals of the New York Academy of Sciences

2009 Volume 1173, Page(s) 752–756

Abstract: Sirolimus and everolimus belong to the novel class of immunosuppressant agents known as proliferation signal inhibitors (PSIs). They act by preventing antigen-driven T cell proliferation. While PSIs are widely used in transplantation, there are few ... ...

Abstract	Sirolimus and everolimus belong to the novel class of immunosuppressant agents known as proliferation signal inhibitors (PSIs). They act by preventing antigen-driven T cell proliferation. While PSIs are widely used in transplantation, there are few reports of PSI usage in the treatment of autoimmune rheumatic diseases. The author has presented a series in the APLAR 2006 conference. This report summarizes the clinical experience with PSIs in the treatment of resistant or relapsed rheumatic diseases where conventional immunosuppressive agents have failed. This is a retrospective review of patients with various autoimmune rheumatic diseases who had sirolimus and everolimus treatment from the rheumatological clinics of Changi Hospital or the Arthritis and Rheumatism Specialist Medical Centre. The period of review was from April 2006 to April 2008. A total of 46 patients were reviewed, 39 females and 7 males. The racial distribution was 33 Chinese, 7 Malays, and 6 Indians. Their disease conditions were as follows: 26 (57%) rheumatoid arthritis, 7 psoriatic arthritis, 4 systemic lupus erythematosus, 3 scleroderma, 2 anti-Jo-1 syndrome, 2 spondyloarthropathy, 1 MCTD, and 1 vasculitis. All patients had failed at least three DMARDs or immunosuppressants. Twenty-eight patients received sirolimus and 28 patients received everolimus. Overall positive response rate was 48.2%. Twenty-seven percent had adverse events. 20% had no response. 7% relapsed after initial response. PSIs, namely sirolimus and everolimus, are a novel class of immunosuppressants that can be added to the armamentarium of rheumatologists for the treatment of patients with refractory autoimmune rheumatic diseases.
MeSH term(s)	Adult ; Aged ; Arthritis, Psoriatic/drug therapy ; Arthritis, Rheumatoid/drug therapy ; Autoimmune Diseases/drug therapy ; Drug Resistance ; Everolimus ; Female ; Humans ; Immunosuppressive Agents/chemistry ; Immunosuppressive Agents/therapeutic use ; Lupus Erythematosus, Systemic/drug therapy ; Male ; Middle Aged ; Molecular Structure ; Retrospective Studies ; Rheumatic Diseases/drug therapy ; Scleroderma, Systemic/drug therapy ; Sirolimus/analogs & derivatives ; Sirolimus/chemistry ; Sirolimus/therapeutic use ; Spondylarthropathies/drug therapy ; Treatment Outcome ; Vasculitis/drug therapy
Chemical Substances	Immunosuppressive Agents ; Everolimus (9HW64Q8G6G) ; Sirolimus (W36ZG6FT64)
Language	English
Publishing date	2009-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	211003-9
ISSN	1749-6632 ; 0077-8923
ISSN (online)	1749-6632
ISSN	0077-8923
DOI	10.1111/j.1749-6632.2009.04663.x
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Article ; Online: Efficacy and Cytokine Modulating Effects of Tacrolimus in Systemic Lupus Erythematosus

Kam Hon Yoon

Journal of Biomedicine and Biotechnology, Vol

A Review

2010 Volume 2010

Abstract	Systemic lupus erythematosus (SLE) is a complex systemic autoimmune disease with involvement of both B cells and cytotoxic T lymphocytes and several cytokines aberrations. Standard therapy for SLE has its limitations. Tacrolimus, a novel calcineurin inhibitor with potent immunosuppressive effects, has been shown in the recent years to be effective in SLE therapy. This paper serves to collate the experimental and clinical data on the efficacy of tacrolimus in the treatment of SLE and lupus nephritis. Tacrolimus as a key component of multitarget therapy in SLE is also discussed. The immunocytokine modulatory effects of tacrolimus are also reviewed with reference to SLE. It can be concluded that tacrolimus has an established role in the management of SLE.
Keywords	Biotechnology ; TP248.13-248.65 ; Medicine ; R
Language	English
Publishing date	2010-01-01T00:00:00Z
Publisher	Hindawi Limited
Document type	Article ; Online
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Article: Sufficient evidence to consider hydroxychloroquine as an adjunct therapy in antiphospholipid antibody (Hughes') syndome.

