Preview

Current Pediatrics

Advanced search

CLINICAL CASE OF USING TOCILIZUMAB FOR A FEMALE PATIENT WITH AN EARLY DEBUT OF SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS

https://doi.org/10.15690/vsp.v13i5.1159

Abstract

The article describes a case of an early debut and difficult treatment of systemic juvenile idiopathic arthritis resistant to peroral glucocorticoids. The described clinical example demonstrates the successful use of tocilizumab, a monoclonal antibody drug, against interleukin-6 receptors. After the 1st drug infusion the systemic manifestations of the disease were alleviated, by the 6th week of the tocilizumab treatment inflammatory changes in the joints were reduced, and by the 16th week the inactive stage of the disease was registered, which made it possible to stop the administration of glucocorticoids per os. Duration of remission of articular syndrome and extra-articular manifestations was 10 months.

About the Authors

О. L. Lomakina
Scientific Centre of Children Health, Moscow
Russian Federation


Ye. I. Alekseyeva
Scientific Centre of Children Health, Moscow; I.M. Sechenov First Moscow State Medical University
Russian Federation


S. I. Valieva
Scientific Centre of Children Health, Moscow
Russian Federation


Т. М. Bzarova
Scientific Centre of Children Health, Moscow
Russian Federation


R. V. Denisova
Scientific Centre of Children Health, Moscow
Russian Federation


Т. V. Sleptsova
Scientific Centre of Children Health, Moscow
Russian Federation


References

1. Cassidy J. T., Petty R. E., Laxer R. M., Lindsley C. B. Textbook of pediatric rheumatology. 6th edn. Philadelphia: Saunders Elsevier. 2011. 794 p.

2. Баранов А. А., Алексеева Е. И., Денисова Р. В., Валиева С. И., Бзарова Т. М., Исаева К. Б., Слепцова Т. В., Митенко Е. В., Чистякова Е. Г., Фетисова А. Н. Ретроспективный анализ эффективности и безопасности тоцилизумаба у больных тяжелым системным ювенильным идиопатическим артритом: 12 месяцев наблюдения. Вопросы современной педиатрии. 2013; 12 (2): 26–34.

3. 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.

4. Kelly A., Ramanan A. V. Recognition and management of macrophage activation syndrome in juvenile arthritis. Curr. Opin. Rheumatol. 2007; 19: 477–481.

5. Cortis E., Insalaco A. Macrophage activation syndrome in juvenile idiopathic arthritis. Acta Paediatr. Suppl. 2006; 95: 38–41.

6. Heliovaara M. K., Teppo A. M., Karonen S. L., Tuominen J. A., Ebeling P. Plasma IL-6 concentration is inversely related to insulin sensitivity, and acute phase proteins associate with glucose and lipid metabolism in healthy subjects. Diabetes Obes. Metab. 2005; 7: 729–736.

7. European Medicines Agency. RoActemra (tocilizumab): summary of product characteristics [online]. URL: http://www.ema.europa.eu/ docs/en_GB/document_library/EPAR.

8. Chugai Pharmactutical Co. Actemra, a humanized antihuman IL-6 receptor monoclonal antibody obtained approval for indications of rheumatoid arthritis, polyarticular-course juvenile idiopathic arthritis and systemic-onset juvenile idiopathic arthritis [media release]. URL: http://www.chugai-pharm.co.jp/hc/ss/english/index.html

9. Imagawa T., Ozawa R., Miyamae T., Mori M., Nerome Y., Imanaka N. Efficacy and safety in 48-week treatment of tocilizumab in children with polyaticular course JIA with polyarticlar or olygoarticular onset. Ann. Rheum. Dis. 2007; 66 (Suppl. II): 550.

10. Yokota S., Imagawa T., Miyamae T. Safety and efficacy of up to three years of continuous tocilizumab therapy in children with systemic-onset juvenile idiopathic arthritis [SAT0536]. Ann. Rheum. Dis. 2009; 68 (Suppl. 3): 715.

11. Inaba Y., Aoki C., Ozawa R. Radiologic evaluation of large joints during tocilizumab treatment in children with systemic juvenile idiopathic arthritis [SAT0555]. Ann. Rheum. Dis. 2009; 68 (Suppl. 3): 720.

12. Yokota S., Imagawa T., Mori M., Miyamae T., Aihara Y., Takei S., Iwata N., Umebayashi H., Murata T., Miyoshi M., Tomiita M., Nishimoto N., Kishimoto T. Efficacy and safety of tocilizumab in patients with systemic-onset juvenile idiopathic arthritis: a randomized, double-blind, placebo-controlled, withdrawal phase III trial. Lancet. 2008; 371: 998–1006.

13. Quartier P., Maire D., Souabni L. Efficacy and safety of tocilizumab in systemic onset juvenile idiopathic arthritis in french centers [FRI0462]. Ann. Rheum. Dis. 2009; 68 (Suppl. 3): 506.

14. De Benedetti F., Brunner H. I., Ruperto N., Kenwright A., Wright S., Calvo I., Cuttica R., Ravelli A., Schneider R., Woo P., Wouters C. Efficacy and safety of Tocilizumab in Patients with Systemic Juvenile Idiopathic Arthritis (SJIA): 12-week data from the phase 3 tender trial [OP0273]. Ann. Rheum. Dis. 2010; 69 (Suppl. 3): 146.

15. De Benedetti F., Brunner H. I., Ruperto N., Kenwright A., Wright S., Calvo I., Cuttica R., Ravelli A., Schneider R., Woo P., Wouters C. Efficacy and Safety of Tocilizumab (TCZ) in Patients with Systemic Juvenile Idiopathic Arthritis (sJIA): TENDER 52-Week Data [OP0006]. Ann. Rheum. Dis. 2011; 70 (Suppl. 3): 67.


Review

For citations:


Lomakina О.L., Alekseyeva Ye.I., Valieva S.I., Bzarova Т.М., Denisova R.V., Sleptsova Т.V. CLINICAL CASE OF USING TOCILIZUMAB FOR A FEMALE PATIENT WITH AN EARLY DEBUT OF SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS. Current Pediatrics. 2014;13(5):100-103. (In Russ.) https://doi.org/10.15690/vsp.v13i5.1159

Views: 889


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