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EXPERIENCE OF CLINICAL USE OF RITUXIMAB IN PATIENT WITH SYSTEMIC JUVENILE ARTHRITIS (A CASE REPORT)

Abstract

The case of early onset and severe course of systemic juvenile rheumatoid arthritis refractory to classic immunosuppressive agents and blockers of tumor necrosis factor (TNF) is presented in this article. Successful clinical use of biological agent rituximab was described. extraarticular symptoms of disease were stopped by 6 week of treatment, and acute inflammatory alteration of articulations was reduced by 16 week, the range of motions was completely restored. This case report demonstrates high activity of rituximab. A clinical and laboratory remission of disease in patient with severe course of systemic juvenile rheumatoid arthritis continues for a 32 weeks.
Key words: children, juvenile rheumatoid arthritis, rituximab.

About the Authors

E.I. Alexeeva
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


E.L. Semikina
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


T.M. Bzarova
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


S.I. Valieva
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


R.V. Denisova
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


A.O. Lisitsin
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


E.Yu. Gudkova
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


S.S. Akulova
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


E.A. Kopyl'tsova
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


References

1. Бзарова Т.М, Алексеева Е.И., Петеркова В.А. Роль факторов болезни и факторов противоревматической терапии в развитии низкорослости у детей, страдающих ювенильным ревматоидным артритом. Вопросы современной педиатрии. 2006; 5 (5): 13–18.

2. Johnson P., Glennie M. The mechanism of action of rituximab in the elimination of tumor cells. Semin. Oncol. 2003; 2 (30): 3–8.

3. Насонов Е.Л. Новые направления терапии ревматоидного артрита: перспективы применения моноклональных антител к В лимфоцитам (ритуксимаб). Русский медицинский журнал. 2006; 4 (25): 1–4.

4. Edwards J., Cambridge G. Sustained improvement in rheumatoid arthritis following a protocol designed to deplete В lymphocytes. Rheumatology (Oxford). 2001; 40: 205–211.

5. Leandro M., Edwards J., Cambridge G. Clinical outcome in 22 patients with rheumatoid arthritis treated with В lymphocyte depletion. Ann. Rheum. Dis. 2002; 61: 883–888.

6. De Vita S., Zaja F., Sacco S. et al. Efficacy of selective В cell blockade in the treatment of rheumatoid arthritis. Arthritis Rheum. 2002; 46: 2029–2033.

7. Kramrn H., Hansen K., Gowing E. et al. Successful therapy of rheumatoid arthritis with rituximab. Renewed interest in the role of В ceils in the pathogenesis of rheumatoid arthritis. J. Clin. Rheumatol. 2004; 10: 28–32.

8. Kneitz C., Wilhelm M., Tony H. Improvement of refractory rheumatoid arthritis after depletion of B cells. Scand. J. Rheumatol. 2004; 33: 82–86.

9. Cambridge G., Leandro M., Edwards J. et al. Serologic changes following В lymphocyte depletion therapy for rheumatoid arthritis. Arthritis Rheum. 2003; 48: 2146–2154.

10. Насонов Е.Л. Перспективы применения моноклональных антител к В лимфоцитам (ритуксимаб) при ревматоидном артрите. Клин. фармакология и терапия. 2006; 1 (5): 55-58.

11. Edwards C., Szczepanski L., Szechinski J. et al. Efficacy of B–cell Targeted therapy with rituximab in patients with rheumatoid arthritis. New Engl. J. Med. 2005; 350: 2572–2581.

12. Emery P., Fleishmann R., Filipowicz–Sospowska A. et al. for the DANCER Study group. The Efficacy and safety of rituximab in patients with active rheumatoid arthritis despite methotrexate treatment. Results of a phase lib randomized, double-blind, placebo-controlled dose-range trial. Arthritis Rheum. 2006; 54: 1390–1400.

13. Алексеева Е.И, Бзарова Т.М., Семикина Е.Л. и др. Опыт применения ритуксимаба у больной с системным ювенильным ревматоидным артритом. Вопросы современной педиатрии. 2006; 5 (6): 96–100.

14. Алексеева Е.И., Литвицкий П.Ф. Ювенильный ревматоидный артрит. Этиология. Патогенез. Клиника. Алгоритмы диагностики и лечения. Руководство для врачей, преподавателей, научных сотрудников. Под общей ред. А.А. Баранова. М. 2007. С. 325–339.

15. Алексеева Е.И., Бзарова Т.М., Валиева С.И. и др. Ритуксимаб: новые возможности лечения тяжелого рефрактерного ювенильного артрита. Вопросы современной педиатрии. 2008; 7 (2): 22–30.


Review

For citations:


Alexeeva E., Semikina E., Bzarova T., Valieva S., Denisova R., Lisitsin A., Gudkova E., Akulova S., Kopyl'tsova E. EXPERIENCE OF CLINICAL USE OF RITUXIMAB IN PATIENT WITH SYSTEMIC JUVENILE ARTHRITIS (A CASE REPORT). Current Pediatrics. 2008;7(3):79-85.

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ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)