Clinical Remission in Patients with Systemic Juvenile Idiopathic Arthritis Treated with Anti-Tumor Necrosis Factor Agents

Russo, Ricardo; Katsicas, María M.

doi:10.3899/jrheum.090952

Cited by 75 publications

(48 citation statements)

References 18 publications

(11 reference statements)

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“…Kaplan-Meier estimates showed a 54% (95% CI, 30%-77%) probability of staying in remission 1 year after onset of CR. Lack of systemic features at initiation of TNF therapy and quick improvement (within 3 months) following TNF initiation were associated with remission [30].…”

Section: Recent Studies Using Preliminary Remission Criteriamentioning

confidence: 92%

Remission in Juvenile Idiopathic Arthritis: Current Facts

Shenoi

Wallace

2010

Curr Rheumatol Rep

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Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory arthritic disease affecting children. Despite the availability of potent disease-modifying antirheumatic medications, most children still experience a chronic course with long periods of active disease. Goals of treatment should include achievement of disease remission with optimal physical functioning that allows children to lead normal lives with no structural joint damage. The term remission implies a complete lack of disease activity. This article focuses on recently developed preliminary criteria for inactive disease and remission in JIA. Recent studies using these new definitions demonstrate only modest rates of achievement of remission favoring children with persistent oligoarticular JIA. Children with rheumatoid factor-positive polyarticular JIA are least likely to achieve remission. Therapeutic strategies to achieve remission are also discussed.

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Section: Recent Studies Using Preliminary Remission Criteriamentioning

confidence: 92%

Remission in Juvenile Idiopathic Arthritis: Current Facts

Shenoi

Wallace

2010

Curr Rheumatol Rep

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“…A significant and sustained reduction in disease activity is seen in ,60% of patients in articular manifestations and uveitis [67,68]. However, only 25% of patients attain remission, and disease flares occur in ,50% once in remission [69].…”

Section: Juvenile Idiopathic Arthritismentioning

confidence: 99%

The risk of tuberculosis related to tumour necrosis factor antagonist therapies: a TBNET consensus statement

Solovič

Sester

Gómez-Reino

et al. 2010

European Respiratory Journal

453

341

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Anti-tumour necrosis factor (TNF) monoclonal antibodies or soluble TNF receptors have become an invaluable treatment against chronic inflammatory diseases, such as rheumatoid arthritis, inflammatory bowel disease and psoriasis. Individuals who are treated with TNF antagonists are at an increased risk of reactivating latent infections, especially tuberculosis (TB).Following TNF antagonist therapy, the relative risk for TB is increased up to 25 times, depending on the clinical setting and the TNF antagonist used. Interferon-c release assays or, as an alternative in individuals without a history of bacille Calmette-Guérin vaccination, tuberculin skin testing is recommended to screen all adult candidates for TNF antagonist treatment for the presence of latent infection with Mycobacterium tuberculosis.Moreover, paediatric practice suggests concomitant use of both the tuberculin skin test and an interferon-c release assay, as there are insufficient data in children to recommend one test over the other. Consequently, targeted preventive chemotherapy is highly recommended for all individuals with persistent M. tuberculosis-specific immune responses undergoing TNF antagonist therapy as it significantly reduces the risk of progression to TB. This TBNET consensus statement summarises current knowledge and expert opinions and provides evidence-based recommendations to reduce the TB risk among candidates for TNF antagonist therapy.KEYWORDS: Interferon-c release assay, tuberculin skin test, tuberculosis, tumour necrosis factor T umour necrosis factor (TNF) and TNF receptors play a key role in mediating immune responses in acute and chronic inflammation [1][2][3]. Over the past decade, TNF antagonists in the form of anti-TNF monoclonal antibodies or TNF fusion protein have become an invaluable treatment against chronic inflammatory diseases, such as rheumatoid arthritis, psoriasis and psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis and inflammatory bowel disease [4][5][6][7]. Tuberculosis (TB) is a granulomatous disease caused by infection with Mycobacterium tuberculosis.Most of the individuals who are thought to have become infected with M. tuberculosis will never develop TB due to the control exercised by the host immune system [8,9]. One of the key cytokines in the immune response against infection with M. tuberculosis is TNF, which is also critical for the integrity of the granuloma [10]. Individuals who are being treated with anti-TNF therapies are at increased risk of developing TB. Following TNF antagonist therapy, the relative risk for TB is increased 1.6-25.1 times, depending on the clinical setting and the TNF antagonist used [4,7,11,12]. The majority of cases of TB related to TNF antagonist therapies occur in close temporal proximity to

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“…В исследовании аргентинских ревматологов прове-ден анализ эффективности анти-ФНО-терапии у больных с сЮИА, и доказано, что вероятность развития ремиссии выше у пациентов без системных проявлений на момент назначения блокаторов ФНО ␣ [27].…”

Section: Discussionunclassified

Adalimumab in Treatment of Systemic Juvenile Idiopathic Arthritis

Денисова¹,

Alekseeva²,

Исаева³

et al. 2013

Vopr. sovr. pediatr.

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ВВЕДЕНИЕ Ювенильный идиопатический артрит (ЮИА) -тяже-лое, хроническое, неуклонно прогрессирующее заболе-вание, в основе развития которого лежит активация кле-точного и гуморального звена иммунитета. Иммунное воспаление приводит к развитию хронического сино-вита и экстраартикулярных проявлений, результатом которых нередко становится полиорганная недостаточ-ность, деструкция хрящевой и костной ткани суставов. Подобные изменения являются причиной инвалидиза-ции, а в некоторых случаях -смерти пациентов [1].Контроль течения ЮИА достигается только примене-нием патогенетической терапии и подразумевает пода-вление активности воспалительного синовита, макси-мальное восстановление функции суставов, замедление прогрессирования деструктивных изменений в суста-вах, контроль системных проявлений болезни, а так-же купирование боли и уменьшение психологических ограничений, связанных с заболеванием. В настоящее время к противоревматической терапии предъявляются требования достижения ремиссии или хотя бы очень низкой активности болезни [2][3][4].

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Clinical Remission in Patients with Systemic Juvenile Idiopathic Arthritis Treated with Anti-Tumor Necrosis Factor Agents

Abstract: Twenty-four percent of patients with systemic JIA experienced remission with anti-TNF therapy, but only 13% experienced sustained benefit.

Cited by 75 publications

References 18 publications

Remission in Juvenile Idiopathic Arthritis: Current Facts

Remission in Juvenile Idiopathic Arthritis: Current Facts

The risk of tuberculosis related to tumour necrosis factor antagonist therapies: a TBNET consensus statement

Adalimumab in Treatment of Systemic Juvenile Idiopathic Arthritis

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