AA (Inflammatory) Amyloidosis Medication
- Author: Richa Dhawan, MD; Chief Editor: Herbert S Diamond, MD more...
Medication Summary
No specific therapeutic agents are recommended for the treatment of amyloid A (AA) amyloidosis. Therapy for the underlying inflammatory disorders should be as aggressive as possible.
Anti-inflammatory agents
Class Summary
Colchicine is a disaggregator of microtubules, not a member of any of the traditional categories of anti-inflammatory agents.
Colchicine
Decreases leukocyte motility and phagocytosis in inflammatory responses. Effective in the treatment of acute gout, pseudogout, and the prophylaxis of acute febrile episodes of FMF. The latter effect probably is responsible for the reduced frequency of renal amyloidosis when treatment is adequate.
Perfetto F, Moggi-Pignone A, Livi R, Tempestini A, Bergesio F, Matucci-Cerinic M. Systemic amyloidosis: a challenge for the rheumatologist. Nat Rev Rheumatol. Jul 2010;6(7):417-29. [Medline].
Obici L, Raimondi S, Lavatelli F, Bellotti V, Merlini G. Susceptibility to AA amyloidosis in rheumatic diseases: a critical overview. Arthritis Rheum. Oct 15 2009;61(10):1435-40. [Medline].
Sipe J. Revised nomenclature for serum amyloid A (SAA). Nomenclature Committee of the International Society of Amyloidosis. Part 2. Amyloid. Mar 1999;6(1):67-70. [Medline].
Simms RW, Prout MN, Cohen AS. The epidemiology of AL and AA amyloidosis. Baillieres Clin Rheumatol. Aug 1994;8(3):627-34. [Medline].
Lachmann HJ, Goodman HJ, Gilbertson JA, Gallimore JR, Sabin CA, Gillmore JD, et al. Natural history and outcome in systemic AA amyloidosis. N Engl J Med. Jun 7 2007;356(23):2361-71. [Medline].
Myllykangas-Luosujärvi R, Aho K, Kautiainen H, Hakala M. Amyloidosis in a nationwide series of 1666 subjects with rheumatoid arthritis who died during 1989 in Finland. Rheumatology (Oxford). Jun 1999;38(6):499-503. [Medline].
Gillmore JD, Lovat LB, Persey MR, Pepys MB, Hawkins PN. Amyloid load and clinical outcome in AA amyloidosis in relation to circulating concentration of serum amyloid A protein. Lancet. Jul 7 2001;358(9275):24-9. [Medline].
Immonen K, Finne P, Hakala M, Kautiainen H, Pettersson T, Grönhagen-Riska C. No improvement in survival of patients with amyloidosis associated with inflammatory rheumatic diseases -- data from the Finnish national registry for kidney diseases. J Rheumatol. Jul 2008;35(7):1334-8. [Medline].
Tanaka F, Migita K, Honda S, Fukuda T, Mine M, Nakamura T, et al. Clinical outcome and survival of secondary (AA) amyloidosis. Clin Exp Rheumatol. May-Jun 2003;21(3):343-6. [Medline].
Uda H, Yokota A, Kobayashi K, Miyake T, Fushimi H, Maeda A, et al. Two distinct clinical courses of renal involvement in rheumatoid patients with AA amyloidosis. J Rheumatol. Aug 2006;33(8):1482-7. [Medline].
Kofman T, Grimbert P, Poitrine FC, Zuber J, Garrigue V, Mousson C, et al. Renal Transplantation in Patients With AA Amyloidosis Nephropathy: Results From a French Multicenter Study. Am J Transplant. Jun 30 2011;[Medline].
Falk RH. Diagnosis and management of the cardiac amyloidoses. Circulation. Sep 27 2005;112(13):2047-60. [Medline].
Silva L, Sampaio L, Terroso G, Almeida G, Lucas R, Rios E, et al. Amyloidosis secondary to rheumatic diseases - 16 cases. Acta Reumatol Port. Oct-Dec 2010;35(5):518-23. [Medline].
