Certolizumab pegol has a relatively long elimination half-life of approximate to 2 weeks, allowing subcutaneous administration once every 2 or 4 weeks.

In two randomized, phase III trials in patients with active rheumatoid arthritis despite previous methotrexate therapy (RAPID 1 and 2), the combination of Tubastatin A datasheet subcutaneous certolizumab pegol 400mg at weeks 0, 2, and

4, followed by a 200 or 400mg dose every 2 weeks and a stable dosage of methotrexate, was more effective than placebo plus methotrexate for improving the signs and symptoms of arthritis at weeks 24 (RAPID 1 and 2) and 52 (RAPID 1), according to American College of Rheumatology (ACR) criteria. Improvements in ACR response rates were seen as early as 1 week and at all timepoints measured up to 52 weeks.

In RAPID 1 and RAPID 2, radiographic progression was also significantly inhibited with certolizumab pegol plus methotrexate treatment compared with placebo and methotrexate according to van der Heijde modified Total Sharp Scores at 24 and 52 weeks after treatment initiation.

In patients eFT508 in vivo with active rheumatoid arthritis who had previously failed

to respond to treatment with >= 1 disease-modifying antirheumatic drug, certolizumab pegol 400 mg every 4 weeks as monotherapy effectively improved ACR responses at all measured timepoints up to 24 weeks, according to data from the randomized, phase III FAST4WARD trial.

Certolizumab pegol was generally well tolerated in combination with methotrexate or as monotherapy in phase III trials in patients with rheumatoid arthritis, with most adverse events being of mild to moderate EGFR inhibitor intensity. Infections were the most frequently reported adverse events.”
“Laparoscopic sleeve gastrectomy (LSG) is widely adopted but exposes

serious complications.

A retrospective database analysis was done to study LSG staple line complications in a tertiary referral university center with surgical ICU experienced in treatment of morbid obesity and complications. Twenty-two consecutive patients were referred between January 2004 and February 2012 with postoperative gastric leak or stenosis after LSG. Interventions consisted in the control of intra-abdominal and general sepsis; restoration of staple line continuity or revision of LSG; nutritional support; treatment of associated complications. Main outcome measures concerned success rates of therapeutic strategies, morbidity and mortality rates, LOS, and time to cure.

Thirteen patients (59 %) were referred after failure of reoperation (seven fistula repairs were attempted). Three patients received emergency surgery in our center with transorificial intubation and jejunostomy formation. An endoscopic stent was tried in nine patients but failed in 84.6 % of cases within 20 days (1-161). Seven patients (32 %) necessitated total gastrectomy within 217 days (0-1,915 days) for conservative treatment failure.