Yoon, Kam Hon

The Journal of rheumatology

2002 Volume 29, Issue 7, Page(s) 1574–1575

MeSH term(s)	Antiphospholipid Syndrome/diagnosis ; Antiphospholipid Syndrome/drug therapy ; Chemotherapy, Adjuvant ; Clinical Trials as Topic ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drug Therapy, Combination ; Female ; Humans ; Hydroxychloroquine/administration & dosage ; Male ; Prognosis ; Prospective Studies ; Treatment Outcome
Chemical Substances	Hydroxychloroquine (4QWG6N8QKH)
Language	English
Publishing date	2002-07
Publishing country	Canada
Document type	Letter
ZDB-ID	194928-7
ISSN	1499-2752 ; 0315-162X
ISSN (online)	1499-2752
ISSN	0315-162X
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Zs.A 1168: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Nonsteroidal anti-inflammatory drugs in chronic pain: implications of new data for clinical practice.

Ho, Kok Yuen / Gwee, Kok Ann / Cheng, Yew Kuang / Yoon, Kam Hon / Hee, Hwan Tak / Omar, Abdul Razakjr

Journal of pain research

2018 Volume 11, Page(s) 1937–1948

Abstract: COX2-selective and nonselective (ns) nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for chronic pain management. There are marked differences in the risk of adverse gastrointestinal (GI) and cardiovascular (CV) events among different ... ...

Abstract	COX2-selective and nonselective (ns) nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for chronic pain management. There are marked differences in the risk of adverse gastrointestinal (GI) and cardiovascular (CV) events among different NSAIDs. In 2017, publication of two randomized controlled trials and an individual patient-data meta-analysis provided robust data on the relative GI and CV tolerability profiles of currently available NSAIDs. The PRECISION study showed similar CV-event rates with celecoxib vs naproxen and ibuprofen, but GI tolerability was better for celecoxib. In the CONCERN study of high-GI-risk patients, celecoxib was associated with fewer adverse GI-tract events than naproxen. The meta-analysis showed no significant difference between celecoxib and ns-NSAIDs in the rate of acute myocardial infarction, and celecoxib was the only COX2-selective NSAID with a lower risk of adverse CV and GI events vs ns-NSAIDs. These data add to the body of knowledge about the relative tolerability of different NSAIDs and were used to propose an updated treatment algorithm. The decision about whether to use an NSAID and which one should be based on a patient's risk of developing adverse GI and CV events. Lower- and upper-GI-tract events need to be considered. Celecoxib has a better lower-GI-tract tolerability profile than ns-NSAIDs plus a proton-pump inhibitor. In addition, the latest data suggest that long-term use of celecoxib 200 mg/day may be appropriate for patients at increased CV risk.
Language	English
Publishing date	2018-09-20
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2495284-9
ISSN	1178-7090
ISSN	1178-7090
DOI	10.2147/JPR.S168188
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Article: An unusual cause of loin pain in a patient with systemic lupus erythematosus.

Yoon, Kam Hon / Goh, Poh Sun

The Journal of rheumatology

2003 Volume 30, Issue 3, Page(s) 634–635

MeSH term(s)	Adult ; Antiphospholipid Syndrome/complications ; Antiphospholipid Syndrome/diagnostic imaging ; Female ; Humans ; Infarction/diagnostic imaging ; Infarction/etiology ; Kidney/diagnostic imaging ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/diagnostic imaging ; Magnetic Resonance Angiography ; Pain/diagnostic imaging ; Pain/etiology ; Radiography
Language	English
Publishing date	2003-03
Publishing country	Canada
Document type	Case Reports ; Journal Article
ZDB-ID	194928-7
ISSN	1499-2752 ; 0315-162X
ISSN (online)	1499-2752
ISSN	0315-162X
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Zs.A 1168: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Fatal cytomegalovirus infection in two patients with systemic lupus erythematosus undergoing intensive immunosuppressive therapy: role for cytomegalovirus vigilance and prophylaxis?