Wester AL, Vatn MH, Fausa O. Secondary amyloidosis in inflammatory bowel disease: a study of 18 patients admitted to Rikshospitalet University Hospital, Oslo, from 1962 to 1998. Inflamm Bowel Dis. Nov 2001;7(4):295-300. [Medline].
Lachmann HJ, Gilbertson JA, Gillmore JD, et al. Unicentric Castleman's disease complicated by systemic AA amyloidosis: a curable disease. QJM. Apr 2002;95(4):211-8. [Medline].
Picken MM. Amyloidosis-where are we now and where are we heading?. Arch Pathol Lab Med. Apr 2010;134(4):545-51. [Medline].
Ahlmen M, Ahlmen J, Svalander C, et al. Cytotoxic drug treatment of reactive amyloidosis in rheumatoid arthritis with special reference to renal insufficiency. Clin Rheumatol. Mar 1987;6(1):27-38. [Medline].
Fernández-Nebro A, Tomero E, Ortiz-Santamaría V, Castro MC, Olivé A, de Haro M, et al. Treatment of rheumatic inflammatory disease in 25 patients with secondary amyloidosis using tumor necrosis factor alpha antagonists. Am J Med. May 2005;118(5):552-6. [Medline].
Kuroda T, Otaki Y, Sato H, Fujimura T, Nakatsue T, Murakami S, et al. A case of AA amyloidosis associated with rheumatoid arthritis effectively treated with Infliximab. Rheumatol Int. Sep 2008;28(11):1155-9. [Medline].
Shimoyama M, Ohtahara A, Fukui H, Okamura T, Shimizu H, Miyamoto M, et al. Acute secondary gastrointestinal amyloidosis in a patient with rheumatoid arthritis. Am J Med Sci. Sep 2003;326(3):145-7. [Medline].
Leslie KS, Lachmann HJ, Bruning E, McGrath JA, Bybee A, Gallimore JR, et al. Phenotype, genotype, and sustained response to anakinra in 22 patients with autoinflammatory disease associated with CIAS-1/NALP3 mutations. Arch Dermatol. Dec 2006;142(12):1591-7. [Medline].
Fushimi T, Takahashi Y, Kashima Y, et al. Severe protein losing enteropathy with intractable diarrhea due to systemic AA amyloidosis, successfully treated with corticosteroid and octreotide. Amyloid. Mar 2005;12(1):48-53. [Medline].
Perez Equiza E, Arguinano JM, Gastearena J. Successful treatment of AA amyloidosis secondary to Hodgkin's disease with 4'-iodo-4'-deoxydoxorubicin. Haematologica. Jan 1999;84(1):93-4. [Medline].
Bodin K, Ellmerich S, Kahan MC, Tennent GA, Loesch A, Gilbertson JA, et al. Antibodies to human serum amyloid P component eliminate visceral amyloid deposits. Nature. Nov 4 2010;468(7320):93-7. [Medline]. [Full Text].
Dember LM, Hawkins PN, Hazenberg BP, Gorevic PD, Merlini G, Butrimiene I, et al. Eprodisate for the treatment of renal disease in AA amyloidosis. N Engl J Med. Jun 7 2007;356(23):2349-60. [Medline].
Ueda M, Ando Y, Nakamura M, Yamashita T, Himeno S, Kim J, et al. FK506 inhibits murine AA amyloidosis: possible involvement of T cells in amyloidogenesis. J Rheumatol. Nov 2006;33(11):2260-70. [Medline].
Yan SD, Zhu H, Zhu A, Golabek A, Du H, Roher A, et al. Receptor-dependent cell stress and amyloid accumulation in systemic amyloidosis. Nat Med. Jun 2000;6(6):643-51. [Medline].
Vandecasteele SJ, De Paepe P, De Vriese AS. Successful treatment of renal AA amyloidosis in familial Mediterranean fever with pegylated alpha-2a interferon. Clin Nephrol. Feb 2011;75 Suppl 1:1-3. [Medline].
