Treatment of AA Amyloidosis — First-Line Protocol
AA amyloidosis involves progressive amyloid deposition that is managed independently of the underlying causative disease. The clinical approach centres on reducing circulating SAA levels, limiting amyloid deposits, and protecting renal function.
Clinical Goals
The defined treatment targets are reduction in circulating serum SAA levels, reduction of amyloid deposits, and stabilization of renal function.
Treatment Approach (Partial Overview)
First-line therapy is directed at the amyloid deposits, independent of the underlying disease. Options include agents that act on inflammatory signalling pathways to reduce SAA levels, alongside several other classes of molecules. The structured protocol specifies which agents apply and under what circumstances.
References
DOI: 10.2147/CLEP.S39981
- In this sense, tocilizumab, a humanized anti-IL-6 monoclonal antibody, proved to be extremely effective in reducing circulating SAA levels and controlling the progression of amyloidosis in several autoimmune joint diseases.
- It has been tested in patients with gastrointestinal and renal amyloidosis and can lower acute phase reactant levels and improve gastrointestinal complaints while reducing local amyloid deposits.
- Phase II trials showed stabilization of renal function in 42% of cases, although the drug was unable to modify serum SAA levels and had no significant effect on proteinuria or overall survival.
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