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EFFECT OF INFLIXIMAB ON DYNAMICS OF FUNCTIONAL CLASS AND RADIOLOGICAL SIGN OF BONE AND CARTILAGINOUS TISSUES ALTERATION OF JOINTS IN PATIENTS WITH DIFFERENT TYPES OF JUVENILE ARTHRITIS

Abstract

An objective of this trial was evaluation of effect of treatment with blocker of tumor necrosis factor infliximab on dynamics of functional class and radiological changes of bone and cartilaginous tissue of joints in children with different clinical types of juvenile arthritis (JA). Infliximab was used according to standard scheme on 0, 2, 6 and then every 8 week by intravenous infusion. Mean single dose of infliximab was 6,8 ± 2,3 mg/kg. All children were treated with immunosuppressive agents (ciclosporin in 6% of patients, methotrexate in 60%, ciclosporin combined with methotrexate — 20%, ciclosporin with leflunomide — 5%, leflunomide with methotreate — 4%) combined with anti cytokine treatment. 7 children were treated with oral glucocorticoids in mean dose 0,37 mg/kg daily. disorders in joint function and structural changes of joints of different severity (radiological sign) were discovered in all patients before starting of treatment with infliximab. Duration of observation was 6 week — 2 years. Authors made a conclusion that treatment with infliximab prevents progressing of bone and cartilaginous destruction in all types of AJ, not depending on intensity of its clinical activity. This medication provides for full functional recovery of joints and elimination of features of disablement in patients with good clinical activity.
Key words: children, juvenile arthritis, infliximab, treatment.

About the Authors

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


A.M. Alekseeva
I.M. Sechenov Moscow Medical Academy
Russian Federation


S.I. Valieva
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


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


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


References

1. Cush J. J. Rheumatoid arthritis. Clin. Symp. 1999; 51: 40.

2. Ройт А., Бростофф Дж., Мейл Д. Иммунология. 2000.

3. Brenann F.M., Feldman M. Cytokines in autoimmunity. Curr. Opin. Immunol. 1992; 4: 754–759.

4. Sewell E., Trentham D. Pathogenesis of rheumatoid arthritis. Lancet. 1993; 341: 283-286.

5. Arend W.P., Dayer J.M. Inhibition of the production and effects of interleukin–1 and tumor necrosis factor α in rheumatoid arthritis. Arthritis Rheum. 1995; 38: 151–160.

6. Moore T.L. Immunopathogenes of juvenile rheumatoid arthritis. Curr. Opin. Rheumatol. 1999; 11: 377–383.

7. Brahn E., Peacock D., Banquero M., Lui D. Effects of tumor necrosis alpha (TNF-α) on collagen arthritis. Lymphokine Cytotine Res. 1992; 11: 253–256.

8. Brennan F.M, Browne K.A., Green P.A., et al. Reduction of serum matrix metalloproteinase 1 and matrix metalloproteinase 3 in rheumatoid arthritis patients following anti-tumor necrosis factor (cA2) therapy. Br. J. Rheumatol. 1997; 36: 643–650.

9. Danks L., Sabokbar A., Gundle R., Athanasou N.A. Synovial macrophage-osteoclast differentiation in inflammatory arthritis. Ann. Rheum. Dis. 2002; 61: 916–921.

10. Насонов Е.Л., Самсонов М.Ю., Тилз Г.П. и др., 1999; Насонов Е.Л., Самсонов М.Ю., Тилз Г.П. и др. Растворимые молекулы адгезии (Р–селектин, ICAM-3) при ревматоидном артрите. Терапевтический архив. 1999; 5: 17–20.

11. Moser R.B., Schleiffenbaum B., Groscurth P., Fehr J. Interleikin 1 and tumor necrosis factor stimulate human vascular endothelial cells to promote transendothelial neutrophil passage. J. Clinic. Invest. 1989; 83: 444–455.

12. Mannel D.N., Echtenacher B. TNF in the inflammatory response. Chem. Immunol. 2000; 74: 141–161.

13. Tak P.P., Taylor P.C., Breedveld F.C. et al. Decrease in cellularity and expression of adhesion molecules by anti-tumor necrosis factor α monoclonal antibody treatment in patients with rheumatoid arthritis. Arthritis Rheum. 1996; 39: 1077–1081.

