In AA amyloidosis therapy is aimed at treatment of the underlying causative inflammatory disease (such as rheumatoid arthritis, FMF, or tuberculosis). Recently an international study has been started in AA amyloidosis to investigate a drug that possibly can inhibit the deposition of amyloid or even can help to remove amyloid deposits. However, the first results of this study will not be available before the summer of 2005.
The current therapy aims to get the SAA concentration (or CRP as surrogate marker) below 10 mg/l and to keep it below this level. The type of inflammation determines which treatment is most appropriate for this purpose. In bacterial infections such as tuberculosis or leprosy antibiotics are the therapy of choice. In other bacterial infections such as osteomyelitis surgery is indicated. A maintenance therapy with antibiotics can be useful in chronic bronchitis, sinusitis, or urinary tract infections. Many inflammatory diseases do not have a well-known cause, such as rheumatoid arthritis or Crohn's disease. In these diseases anti-inflammatory drugs are used in order to to suppress the inflammation as much as possible.
To evaluate the effect of therapy it is recommended to look at predefined time intervals at the amyloid A protein concentration in fat tissue, at the SAP scan, and at clinical data such as creatinine clearance and severity of proteinuria.
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