Impact of biologics on disease course in systemic onset juvenile idiopathic arthritis

Baris, Hatice Ezgi; Anderson, Edwin L.; Sözeri, Betül; Dedeoğlu, Fatma

doi:10.1007/s10067-018-4297-6

Cited by 16 publications

(11 citation statements)

References 31 publications

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“…Sixteen (88.9%) of our patients responded well to tocilizumab treatment. Furthermore, anakinra and canakinumab are successfully used in patients with resistant sJIA and MAS . We noted the clinical and laboratory response to treatment with anakinra in 20 (74%) patients.…”

Section: Discussionmentioning

confidence: 85%

Prognosis, complications and treatment response in systemic juvenile idiopathic arthritis patients: A single‐center experience

et al. 2019

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Aim Systemic juvenile idiopathic arthritis (sJIA) is a distinctive subtype of JIA characterized by systemic features and poor outcome. We aimed to investigate demographic and clinical features, long‐term treatment response and disease complications in a large sJIA cohort. Methods Patients diagnosed with sJIA followed up at a pediatric rheumatology outpatient department from January 2003 to December 2017 were included. Demographic and clinical features, long‐term treatment response and disease complications were retrospectively collected. Results A total of 168 sJIA patients (51.8% female, 48.2% male) were included: 31.5% with monocyclic, 13.7% polycyclic and 54.8% with persistent clinical course. Corticosteroids were initially used in all patients. Methotrexate was used in 75% and cyclosporine A was used in 17.3% patients. Biological drugs were used in 42.8% patients; etanercept in 29.7%, anakinra in 16%, canakinumab in 16%, tocilizumab in 10% patients. Remission off medication was achieved in 82 (48.8%). Macrophage activation syndrome (MAS) was present in 11.9%, growth retardation in 11.3% patients. Eight percent (4/50) of patients had low bone mineral density. Three patients (1.78%) died due to MAS secondary multiorgan insufficiency and infection. Conclusion The disease is characterized with diverse clinical presentation and possibly severe complications. MAS complicated with multiorgan insufficiency is the major mortality factor. Corticosteroids represent the mainstay of the initial treatment. In patients resistant to classic treatment, biological drugs should be timely introduced.

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Section: Discussionmentioning

confidence: 85%

Prognosis, complications and treatment response in systemic juvenile idiopathic arthritis patients: A single‐center experience

et al. 2019

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“…The prognosis of SoJIA is largely dependent upon the disease course. Long-term outcome studies have indicated that patients with SoJIA with polycyclic or persistent disease course display greater disability, weakness, and disease damage than those with monocyclic disease course [2]. Therefore, detecting disease course in its early stage may be essential to the management of SoJIA.…”

Section: Discussionmentioning

confidence: 99%

“…Systemic-onset juvenile idiopathic arthritis (SoJIA) is a particular type of juvenile arthritis affecting children younger than 16 years of age, distinguished from the other subtypes of juvenile idiopathic arthritis (JIA) for its extra-articular features, such as spiking fever, evanescent rash, and serositis with elevated laboratory parameters of inflammation [1]. SoJIA is exceptional with its systemic features, which broaden the differential diagnosis to infections, malignancy, and Kawasaki disease [2]. Adult-onset Still's disease (AOSD), a systemic inflammatory disorder shared clinical similarities with SoJIA, is also known as the adult form of SoJIA [3].…”

Section: Introductionmentioning

confidence: 99%

The Association of Serum IL-10 Levels with the Disease Activity in Systemic-Onset Juvenile Idiopathic Arthritis Patients

Duan

et al. 2021

Mediators of Inflammation

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Objectives. Interleukin-10 (IL-10) has been suggested as a biomarker of disease activity in patients with adult-onset Still’s disease (AOSD). In this study, we evaluated the serum IL-10 levels and investigated its clinical relevance in systemic-onset juvenile idiopathic arthritis (SoJIA). Methods. IL-10 levels were determined in 21 patients diagnosed with SoJIA and 35 patients with fever diseases which were suspected as SoJIA, and IL-10 levels were compared between SoJIA patients with regard to disease activity, disease courses, and other biomarkers. Results. Patients with SoJIA had significantly higher levels of IL-10 compared to patients with other febrile diseases. The serum levels of IL-10 were significantly higher in active SoJIA compared to inactive and positively correlated with known disease activity markers such as erythrocyte sedimentation rate (ESR), C-reactive protein level (CRP), ferritin (FER), and IL-6 levels. Moreover, the levels of IL-10 at diagnosis were significantly higher in SoJIA patients with a nonmonocyclic pattern than in patients with a monocyclic pattern. Compared to CRP, ESR, FER, and IL-6, IL-10 levels were superior in predicting monocyclic patients from nonmonocyclic patients. Conclusion. Compared to other febrile diseases, SoJIA patients have markedly higher levels of IL-10 which may assist with diagnosis. And a clear association of serum IL-10 levels with disease activity and disease courses in SoJIA was found. These results suggest that serum IL-10 might be a reliable clinical marker in SoJIA.