Yoon, Kam Hon / Fong, Kok Yong / Tambyah, Paul Ananth

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases

2006 Volume 8, Issue 4, Page(s) 217–222

Abstract: Cytomegalovirus (CMV) infection is an uncommon but potentially fatal opportunistic infection in patients with systemic lupus erythematosus (SLE). We report 2 patients with severe SLE with life-threatening, multisystemic involvement who were treated with ... ...

Abstract	Cytomegalovirus (CMV) infection is an uncommon but potentially fatal opportunistic infection in patients with systemic lupus erythematosus (SLE). We report 2 patients with severe SLE with life-threatening, multisystemic involvement who were treated with intensive immunosuppressive therapy. SLE was successfully controlled, but the patients succumbed to fatal reactivation of CMV disease despite antiviral therapy. Both were seropositive for CMV. We therefore advocate that there should be more active CMV vigilance, and polymerase chain reaction (PCR)-based CMV prophylaxis should be considered in CMV PCR-positive patients with SLE/rheumatic disease undergoing intensive immunosuppressive therapy.
Language	English
Publishing date	2006-09-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	1283266-2
ISSN	1076-1608
ISSN	1076-1608
DOI	10.1097/00124743-200208000-00011
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Article: Paraneoplastic Raynaud phenomenon and idiopathic thrombocytopenic purpura in non-small-cell lung cancer.

Wong, Alvin S C / Hon Yoon, Kam

American journal of clinical oncology

2003 Volume 26, Issue 1, Page(s) 26–29

Abstract: The association of Raynaud phenomenon with malignancy has rarely been reported. Idiopathic thrombocytopenic purpura is also an infrequent complication of solid tumors. We report a 62-year-old man who sought treatment for severe Raynaud phenomenon ... ...

Abstract	The association of Raynaud phenomenon with malignancy has rarely been reported. Idiopathic thrombocytopenic purpura is also an infrequent complication of solid tumors. We report a 62-year-old man who sought treatment for severe Raynaud phenomenon requiring medical therapy and was subsequently diagnosed to have non-small-cell lung cancer. After chemotherapy and radiotherapy, his cancer was in complete remission and the Raynaud phenomenon resolved. Severe thrombocytopenia later developed for which no apparent cause was found, and which was responsive to steroid therapy. This heralded relapse of his lung cancer. This is a case of lung cancer with two rare paraneoplastic syndromes.
MeSH term(s)	Brain Neoplasms/diagnosis ; Brain Neoplasms/secondary ; Brain Neoplasms/therapy ; Carcinoma, Non-Small-Cell Lung/complications ; Carcinoma, Non-Small-Cell Lung/diagnosis ; Carcinoma, Non-Small-Cell Lung/secondary ; Carcinoma, Non-Small-Cell Lung/therapy ; Fatal Outcome ; Humans ; Lung Neoplasms/complications ; Lung Neoplasms/diagnosis ; Lung Neoplasms/pathology ; Lung Neoplasms/therapy ; Male ; Middle Aged ; Paraneoplastic Syndromes/complications ; Paraneoplastic Syndromes/diagnosis ; Paraneoplastic Syndromes/therapy ; Purpura, Thrombocytopenic, Idiopathic/complications ; Purpura, Thrombocytopenic, Idiopathic/diagnosis ; Purpura, Thrombocytopenic, Idiopathic/therapy ; Raynaud Disease/complications ; Raynaud Disease/diagnosis ; Raynaud Disease/therapy ; Recurrence ; Remission Induction
Language	English
Publishing date	2003-02
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	604536-4
ISSN	1537-453X ; 0277-3732
ISSN (online)	1537-453X
ISSN	0277-3732
DOI	10.1097/00000421-200302000-00006
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Article: Primary Antiphospholipid Antibody Syndrome and Mesangial IgA Glomerulonephritis

Sinniah, Raja / Gan, Hwa Chau / Yoon, Kam Hon

American Journal of Nephrology

2001 Volume 21, Issue 2, Page(s) 134–140

Abstract: The antiphospholipid antibody syndrome (APS) is characterized by recurrent thrombosis, fetal loss, multiorgan involvement, and the presence of lupus anticoagulant and/or anticardiolipin antibody. When not associated with systemic lupus erythematosus, ... ...

