Comparative efficacy and safety of advanced drug therapy in children with juvenile rheumatoid arthritis

Giannini, Edward H.; Cassidy, James T.; Brewer, Earl J.; Shaikov, Alexander; Maximov, Alexei; Кузьмина, Н. Н.

doi:10.1016/s0049-0172(05)80025-3

Cited by 59 publications

(22 citation statements)

References 39 publications

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“…Likert and VAS measurements of juvenile IIM global disease activity and damage were highly correlated and were comparable in responsiveness. Although physician global assessments of disease activity have often been highly responsive measures in other rheumatic diseases (16,17,32), it is likely that only moderate sensitivity to change was observed in this study due to variability in disease duration, with many patients who had little capacity for change in their disease severity due to longstanding disease. In the analysis of a subset of juvenile IIM patients who were within 7 months of diagnosis at study entry, the physician global assessment of disease activity was similar in responsiveness to the CHAQ in a comparable cohort of patients with early juvenile DM (4).…”

Section: Discussionmentioning

confidence: 89%

“…Diminished sensitivity to change in global assessments may also be due to the diverse therapeutic approaches used in the population under study. The responsiveness of physician global assessments varies with different types of medications in clinical trials of adult and juvenile rheumatoid arthritis patients (17,32). Comparison of the sensitivity to change in global disease activity assessments with other measures of juvenile IIM disease activity, such as manual muscle strength testing, serum muscle enzyme levels, and CHAQ scores, is in progress as part of the collaborative study.…”

Section: Discussionmentioning

confidence: 99%

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Development of validated disease activity and damage indices for the juvenile idiopathic inflammatory myopathies. I. Physician, parent, and patient global assessments

Rider¹,

Miller²,

Feldman³

et al. 1997

Arthritis & Rheumatism

134

102

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in cooperation with the JUVENILE DERMATOMYOSITIS DISEASE ACTIVITY COLLABORATIVE STUDY GROUP Objective. To determine the reliability, content validity, and responsiveness of physician global assessments of disease activity and damage in the juvenile idiopathic inflammatory myopathies (IIM), and to investigate concordance among physician, parent, and patient global ratings.Methods. Sixteen pediatric rheumatologists rated 10 juvenile IIM paper patient cases for global disease activity and damage, and assessed the importance of 51 clinical and laboratory parameters in formulating their global assessments. Then, 117 juvenile IIM patients were enrolled in a protocol to examine the relationship between Likert and visual analog scale global assessments, their sensitivity to change, and the comparability of physician, parent, and patient global ratings.Results. Pediatric rheumatologists demonstrated excellent interrater reliability in their global assessments of juvenile IIM disease activity and damage (97.7% and 94.7% agreement among raters, respectively), and agreed on a core set of clinical parameters in formulating their judgments. Likert scale ratings correlated with those on a visual analog scale, and both were comparable in responsiveness (standardized response means -0.56 for disease activity, 0. Conclusion. Physician global assessments of juvenile IIM disease activity and damage demonstrated high interrater reliability and were shown to be comprehensive measures. Both physician and parent disease activity assessments should be considered valuable as

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Development of validated disease activity and damage indices for the juvenile idiopathic inflammatory myopathies. I. Physician, parent, and patient global assessments

Rider¹,

Miller²,

Feldman³

et al. 1997

Arthritis & Rheumatism

134

102

View full text Add to dashboard Cite

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“…Применение метотрексата (15 мг/м 2 площади поверхности тела) по-зволяет добиться контроля заболевания у многих паци-ентов с ЮИА [1]. Однако у 30-50% больных имеет место лишь частичный эффект препарата [2][3][4][5][6]. Прорывом в лечении ревматоидного артрита у взрослых и ЮИА стало внедрение в клиническую практику генно-инже-нерных биологических препаратов.…”