14. Den Broeder A.A., Joosten L.A., Saxnee T. et al. Long term anti-tumor necrosis factor alpha monotherapy in rheumatoid in rheumatoid arthritis: effects on radiological course and prognostic value of markers of cartilage turnover and endothelial activation. Ann. Rheum. Dis. 2002; 61: 311–318.

15. Shingu M., Nagai Y., Isayama T. et al. The effects of cytokines on metalloproteinase inhibitors (TIMP) and collagenase production by human chondrocytes and TIMP production by synovial cells and endothelial cells. Clin. Exp. Immunol. 1993; 94: 145–149.

16. Black R.A., Rauch C.T., Kozlosky C.J. et al. A metalloproteinase disintegrin that releases tumor-necrosis factor-α from cells. Nature. 1997; 385: 729–733.

17. Barksby H.E., Milner J.M., Patterson A.M. et al. Matrix metalloproteinase 10 promotion of collagenolysis via procollagenase activation: implications for cartilage degration in arthritis. Arthritis Rheum. 2006; 54: 3244–3253.

18. Georgopoulos S., Plows D., Kollias G. Transmembrane TNF is sufficient to induce localized tissue toxicity and chronic inflammatory arthritis in transgenic mice. J. Inflamm. 1996; 46: 86–97.

19. Williams R.O., Malfait A.M., Butler D.M. et al. Combination therapy with DMARDs and biological agents in collagen-induced arthritis. Clin. Exp. Rheumatol. 1999; 17: 115–120.

20. Williams R.O. Collagen-induced arthritis in mice: a major role for tumor necrosis factor-alpha. Methods Mol. Biol. 2006; 361: 265–284.

21. Maini R., St. Clair E.W., Breedveld F. et al. Infliximab (chimeric anti-tumour necrosis factor alpha monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomized phase III trial. ATTRACT Study Group. Lancet. 1999; 4: 1932–1939.

22. Lipsky P.E., van der Heijde D.M.F.M, St Clair E.W. et al. Infliximab and methotrexate in the treatment of rheumatoid arthritis. N. Engl. J. Med. 2000; 343: 1594–1602.

23. Bredveld F.C., Emery P., Keystone E. et al. Infliximab in active early rheumatoid arthritis. Ann. Rheum. Dis. 2004; 63: 149–155.

24. Vis M., Wolbink J., Soesbergen R. et al. Early changes in bone metabolism in patients with rheumatoid arthritis treated with infliximab. Ann. Rheum. Dis. 2002; 61: 51.

25. Алексеева Е.И., Алексеева А.М., Валиева С.И., Бзарова Т.М. Эффективность лечения инфликсимабом резистентных форм ювенильного ревматоидного артрита. Вопросы современной педиатрии. 2006; 5 (2): 20–30.

26. Алексеева Е.И., Алексеева А.М., Валиева С.И., Бзарова Т.М., Денисова Р.В. Влияние инфликсимаба на клинические и лабораторные показатели активности различных вариантах юношеского артрита. Вопросы современной педиатрии. 2008; 7 (2): 42–53.

27. Долгополова А., Бисярина В., Алексеев А. Вопросы ревматологии. 1979; 4: 3–7.

28. Arnet F.C., Edworthy S.M., Bloch D.A., et al. The American Rheumatism Association 1987 revised criteria for classification of rheumatoid arthritis. Arthr. Rheum. 1988; 27: 315–324.

29. Steinbroker Q., Traeger C.H., Batterman R.C. Therapeutic criteria in rheumatoid arthritis. J. Am. Med. Assoc. 1949; 140: 659–662.

30. Sharp J.T., Young D.Y., Bluhm G.B. et al. How many joints in the hands and wrists should be included in a score of the radiological abnormalities used to assess rheumatoid arthritis? Arthritis Rheum. 1985; 28: 1326–1335.

31. van der Heijde D.M.F.M., van´t Hof M.A., Reil P.L.C.M. et al. Judging disease activity in clinical practice in rheumatoid arthritis: first step in the development of disease activity score. Ann. Rheum. Dis. 1990; 49: 916-920.


Review

For citations:


Alexeeva E., Alekseeva A., Valieva S., Bzarova T., Denisova R., Mikhaleva G. EFFECT OF INFLIXIMAB ON DYNAMICS OF FUNCTIONAL CLASS AND RADIOLOGICAL SIGN OF BONE AND CARTILAGINOUS TISSUES ALTERATION OF JOINTS IN PATIENTS WITH DIFFERENT TYPES OF JUVENILE ARTHRITIS. Current Pediatrics. 2008;7(4):30-44.

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