Institution	Departments of Pathology and Medicine, National University Hospital, Singapore
Abstract	The antiphospholipid antibody syndrome (APS) is characterized by recurrent thrombosis, fetal loss, multiorgan involvement, and the presence of lupus anticoagulant and/or anticardiolipin antibody. When not associated with systemic lupus erythematosus, other collagen diseases, or ingestion of medications, the condition is called primary APS. The kidney may be involved in the APS syndrome with acute nephritis and renal failure. The cases with renal biopsy studies have shown variable glomerular morphology, ranging from mild mesangial changes to a diffuse endocapillary proliferative glomerulonephritis. The most frequent lesion is thrombotic microangiopathy or features seen in the hemolytic uremic syndrome. Apart from fibrin thrombus deposition, only a few cases have shown focal and segmental deposits of IgG and/or IgM and/or C3. We describe a patient with primary APS who had thrombosis with lower limb amputation and acute renal failure. The renal biopsy specimen showed a focal proliferative glomerulonephritis with endothelial proliferation and damage, with diffuse heavy mesangial deposits of IgA and fibrinogen. This case with diabetes mellitus, but without diabetic nephropathy, represents the occurrence of primary APS and mesangial IgA nephropathy which potentiated the renal injury, leading to acute renal failure. The relationship to the Henoch-Schönlein syndrome is discussed.
Keywords	Antiphospholipid antibody syndrome, primary ; IgA nephropathy ; Henoch-Schönlein syndrome
Language	English
Publishing date	2001-05-07
Publisher	S. Karger AG
Publishing place	Basel, Switzerland
Document type	Article
Note	Case Report
ZDB-ID	604540-6
ISSN	1421-9670 ; 0250-8095
ISSN (online)	1421-9670
ISSN	0250-8095
DOI	10.1159/000046236
Database	Karger publisher's database

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Article ; Online: Do English and Chinese EQ-5D versions demonstrate measurement equivalence? an exploratory study

Ng Swee-Cheng / Koh Dow-Rhoon / Fong Kok-Yong / Chew Ling-Huo / Luo Nan / Yoon Kam-Hon / Vasoo Sheila / Li Shu-Chuen / Thumboo Julian

Health and Quality of Life Outcomes, Vol 1, Iss 1, p

2003 Volume 7

Abstract: Abstract Background Although multiple language versions of health-related quality of life instruments are often used interchangeably in clinical research, the measurement equivalence of these versions (especially using alphabet vs pictogram-based ... ...

Abstract	Abstract Background Although multiple language versions of health-related quality of life instruments are often used interchangeably in clinical research, the measurement equivalence of these versions (especially using alphabet vs pictogram-based languages) has rarely been assessed. We therefore investigated the measurement equivalence of English and Chinese versions of the EQ-5D, a widely used utility-based outcome instrument. Methods In a cross-sectional study, either EQ-5D version was administered to consecutive outpatients with rheumatic diseases. Measurement equivalence of EQ-5D item responses and utility and visual analog scale (EQ-VAS) scores between these versions was assessed using multiple regression models (with and without adjusting for potential confounding variables), by comparing the 95% confidence interval (95%CI) of score differences between these versions with pre-defined equivalence margins. An equivalence margin defined a magnitude of score differences (10% and 5% of entire score ranges for item responses and utility/EQ-VAS scores, respectively) which was felt to be clinically unimportant. Results Sixty-six subjects completed the English and 48 subjects the Chinese EQ-5D. The 95%CI of the score differences between these versions overlapped with but did not fall completely within pre-defined equivalence margins for 4 EQ-5D items, utility and EQ-VAS scores. For example, the 95%CI of the adjusted score difference between these EQ-5D versions was -0.14 to +0.03 points for utility scores and -11.6 to +3.3 points for EQ-VAS scores (equivalence margins of -0.05 to +0.05 and -5.0 to +5.0 respectively). Conclusion These data provide promising evidence for the measurement equivalence of English and Chinese EQ-5D versions.
Keywords	Computer applications to medicine. Medical informatics ; R858-859.7
Subject code	310
Language	English
Publishing date	2003-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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