Eprodisate in amyloid A amyloidosis: a novel therapeutic approach?

Abstract

BACKGROUND:

Amyloid A (AA) amyloidosis can complicate chronic inflammatory diseases, chronic infections and recurrent periodic fever syndromes. Its treatment is challenging, given its heterogeneous spectrum of etiologies.

OBJECTIVE:

To review the available literature regarding treatment options for AA amyloidosis, particularly focusing on eprodisate, a newly developed inhibitor of fibrillogenesis.

METHODS:

A PubMed search was performed without any date limits, mainly using the search terms 'amyloidosis', 'colchicine', 'eprodisate', '1,3-propanedisulfonate', 'NC-503', 'Fibrillex' and 'TNF-blockers'.

RESULTS/CONCLUSION:

Antibiotics and colchicine are effective in preventing and treating infection-related and familial Mediterranean fever-related AA amyloidosis, respectively. Recently, TNF-alpha blockers have emerged as effective agents in inflammatory AA amyloidosis. Eprodisate binds to the glycosaminoglycan binding site on amyloid fibrils, thus targeting amyloid fibril polymerization and tissue deposition. Eprodisate has possible applicability to other types of amyloidosis; the results of a recent randomized trial showed that it may slow the progression of AA amyloidosis-related renal disease but confirmatory studies are necessary.

• Authors: Lucio Manenti, Pius Tansinda, Augusto Vaglio
• Journal: Expert opinion on pharmacotherapy (Expert Opin Pharmacother) Vol. 9 Issue 12 Pg. 2175-80 (Aug 2008) ISSN: 1744-7666 [Electronic] England
• PMID: 18671471 (Publication Type: Journal Article, Review)

Chemical References

• Glycosaminoglycans
• Immunosuppressive Agents
• Serum Amyloid A Protein
• Sulfonic Acids
• Tumor Necrosis Factor-alpha
• eprodisate
• Colchicine
• Propane

Topics

• Amyloidosis (drug therapy)
• Colchicine (therapeutic use)
• Glycosaminoglycans (antagonists & inhibitors)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Propane (adverse effects, analogs & derivatives, therapeutic use)
• Serum Amyloid A Protein (metabolism)
• Sulfonic Acids (adverse effects, therapeutic use)
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)