Anti–tumor necrosis factor α blockade in the treatment of juvenile spondylarthropathy

Tse, Shirley M. L.; Burgos‐Vargas, Rubén; Laxer, Ronald M.

doi:10.1002/art.21121

Cited by 107 publications

(65 citation statements)

References 29 publications

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“…The distributions of age, sex, race, and family history of HLA-B27-associated disease are consistent with the results of previously published cohorts of juvenile-onset AS (18) and juvenile spondylarthritis (SpA) (19). The median disease duration at the time of the initial rheumatology evaluation was 5.5 months (IQR 2.5-21 months).…”

Section: Significance and Innovationssupporting

confidence: 86%

Enthesitis in an inception cohort of enthesitis‐related arthritis

Weiss¹,

Klink²,

Behrens³

et al. 2011

Arthritis Care & Research

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Objective. To describe an enthesitis-related arthritis (ERA) inception cohort and determine which entheses and joints are most commonly affected. Methods. We reviewed a retrospective inception cohort study of children with ERA who were diagnosed and treated at The Children's Hospital of Philadelphia between November 2007 and December 2009. Results. During the study period, there were 32 newly diagnosed ERA patients. Fifty-nine percent were male, and the median age at the date of initial evaluation was 12.5 years (interquartile range [IQR] 10.2-14.3 years). The median number of tender entheses at presentation was 2 (IQR 0 -5), and 21 subjects (66%) had at least 1 tender enthesis. The most prevalent tender entheses were the patellar ligament insertion at the inferior pole of the patella, the plantar fascial insertion at the calcaneus, the Achilles tendon insertion at the calcaneus, and the plantar fascial insertion at the metatarsal heads. Enthesitis was most often symmetric. The median number of active joints was 2 (IQR 0 -4). The most commonly affected joints were the sacroiliacs, knees, and ankles. Sacroiliitis, which was defined clinically, was most often symmetric, while peripheral arthritis was most frequently asymmetric. The odds of having active enthesitis at 6 months increased significantly with each additional tender enthesis at the initial evaluation. Conclusion. Among pediatric patients with ERA, lower extremity enthesitis is prevalent at the time of diagnosis and is likely to persist 6 months later. Future studies should address standardization of the enthesitis examination, the pattern of enthesitis over time, enthesitis response to therapy, and the impact of enthesitis on quality of life.

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Section: Significance and Innovationssupporting

confidence: 86%

Enthesitis in an inception cohort of enthesitis‐related arthritis

Weiss¹,

Klink²,

Behrens³

et al. 2011

Arthritis Care & Research

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“…Moreover, it is also possible to avoid parental TNF-blocking therapy in such cases [19]. Tse et al emphasize that anti-TNFα therapy has potential for juvenile spondyloarthropathy treatment, however further prospective studies are required [20].…”

Section: Discussionmentioning

confidence: 99%

Fibroblast-Like Synovial Cells in Rheumatoid Arthritis- Impact of Infliximab on Hexosoaminidase Activity

Olszewski¹,

Olszewska²,

Popko³

et al. 2015

Adv Clin Exp Med

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Background. The effect of multiple infusions of infliximab (INF), a chimeric anti-tumor necrosis factor alpha antibody, on the concentration of hexosaminidase (HEX) activity in a synovial cell culture derived from human synovial inflamed fluid obtained from patients suffering from rheumatoid arthritis (RA) has been evaluated. Objectives. The aim of this study was to prove INF efficacy in RA. Material and Methods. Inflamed synovial fluid was taken from RA patients (a study group) and patients who had undergone knee trauma within 7 days (a control group). The following solutions of infliximab were used: 40, 60 and 140 µg/mL. Determination of the concentration of HEX activity in cell cultures was performed after 24, 48, 72 and 96 h of infliximab administration. To identify synoviocytes in cell culture immunohistochemical staining with vimentin and pancytokeratin was performed. Results. A predominance of fibroblast-like synovial cells has been observed in the study group. In the control group the concentration of HEX activity without adding infliximab to the cell culture was 283.00 nkat/mL. After 96 h of incubation with infliximab, the concentrations of HEX activity in cultured synoviocytes according to infliximab doses of 40, 60 and 140 µg/mL were respectively: 280.00, 271.50 and 293.50 nkat/mL. In the study group, the concentration of HEX activity without adding infliximab to the cell culture was 542.27 nkat/mL. The final concentrations of HEX activity of cultured fibroblast-like synovial cells measured after 96 h of incubation with infliximab were: 471.72, 498.27 and 556.72 nkat/mL, according to infliximab doses of 40, 60 and 140 µg/mL. In all groups (besides the infliximab concentration of 140 µg/mL after 96 h of incubation), the level of concentration of HEX activity was significantly higher in the study group compared to the control group, irrespective of infliximab concentration and time of infliximab incubation. Conclusions. Infliximab changes the concentration of HEX activity depending on the drug dose and time of administration (Adv Clin Exp Med 2015, 24, 5, 807-813).

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“…Studi di piccole popolazioni, dimostrano che la sua inibizione, sia con Infliximab sia con Etanercept, è efficace sull'artrite e l'entesite, nelle Spondilo-Artropatie Giovanili refrattarie (103,104). In queste forme, inoltre, l'Infliximab potrebbe essere efficace anche nella terapia dell'uveite anteriore acuta (105).…”

Section: L'inibizione Del Tnfα Nelle Spondiloartropatie Giovaniliunclassified

Biological therapy with TNF-inhibitors in pediatric rheumatology. Review of the litterature and personal experience

Gerloni¹,

Pontikaki²,

Gattinara³

et al. 2011

Reumatismo

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The therapeutic approach to JIA is sometimes very troublesome and progression to erosive polyarthritis may occur in all JIA categories. Only Methotrexate has shown efficacy and safety in a large controlled trial. Nevertheless, in many cases, drug resistance or intolerance has led to try other therapeutic options, with still debatable results. Therefore, there has been space, in the last few years, for new therapies as the TNF-inhibitors. This therapeutic approach has shown a dramatic clinical benefit in active polyarticular refractory JIA: the rate and rapidity of response have exceeded those of all other studied DMARDs. Preliminary data show that they are efficacious also for other pediatric rheumatic disease (spondyloarthropathies, autoimmune uveitis, dermatomyositis, Kawasaki syndrome and some auto- inflammatory diseases). TNF-inhibitors in JIA have demonstrated a favourable benefit-to-risk profile. However, as their use has increased worldwide, some unusual, usually not serious, adverse events have emerged. Severe infections, including TB, and deaths have been reported. Long-lasting active disease, systemic disease, concurrent and previous immunosuppressive therapies, all contribute to risk of infection and other serious AEs. Given the evidence that TNF has a primary role in the pathogenesis of JIA, particularly in joint destruction, neutralizing this cytokine early, within the window of opportunity, could halt or delay progression of joint damage and debilitating consequences of the disease. Thus, for JIA patients whose disease is not quickly controlled with MTX, TNF blockers may be considered as first-line treatment, although long-term safety data still need to be established

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Anti–tumor necrosis factor α blockade in the treatment of juvenile spondylarthropathy

Cited by 107 publications

References 29 publications

Enthesitis in an inception cohort of enthesitis‐related arthritis

Enthesitis in an inception cohort of enthesitis‐related arthritis

Fibroblast-Like Synovial Cells in Rheumatoid Arthritis- Impact of Infliximab on Hexosoaminidase Activity

Biological therapy with TNF-inhibitors in pediatric rheumatology. Review of the litterature and personal experience

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