Section: Introductionunclassified

Efficiency and Safety of Human Monoclonal Antibodies to TNF-Α in Children With Juvenile Idiopathic Arthritis in Primary and Secondary Ineffectiveness of Other Biologicals

et al. 2013

Annals RAMS

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“…Aproximadamente um terço dos pacientes podem ter a doença controlada com AINEs aliados a programas adequados de fisioterapia e terapia ocupacional, enquanto os demais são candidatos a terapêuticas com drogas modificadoras de doença ou anti-reumáticas (8) . O metotrexato (MTX) é o medicamento de segunda linha de escolha para pacientes com quadro ativo persistente (9,10) . A dose inicial de 10 mg/m 2 /semana pode ser progressivamente aumentada na ausência de resposta (11,12) e pode ser administrada de forma parenteral até 15 mg/m 2 /semana ou 1 mg/kg/dose (13) .…”

Section: Introductionunclassified

O papel dos inibidores do fator de necrose tumoral no tratamento da artrite idiopática juvenil

Martin¹,

Medeiros²,

Goldenstein-Schainberg³

2006

Rev. Bras. Reumatol.

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A artrite idiopática juvenil (AIJ) é uma doença crônica que pode evoluir para uma incapacidade permanente, necessitando muitas vezes de tratamento agressivo. Enquanto alguns pacientes não respondem ao metotrexato ou imunossupressores, outros não os toleram. Nestes casos, o uso dos inibidores de fator de necrose tumoral (TNF) ou anti-TNF é indicado. Conforme demonstrado por estudos multicêntricos e randomizados, o etanercepte apresenta eficácia no controle da doença, com efeito máximo nos primeiros três meses e até dois anos de tratamento contínuo. Não há publicação de estudos controlados com o infliximabe nem com o adalimumabe, mas seus efeitos parecem ser semelhantes aos do etanercepte. Estes agentes são relativamente seguros, podendo ser observadas complicações infecciosas, como a tuberculose e o herpes zoster. Raramente, podem ocorrer eventos auto-imunes, linfoproliferativos e sintomas gerais, como febre e cefaléia. No entanto, é importante salientar que apesar dos inibidores do TNF serem benéficos para muitas crianças com AIJ refratária, seus efeitos colaterais a longo prazo permanecem indefinidos, de forma que sua indicação deve ser criteriosa. Ademais, o alto custo destas drogas limita seu uso, especialmente em nosso país. Palavras INtRODUÇÃOA artrite idiopática juvenil (AIJ) ou artrite reumatói-de juvenil é a doença reumática crônica mais comum na criança na maioria dos países (1) , sendo que 37 a 50% dos pacientes permanecem em atividade clínica ao atingirem a idade adulta (2 ,3, 4) . Fantini et al (5) mostraram que apenas 1/3 dos pacientes seguidos durante dez anos atingiram remissão. A duração cumulativa da atividade de doença é preditiva da gravidade da limitação funcional (6) , já que sua persistência resulta em dor crônica e rigidez, dano articular irreversível, retardo do crescimento e limitação funcional importante (7) , justificando tratamento agressivo precoce. Os antiinflamatórios não-esteroidais (AINEs) ainda constituem a terapia de primeira linha para AIJ, cujo efeito deve ser observado por volta de um mês após seu início (1) . Aproximadamente um terço dos pacientes podem ter a doença controlada com AINEs aliados a programas adequados Rev Bras Reumatol, v. 46, n. 2, p. 126-133, mar/abr, 2006

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Comparative efficacy and safety of advanced drug therapy in children with juvenile rheumatoid arthritis

Cited by 59 publications

References 39 publications

Development of validated disease activity and damage indices for the juvenile idiopathic inflammatory myopathies. I. Physician, parent, and patient global assessments

Development of validated disease activity and damage indices for the juvenile idiopathic inflammatory myopathies. I. Physician, parent, and patient global assessments

Efficiency and Safety of Human Monoclonal Antibodies to TNF-Α in Children With Juvenile Idiopathic Arthritis in Primary and Secondary Ineffectiveness of Other Biologicals

O papel dos inibidores do fator de necrose tumoral no tratamento da artrite idiopática juvenil

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