Joss N, McLaughlin K, Simpson K, et al. Presentation, survival and prognostic markers in AA amyloidosis. QJM. Aug 2000;93(8):535-42. [Medline].
Akar N, Yalcinkaya F, Akar E, et al. MEFV mutation analysis in Turkish familial Mediterranean fever patients with amyloidosis. Amyloid. Dec 1999;6(4):301-2. [Medline].
Berglund K, Thysell H, Keller C. Results, principles and pitfalls in the management of renal AA-amyloidosis; a 10-21 year followup of 16 patients with rheumatic disease treated with alkylating cytostatics. J Rheumatol. Dec 1993;20(12):2051-7. [Medline].
Bohle A, Wehrmann M, Eissele R, et al. The long-term prognosis of AA and AL renal amyloidosis and the pathogenesis of chronic renal failure in renal amyloidosis. Pathol Res Pract. Apr 1993;189(3):316-31. [Medline].
Booth DR, Booth SE, Gillmore JD, et al. SAA1 alleles as risk factors in reactive systemic AA amyloidosis. Amyloid. Dec 1998;5(4):262-5. [Medline].
Buck FS, Koss MN, Sherrod AE, et al. Ethnic distribution of amyloidosis: an autopsy study. Mod Pathol. Jul 1989;2(4):372-7. [Medline].
Buxbaum J. The amyloidoses. In: Dieppe PA, Klippel JH, eds. Rheumatology. 2nd ed. St. Louis, Mo: Mosby; 1998:1-10.
Cunnane G, Whitehead AS. Amyloid precursors and amyloidosis in rheumatoid arthritis. Baillieres Best Pract Res Clin Rheumatol. Dec 1999;13(4):615-28. [Medline].
Drewe E, Huggins ML, Morgan AG, et al. Treatment of renal amyloidosis with etanercept in tumour necrosis factor receptor-associated periodic syndrome. Rheumatology (Oxford). Nov 2004;43(11):1405-8. [Medline].
Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. Feb 11 1999;340(6):448-54. [Medline].
Gallo GR, Feiner HD, Chuba JV, et al. Characterization of tissue amyloid by immunofluorescence microscopy. Clin Immunol Immunopathol. Jun 1986;39(3):479-90. [Medline].
Gertz MA, Kyle RA. Secondary systemic amyloidosis: response and survival in 64 patients. Medicine (Baltimore). Jul 1991;70(4):246-56. [Medline].
Heering P, Hetzel R, Grabensee B, et al. Renal transplantation in secondary systemic amyloidosis. Clin Transplant. Jun 1998;12(3):159-64. [Medline].
Helin HJ, Korpela MM, Mustonen JT, et al. Renal biopsy findings and clinicopathologic correlations in rheumatoid arthritis. Arthritis Rheum. Feb 1995;38(2):242-7. [Medline].
Hirschfield GM. Amyloidosis: a clinico-pathophysiological synopsis. Semin Cell Dev Biol. Feb 2004;15(1):39-44. [Medline].
Janssen S, Van Rijswijk MH, Meijer S, et al. Systemic amyloidosis: a clinical survey of 144 cases. Neth J Med. 1986;29(11):376-85. [Medline].
Joss N, McLaughlin K, Simpson K, Boulton-Jones JM. Presentation, survival and prognostic markers in AA amyloidosis. QJM. Aug 2000;93(8):535-42. [Medline].
Kisilevsky R, Young ID. Pathogenesis of amyloidosis. Baillieres Clin Rheumatol. Aug 1994;8(3):613-26. [Medline].
Lachmann HJ, Gilbertson JA, Gillmore JD, Hawkins PN, Pepys MB. Unicentric Castleman's disease complicated by systemic AA amyloidosis: a curable disease. QJM. Apr 2002;95(4):211-8. [Medline].
Lachmann HJ, Goodman HJ, Gilbertson JA, Gallimore JR, Sabin CA, Gillmore JD, et al. Natural history and outcome in systemic AA amyloidosis. N Engl J Med. Jun 7 2007;356(23):2361-71. [Medline].
