Mycophenolic acid in rheumatology: mechanisms of action and severe adverse events.

MPA is clinically administered as morfolinoethyl ester (mycophenolate mofetil, MMF) or, more recently, as a salt (enteric-coated mycophenolate sodium). It is a fermentation product of Penicillium brevicompactum and other analogue fungi, identified by Gosio in 1893 as a weak antibacterial agent; in 1969 Franklin and Cook discovered its capacity to inhibit the inosine mono phosphate dehydrogenase (IMPDH), an enzyme involved in purine nucleotide synthesis (1)..

Proton pump inhibitors in rheumatic diseases: clinical practice, drug interactions, bone fractures and risk of infections.

Patients affected by acute coronary syndrome (ACS) or by chronic inflammatory musculoskeletal and connective tissue diseases (i.e. systemic sclerosis), often need antiaggregant therapy (ASA or Clopidogrel). The concomitant use of proton pump inhibitors (PPIs) is suggested to reduce the risk of haemorrhage. Clopidogrel is a prodrug activated by cytocrome P 450. PPIs too have a CYP P450 metabolism, and a drug interaction has been observed between PPIs and clopidogrel. 25% of nonresponsiveness to clopidogrel is due to this drug interaction (1). Some studies have demonstrated that the use of PPIs is associated with an increased risk of bone fractures and Clostridium difficile infection

Mycophenolic acid in Rheumatology: mechanisms of action and severe adverse events

MPA is clinically administered as morfolinoethyl ester (mycophenolate mofetil, MMF) or, more recently, as a salt (enteric-coated mycophenolate sodium). It is a fermentation product of Penicillium brevicompactum and other analogue fungi, identified by Gosio in 1893 as a weak antibacterial agent; in 1969 Franklin and Cook discovered its capacity to inhibit the inosine mono phosphate dehydrogenase (IMPDH), an enzyme involved in purine nucleotide synthesis (1)..

Similarity of the genetic background in rheumatic diseases between northen patients.

ANN RHEUM DI

Proton pump inhibitors in rheumatic diseases: clinical practice, drug interactions, bone fractures and risk of infections

Patients affected by acute coronary syndrome (ACS) or by chronic inflammatory musculoskeletal and connective tissue diseases (i.e. systemic sclerosis), often need antiaggregant therapy (ASA or Clopidogrel). The concomitant use of proton pump inhibitors (PPIs) is suggested to reduce the risk of haemorrhage. Clopidogrel is a prodrug activated by cytocrome P 450. PPIs too have a CYP P450 metabolism, and a drug interaction has been observed between PPIs and clopidogrel. 25% of nonresponsiveness to clopidogrel is due to this drug interaction (1). Some studies have demonstrated that the use of PPIs is associated with an increased risk of bone fractures and Clostridium difficile infection