SK · NR3C1 · Small Molecule
prednisolone farnesil is a small molecule developed by SK. It is approved for therapeutic indications via topical.
| Brand Names | Farnezone, Farnesone, Farnerate |
| Company | SK |
| Drug Class | Small Molecule |
| Molecular Target | NR3C1 |
| Route | Topical |
| Status | Approved |
prednisolone farnesil acts on 1 molecular target:
| NR3C1 | nuclear receptor subfamily 3 group C member 1 (GR, GCCR) |
prednisolone farnesil is developed for 1 unique indication across 1 therapeutic area.
| Therapeutic Area | Condition | Phase |
|---|---|---|
| Musculoskeletal and connective tissue disorders | Rheumatoid arthritis | ✓ Approved |
Nanpo Hiromi H, Hamaguchi Yasuhito Y, Mizumaki Kie K, Shimizu Kyoko K et al.
Zhao Feng F, Wang Yue Y, Gong Jiajun J, Yu Linjie L et al.
Painful tonic spasms (PTS) are an underrecognized initial manifestation of neuromyelitis optica spectrum disorder (NMOSD), presenting before classic neurological deficits in rare cases. A 51-year-old man presented with progressive right lower limb PTS lasting ≤10 s, spreading bilaterally and impairing mobility within 1 month. Neurological examination showed bilateral hyperreflexia and myoclonus. Spinal MRI revealed longitudinally extensive T2 hyperintensity and gadolinium enhancement at T1-T6 levels. Serum aquaporin-4 immunoglobulin G (AQP4-IgG) antibody was positive (1:100), while cerebrospinal fluid AQP4-IgG analysis was negative. Methylprednisolone (0.5 g/day for 3 days, tapered to oral prednisolone) and intravenous immunoglobulin (0.4 g/kg/day for 5 days) significantly reduced spasms. At discharge, he ambulated independently without PTS on prednisolone (60 mg/day), oxcarbazepine (450 mg twice daily), and baclofen (10 mg twice daily). Isolated PTS serves as a potential harbinger of NMOSD, and early diagnosis and precise immunotherapy enables rapid symptom control and attack prevention.
Maekawa Ryuta R, Matsuoka Ryutaro R, Maeda Yasuhiro Y, Fujimoto Takeshi T
A 68-year-old female was admitted to our hospital because of a right-sided headache since one year, an inability to perform housework, and a decrease in speech since March of that year. Upon admission, higher brain dysfunctions, including attention disorder, aphasia, and apraxia, were observed. Contrast-enhanced MRI revealed dural thickening in the bilateral frontal to parietal lobes and FLAIR imaging revealed high signal intensities in the bilateral frontal brain sulcus. Blood tests revealed a high IgG4 level (273 mg/dl). Dural biopsy revealed infiltration of IgG4-positive plasma cells into the tissue, and IgG4-related hypertrophic pachymeningitis was diagnosed. Administration of prednisolone resulted in resolution of the dural thickening, an absence of FLAIR imaging high signal intensities of the cerebral sulcus, and a considerable improvement of the higher brain dysfunctions. In patients with headache and higher brain dysfunctions, hypertrophic pachymeningitis should be considered in the differential diagnosis.
Yamamoto So S, Matsumoto Haruki H, Nibu Hiroki H, Tanuma Yasuhiro Y et al.
