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Managing Side Effects

Radiation therapy

Skin problems: Try not to scratch or rub the treated skin


Nausea and vomiting: Have small meals or snacks throughout the day instead of 2 or 3 large meals

RITUXAN (a targeted therapy)

Fever, chills, and shaking: The doctor may give you certain medicines before infusions to help reduce side effects. For example, it is common for you to be given acetaminophen (Tylenol®) and diphenhydramine HCI (Benadryl®) before the RITUXAN to reduce side effects

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Intravenous immune globulin (IVIG) preparations are efficacious and safe products in use world-wide. Although rare, side-effects of IVIG may be serious, even life-threatening, and clinicians should be aware of their potential occurrence.

The clinical benefit of immune globulin prophylaxis in patients
with primary antibody deficiency syndromes has been clearly
established. In the past, replacement therapy was provided
through intramuscular injections. In the early 1980s, highly
purified monomeric suspensions of IgG for intravenous use
became available and more than 10 commercial preparations
of intravenous immune globulin (IVIG) are now at the disposal
of the clinician. The indications for administration of
IVIG have been enlarged to include transitory primary antibody
deficiencies (such as low birth-weight premature babies),
secondary hypogammaglobulinaemic states [as in chronic
lymphatic leukaemia (CLL) or multiple myeloma], and conditions
with increased susceptibility to infections (such as bone
marrow transplant.or the post-surgery period). In addition to
its efficacy as replacement therapy, IVIG now has wellestablished
therapeutic applications in some haematological
and autoimmune diseases: IVIG preparations are used successfully
in immune thrombocytopenic purpura (ITP), in Kawasaki
disease, and for some desperate diseases for which there is no
other efficient treatment [reviewed in refs 1 and 2]. The mechanisms
of action of IVIG in these conditions, although not yet
fully determined, include a reticulo-endothelial blockade, an
immunomodulatory effect (by supplying anti-idiotype antibodies),
and an anti-inflammatory action.
This growing usage has increased the need for high quality
immune globulin products and, indeed, high-dose IVIG can be
administered with only mild, self-limited side-effects. This
paper reviews the most frequent adverse reactions reported
with IVIG therapy from the time of its introduction into the
clinic. Possible underlying causes of these reactions and their
current management are described briefly.

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Pharmaceutical companies remain on an upward R&D trend through 2010. More than 9,000 new drugs have been added to the pipeline this year, showing growth in all clinical stages

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of development. The pharmaceutical and biotech industries’ top 20 pipeline leaders spent a combined $86.57 billion during 2009. Several leading pharmaceutical companies have implemented large-scale and aggressive M&A strategies.Editors of, a leading source for pharmaceutical business, marketing, and clinical research information, have released the second annual Top 20 Pipelines Special Report.


The nonprofit world is stewing over the ban Apple has put on making donations on the iPhone via charity apps.

No one, including Apple, has data on how many nonprofits have created apps for the iPhone. Organizations like the Monterey Bay Aquarium and American Cancer Society have them, but none can be used to make gifts. Prospective donors instead are directed out of a nonprofit’s app and to its Web site, which the organizations say makes the process of contributing more cumbersome.

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Pharmaceutical (drug) and biotech companies are constantly researching and developing new medications to treat medical conditions, and new drugs come on the market frequently. People who have rare diseases or disorders, however, have not had as much research attention in past decades. This is because their numbers are small and therefore the potential market for new drugs to treat them (commonly referred to as “orphan drugs”) is also small. A rare disease occurs in less than 200,000 individuals in the United States, or less than 5 per 10,000 individuals in the European Union. Government regulatory agencies in the United States and the European Union have thus taken steps to reduce this disparity.

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Pemphigus is a term used to describe blistering of the skin caused by binding of antibodies to the surface of the cells of the outer layer of the skin, the epidermis. In pemphigus vulgaris, the most common form of pemphigus, there are IgG antibodies that bind to the cell surfaces of epidermis of the skin as well as the epithelium lining mucosal surfaces such as the mouth. As a result, patients develop severe oral ulcerations, and may also have inflammation or erosions of the lining of the eye and eyelids (conjunctiva), the nasal mucosa, or the genital mucosa. Half of the patients also develop blisters or erosions of the skin, often in the head and neck area.

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Our scientific knowledge of pemphigus has dramatically progressed in recent years. However, despite the availability of various therapeutic options for the treatment of inflammatory diseases, only a few multicenter controlled trials have helped to define effective therapies in pemphigus. A major obstacle in comparing therapeutic outcomes between centers is the lack of generally accepted definitions and measurements for the clinical evaluation of pemphigus patients. Common terms and endpoints of pemphigus are needed so that experts in the field can accurately measure and assess disease extent, activity, severity, and therapeutic response, and thus facilitate and

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advance clinical trials This consensus statement from the International Pemphigus Committee represents two years of collaborative efforts to attain mutually acceptable common definitions for pemphigus. These should assist in development of consistent reporting of outcomes in future studies.

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The risk of death in patients with pemphigus
vulgaris has been substantially reduced by treat-
ment with systemic corticosteroids.5 Current therapy consists of high doses of corticosteroids plus immunosuppressive agents.6 This combination frequently causes long-term immunosuppression, the consequences of which are now the most
common cause of death in patients with pemphigus vulgaris.7 Patients who do not have a response to corticosteroids plus immunosuppressive agents
or who

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have severe side effects from this therapy have been successfully treated with intravenous immune globulin,8,9 which can be used as monotherapy and can produce long-term remissions.

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Pemphigus VulgarisCurrently, available technologies are limited in their power to characterize autoreactive T cells, which are necessary for the generation of autoantibodies in PV and the development of disease. The research team of the Department of Dermatology at the Weill Medical College of Cornell University is developing two newly emerging technologies to identify, enumerate, and analyze autoreactive T cells.  They are undertaking fine specificity characterization of autoreactive T cell populations and precise mapping of T cell epitopes responsible for disease induction and progression.  These studies are expected to illuminate novel and specific targets for immunoprevention and therapy.

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“This new science is forcing the medical community to take more seriously the popular notions of the mind-body connection,” says Esther M. Sternberg, M.D., director of the Integrative Neural Immune Program at the National Institute of Mental Health. In response to stressful events, our bodies pump out hormones. These hormones aren’t necessarily harmful and can be very useful, says Dr. Sternberg, author of The Balance Within: The Science Connecting Health and Emotions. “The problem is when the stress response goes on for too long,” she says. “That’s when you get sick. Hormones weaken the immune system’s ability to fight disease.”

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