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“…Etanercept was the first approved biologic in JIA in 1999 [12]. Later, many studies with different biological agents have shown that biologics have improved both physical and functional outcomes and quality of life of the patients and also of the families [8,13]. Adalimumab and tocilizumab were the second and third biologics that were approved to be used in JIA [13,14].…”

Section: Discussionmentioning

confidence: 99%

“…However, with the advent of newer treatment modalities remission with or without medication or clinically inactive disease are the main aims of the treatment by treat to target approach in JIA. Especially with the introduction of biologics to the treatment armamentarium of JIA, achieving remission earlier and preventing chronic sequel is more attainable than before [7][8][9]. Biologics are disease-modifying anti-rheumatic drugs (DMARDs) manufactured based on the cytokines that are involved in the disease pathogenesis.…”

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confidence: 99%

The necessity, efficacy and safety of biologics in juvenile idiopathic arthritis

Çakan¹

2019

North Clin Istanbul

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J uvenile idiopathic arthritis (JIA) is the most common cause of chronic arthritis in children. JIA is arthritis of unknown etiology that begins before the 16th birthday and persists for at least six weeks. JIA is a diagnosis of exclusion and other causes of chronic arthritis should have been excluded before calling a child as having JIA [1-3]. JIA is not a single disease but rather a group of disorders as having chronic arthritis a common feature. Currently used International League of Associations for Rheumatology (ILAR) classification criteria divides JIA into seven subtypes as follows: oligoarticular (persistent or extended) JIA, enthesitis-related arthritis (ERA), ABSTRACT OBJECTIVE: Juvenile idiopathic arthritis (JIA) is the most common cause of chronic arthritis in children. Biologics have changed the faith of children with rheumatic diseases. The main objective of this study was to demonstrate the rate of usage, efficacy and safety of biologics in JIA subtypes. METHODS: This retrospective observational cohort study was conducted between May 2010 and September 2017. All children with the diagnosis of JIA and children under a biological agent treatment were recorded into the local registry system. Age, gender, JIA subtype, medications used, the clinical status of the patient, tuberculosis screening results, and side effects observed under biologics were retrieved from the registry. RESULTS: There were 405 patients with the diagnosis of JIA in the cohort. Biologics were used in 123 (30.3%) JIA patients. Subtype frequencies of JIA patients were as follows: persistent oligoarticular JIA (33.6%), enthesitis-related arthritis (29.2%), systemic JIA (13%), rheumatoid factor (RF)-negative polyarticular JIA (13%), extended oligoarticular JIA (4.2%), RF-positive polyarticular JIA (3.4%), psoriatic arthritis (1.8%) and unclassified arthritis (1.8%). The rate of biologic use was high in extended oligoarticular JIA (64.7% of the cases), RF-positive polyarticular JIA (57.1%), psoriatic arthritis (57.1%), RFnegative polyarticular JIA (41.5%), and in systemic JIA (39.6%). Enthesitis-related arthritis (27.1%), persistent oligoarticular JIA (17.6%) and unclassified arthritis (16.6%) patients were the cases that needed a biologic agent in the last order. At the last control, 78.9% of the cases were in remission, while 21.1% of them were active despite biologic treatment. Isoniazid prophylaxis was used in 30.8% of the patients. None of the patients developed active tuberculosis infection under prophylaxis. Adverse events were observed in 18.6% of patients under biologics as recurrent uncomplicated upper respiratory tract infections being the most common. CONCLUSION: Biologics are safe and effective treatment options in children with JIA. Most of the JIA patients with polyarticular involvement require biologics earlier in the disease course. The risk of tuberculosis infection seems not to be increased after appropriate screening and prophylaxis.

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Impact of biologics on disease course in systemic onset juvenile idiopathic arthritis

Cited by 16 publications

References 31 publications

Prognosis, complications and treatment response in systemic juvenile idiopathic arthritis patients: A single‐center experience

Prognosis, complications and treatment response in systemic juvenile idiopathic arthritis patients: A single‐center experience

The Association of Serum IL-10 Levels with the Disease Activity in Systemic-Onset Juvenile Idiopathic Arthritis Patients

The necessity, efficacy and safety of biologics in juvenile idiopathic arthritis

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