Elderly-onset dermatomyositis (DM) is associated with an increased risk of malignancy. Serology supports clinical phenotyping of DM and risk assessment for malignancy, but malignancy cannot be completely excluded by serology alone. T-cell lymphomas can rarely mimic DM or coexist with established DM, posing an important diagnostic pitfall. An 82-year-old woman presented with fever, polyarthralgia, rash, and interstitial lung disease. Myositis autoantibodies assessed by immunoblot were positive for anti-PM/Scl-100 and anti-Mi-2. Aldolase was elevated, and skin biopsy findings were compatible with DM. Computed tomography showed interstitial lung disease and mild bilateral inguinal lymphadenopathy, while the inguinal lymph node biopsy suggested reactive lymphadenitis. She was diagnosed with DM and treated with oral prednisolone. During tapering, she rapidly developed systemic deterioration with severe thrombocytopenia and marked elevations in lactate dehydrogenase, ferritin, and soluble interleukin-2 receptor, raising suspicion for lymphoma-associated hyperinflammation. Bone marrow aspirate ultimately revealed peripheral T-cell lymphoma, not otherwise specified, with bone marrow involvement. A literature review identified 16 reported cases, including ours, of T-cell lymphoma either "mimic" DM or "coexisting" with established DM. 7 cases were classified as mimic and 9 as coexisting. These cases suggest that repeat tissue evaluation, particularly of skin lesions, may be critical in atypical or treatment-refractory cases. Our case highlights that even a DM phenotype with autoantibodies generally considered less strongly associated with malignancy does not exclude occult lymphoma in elderly patients.
Huang Hui H, Yu Haiguo H, Fan Zhidan Z, Guo Yihong Y et al.
Calcinosis cutis is one of the most refractory complications of dermatomyositis (DM), particularly in patients with anti-nuclear matrix protein 2 (NXP2) autoantibodies. Whether tumor necrosis factor-alpha (TNF-α) blockade is associated with regression of established calcinosis remains uncertain. We conducted a retrospective, single-center study of nine patients with refractory dermatomyositis or juvenile dermatomyositis treated with TNF-α inhibitors (infliximab or adalimumab). Myositis-specific autoantibodies, longitudinal muscle strength (MMT8, CMAS), glucocorticoid exposure, and serial imaging of calcinosis were evaluated. Calcinosis change was analyzed as an exploratory endpoint. Three patients were anti-NXP2 positive, and six were negative for tested myositis-specific autoantibodies. TNF-α blockade was associated with sustained clinical improvement and a marked steroid-sparing effect, with median daily prednisolone dose decreasing from 40 mg at baseline to 5 mg at 12 months. Radiographic regression of calcinosis, defined a priori as a ≥20% reduction in maximal lesion diameter on serial imaging, was observed in 2 of 3 anti-NXP2-positive patients after prolonged treatment (12-20 months): notably, calcinosis was absent at baseline in all anti-NXP2-negative patients, precluding assessment of regression in this subgroup. One patient with pre-existing interstitial lung abnormalities experienced pulmonary deterioration, leading to treatment discontinuation. In this small retrospective cohort, prolonged TNF-α blockade was associated with radiographic regression of calcinosis in a subset of anti-NXP2-positive patients, while calcinosis was absent at baseline in antibody-negative patients. These findings generate a hypothesis that antibody-defined subgroups may differ in calcinosis responsiveness and warrant prospective validation.
Herath Madhuni M, Nguyen Hanh H HH, Milat Frances F, Ebeling Peter R PR
A premenopausal woman was reviewed for painful vertebral fractures in the context of prednisolone exposure for her newly diagnosed systemic lupus erythematosus. Known clinical risk factors for bone loss included exposure to depot medroxyprogesterone acetate for 12 yr, cigarette smoking, a family history of osteoporosis and ongoing inflammatory arthritis. Initial investigations also identified vitamin D deficiency and low bone mass for age and sex. She was treated with vitamin D and her contraception was changed to a levonorgestrel intrauterine device. In the context of further vertebral fractures confirmed with both MRI and bone scan and having had additional secondary causes of low bone mass excluded, she commenced targeted osteoporosis treatment. We discuss the complexities of managing bone fragility in young adults and the impact of depot medroxyprogesterone acetate, inflammatory disease (systemic lupus erythematosus) and glucocorticoid-induced osteoporosis on younger adults. In this woman, antiresorptive therapy with zoledronic acid was recommended; we also explore the existing evidence-base for antiresorptive and anabolic therapies in younger adults, with a particular focus on glucocorticoid-induced osteoporosis.
+9996 more articles available with a free account
Sign up free to view all articles →