Lam SKL, Ngian GS, Travers R, Lim KKT. Amyloidosis: a rheumatological perspective on diagnosis, further investigation and treatment. International Journal of Rheumatic Diseases. Jun 2008;11(1):55-9.
Lee H, Han KH, Jung YH, Kang HG, Moon KC, Ha IS, et al. A case of systemic amyloidosis associated with cyclic neutropenia. Pediatr Nephrol. Apr 2011;26(4):625-9. [Medline].
Livneh A, Langevitz P, Shinar Y, et al. MEFV mutation analysis in patients suffering from amyloidosis of familial Mediterranean fever. Amyloid. Mar 1999;6(1):1-6. [Medline].
Livneh A, Zemer D, Langevitz P, et al. Colchicine treatment of AA amyloidosis of familial Mediterranean fever. An analysis of factors affecting outcome. Arthritis Rheum. Dec 1994;37(12):1804-11. [Medline].
Lofberg H, Thysell H, Westman K, et al. Demonstration and classification of amyloidosis in needle biopsies of the kidneys, with special reference to amyloidosis of the AA-type. Acta Pathol Microbiol Immunol Scand [A]. Nov 1987;95(6):357-63. [Medline].
Mihara M, Shiina M, Nishimoto N, et al. Anti-interleukin 6 receptor antibody inhibits murine AA-amyloidosis. J Rheumatol. Jun 2004;31(6):1132-8. [Medline].
Moriguchi M, Terai C, Koseki Y, et al. Influence of genotypes at SAA1 and SAA2 loci on the development and the length of latent period of secondary AA-amyloidosis in patients with rheumatoid arthritis. Hum Genet. Oct 1999;105(4):360-6. [Medline].
Nakamura T. Clinical strategies for amyloid A amyloidosis secondary to rheumatoid arthritis. Mod Rheumatol. 2008;18(2):109-18. [Medline].
Naya MT, Soria C, Quereda C, Orte L, Romero R, Ortuño J. End-stage renal disease in a patient with amyloidosis secondary to acne conglobata. Nephron. 1991;57(1):109-10. [Medline].
Obici L, Perfetti V, Palladini G, et al. Clinical aspects of systemic amyloid diseases. Biochim Biophys Acta. Nov 10 2005;1753(1):11-22. [Medline].
Oka T, Iwata J, Furihata M, Sonobe H, Miyoshi I, Ohtsuki Y. Inhibitory effects of human interferons on the immortalization of human, but not rabbit, T lymphocytes by human T-lymphotropic virus type-I (HTLV-I). Int J Cancer. Jul 30 1992;51(6):915-20. [Medline].
Oka T, Iwata J, Furihata M, Sonobe H, Miyoshi I, Ohtsuki Y. Inhibitory effects of human interferons on the immortalization of human, but not rabbit, T lymphocytes by human T-lymphotropic virus type-I (HTLV-I). Int J Cancer. Jul 30 1992;51(6):915-20. [Medline].
Sipe J. Revised nomenclature for serum amyloid A (SAA). Nomenclature Committee of the International Society of Amyloidosis. Part 2. Amyloid. Mar 1999;6(1):67-70. [Medline].
van der Hilst JC, Yamada T, Op den Camp HJ, van der Meer JW, Drenth JP, Simon A. Increased susceptibility of serum amyloid A 1.1 to degradation by MMP-1: potential explanation for higher risk of type AA amyloidosis. Rheumatology (Oxford). Nov 2008;47(11):1651-4. [Medline].
Wiland P, Wojtala R, Goodacre J, Szechinski J. The prevalence of subclinical amyloidosis in Polish patients with rheumatoid arthritis. Clin Rheumatol. Jun 2004;23(3):193-8. [Medline].
Zhang CL, Lyngmo V, Nordøy A. The effects of saturated fatty acids on endothelial cells. Thromb Res. Jan 1 1992;65(1):65-75. [Medline].

