Adalimumab for recurrent orbital myositis in Crohn's disease: Report of a case with a 3-year follow-up

Hernández-Garfella, M. Luisa; Gracia‐García, Alicia; Cervera-Taulet, Enrique; García–Villanueva, Carolina; Montero-Hernández, Javier

doi:10.1016/j.crohns.2011.02.010

Cited by 18 publications

(9 citation statements)

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“…In contrast, another anti-TNFα drug, etanercept, does not appear to be as effective for myositis [33–35]. The use of a third anti-TNF-α drug, adalimumab, has not yet been reported in myositis treatment but has been helpful for interstitial pneumonitis associated with adult dermatomyositis, anti-synthetase syndrome, and orbital myositis [36–38]. Also abatacept, an anti-CTAL-4 monoclonal, has been beneficial in an adult overlap myositis resistant to other treatment [39], in refractory polymyositis [40], and in a recalcitrant JDM child with ulcerations and calcinosis [41].…”

Section: Introductionmentioning

confidence: 99%

Biologic therapies for refractory juvenile dermatomyositis: five years of experience of the Childhood Arthritis and Rheumatology Research Alliance in North America

et al. 2017

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BackgroundThe prognosis of children with juvenile dermatomyositis (JDM) has improved remarkably since the 1960’s with the use of corticosteroid and immunosuppressive therapy. Yet there remain a minority of children who have refractory disease. Since 2003 the sporadic use of biologics (genetically-engineered proteins that usually are derived from human genes) for inflammatory myositis has been reported. In 2011–2016 we investigated our collective experience of biologics in JDM through the Childhood Arthritis and Rheumatology Research Alliance (CARRA).MethodsThe JDM biologic study group developed a survey on the CARRA member experience using biologics for Juvenile DM utilizing Delphi consensus methods in 2011–2012. The survey was completed online by the CARRA members interested in JDM in 2012. A second survey was similarly developed that provided more opportunity to describe their experiences with biologics in JDM in detail and was completed by CARRA members in Feb 2013. During three CARRA meetings in 2013–2015, nominal group techniques were used for achieving consensus on the current choices of biologic drugs. A final survey was performed at the 2016 CARRA meeting.ResultsOne hundred and five of a potential 231 pediatric rheumatologists (42%) responded to the first survey in 2012. Thirty-five of 90 had never used a biologic for Juvenile DM at that time. Fifty-five of 91 (denominators vary) had used biologics for JDM in their practice with 32%, 5%, and 4% using rituximab, etanercept, and infliximab, respectively, and 17% having used more than one of the three drugs. Ten percent used a biologic as monotherapy, 19% a biologic in combination with methotrexate (mtx), 52% a biologic in combination with mtx and corticosteroids, 42% a combination of a biologic, mtx, corticosteroids (steroids), and an immunosuppressive drug, and 43% a combination of a biologic, IVIG and mtx. The results of the second survey supported these findings in considerably more detail with multiple combinations of drugs used with biologics and supported the use of rituximab, abatacept, anti-TNFα drugs, and tocilizumab in that order. One hundred percent recommended that CARRA continue studying biologics for JDM. The CARRA meeting survey in 2016 again supported the study and use of these four biologic drug groups.ConclusionsOur CARRA JDM biologic work group developed and performed three surveys demonstrating that pediatric rheumatologists in North America have been using multiple biologics for refractory JDM in numerous scenarios from 2011 to 2016. These survey results and our consensus meetings determined our choice of four biologic therapies (rituximab, abatacept, tocilizumab and anti-TNFα drugs) to consider for refractory JDM treatment when indicated and to evaluate for comparative effectiveness and safety in the future.Significance and InnovationsThis is the first report that provides a substantial clinical experience of a large group of pediatric rheumatologists with biologics for refractory JDM over five years.This experience with biologic thera...

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Section: Introductionmentioning

confidence: 99%

Biologic therapies for refractory juvenile dermatomyositis: five years of experience of the Childhood Arthritis and Rheumatology Research Alliance in North America

et al. 2017

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“…Acute OM often responds to systemic corticosteroids; treatment with nonsteroidal antiinflammatory drugs has also had some success, but these drugs are not considered as effective as corticosteroids. Moreover, salazopyrine, azathioprine, mercaptopurine, methotrexate, cyclophospahide, cyclosporine, infliximab, adlimumab, and even radiotherapy and/or resection of the involved extraocular muscles had been reported [1,9,11]. As in other cases, the diagnosis was delayed while our patient received antibiotics before administration to our hospital.…”

Section: Discussionmentioning

confidence: 48%

“…It is one of the most common orbital disorders, following thyroid associated orbitopathy and lymphoproliferative disease, and accounts for about 5% of orbital disorders [3]. Very rarely it is associated with some systemic diseases such as systemic lupus erythematosus, rheumatoid arthritis, Wegener's granulomatosis, sarcoidosis, scleroderma, polyarteritis nodosa, Kawasaki disease and inflammatory bowel disease (IBD) [7][8][9][10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Orbital myositis associated with focal active colitis in a teenage girl

et al. 2011

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“…A population-based study has shown that ocular involvement occurs in 1-2% of patients with IBD [167], with the prevalence of orbital manifestations being presumably lower. Less than 25 cases of IBD associated with orbital inflammation and/or orbital myositis have been reported in the literature [9,[168][169][170][171][172][173][174][175][176][177][178][179][180][181][182][183][184][185].…”

Section: Inflammatory Bowel Diseasementioning

confidence: 99%

“…Immunosuppressive agents including methotrexate, cyclosporine, cyclophosphamide, mycophenolate mofetil, azathioprine, and intravenous immunoglobulin (IVIG) have shown efficacy in steroid tapering and/or symptom relief [2]. Among biologic agents, infliximab, daclizumab, rituximab, and adalimumab have all shown efficacy in isolated cases of orbital myositis [7][8][9][10][11]. Radiation therapy has also been utilized in treating orbital myositis, and although a good initial response was noted, long-term control of recurrences was noted to be suboptimal [4].…”

Section: Orbital Myositismentioning

confidence: 99%