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In Vitro and In Vivo Assessment of T, B and Myeloid Cells Suppressive Activity and Humoral Responses from Transplant Recipients
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Preparing the patient for immunosuppressive therapy.

Sunanda Kane1

  • 1Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. kane.sunanda@mayo.edu

Current Gastroenterology Reports
|October 5, 2010
PubMed
Summary
This summary is machine-generated.

Choosing immunosuppressive therapy requires careful patient selection and discussion of risks. Factors like diagnosis and disease activity influence treatment decisions, with various drugs like methotrexate and biologics having specific monitoring needs and potential side effects.

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Area of Science:

  • Immunology
  • Pharmacology
  • Clinical Medicine

Background:

  • Immunosuppressive therapy offers benefits but carries significant risks.
  • Patient selection is critical and depends on diagnosis, disease activity, comorbidities, and socioeconomic factors.
  • Open communication regarding side effects, adverse events, and monitoring is essential.

Purpose of the Study:

  • To review the considerations for initiating immunosuppressive therapy.
  • To highlight the risks and benefits associated with different immunosuppressive agents.
  • To emphasize the importance of patient selection and monitoring.

Main Methods:

  • Literature review of immunosuppressive therapies.
  • Analysis of factors influencing treatment decisions.
  • Discussion of specific drug classes including steroids, thiopurines, methotrexate, and biologics.

Main Results:

  • Steroids are potent but require defined treatment endpoints.
  • Thiopurines necessitate routine blood monitoring and have a discontinuation rate of ~20% due to side effects.
  • Methotrexate may be underutilized; biologics targeting TNF-α and integrins show efficacy but carry risks like serious infections.

Conclusions:

  • Careful patient selection and risk-benefit assessment are paramount for immunosuppressive therapy.
  • Different immunosuppressants have unique monitoring requirements and potential adverse events.
  • Methotrexate's potential benefits warrant wider consideration, while biologics require cautious use due to associated risks.