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Novel treatments for systemic amyloidosis
International Journal of Clinical Rheumatology, 05/07/09

van Gameren II et al. – Article reviews the current treatments for systemic amyloidoses:

• Current treatment is directed against an ongoing supply of precursor proteins
• Treatment modalities include:
  • liver transplantation for transthyretin-related (ATTR) amyloidosis
  • elimination of inflammation in amyloid A (AA) amyloidosis and
  • intensive chemotherapy in immunoglobulin light chain (AL) amyloidosis
• These therapies often elicit substantial morbidity and mortality or insufficient effectiveness
• Therefore, the search for new, more effective therapies without serious side-effects remains mandatory
• Since cardiac involvement is vital when deciding on therapy, the introduction of N-terminal probrain natriuretic peptide (NT-proBNP) and troponin are of great importance
• New potent precursor-lowering drugs, such as thalidomide, lenalidomide and bortezomib, need to find their place in treatment protocols in AL amyloidosis

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