EFFICACY OF ETANERCEPT TREATMENT AS A SECOND TNF α INHIBITOR IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS AND PRIMARY AND SECONDARY INEFFICIENCY OR INTOLERANCE OF INFLIXIMAB

The aim of the study was to assess the efficacy and safety of etanercept treatment in combination with methotrexate in 32 patients with juvenile idiopathic arthritis and primary and secondary inefficiency of intolerance of infliximab. In 1 month after the switching to etanercept the improvement was achieved in 84% of patients, 50% improvement — in 66%, 70% — in 55% according to the ACR_pedi criteria. In 6 months of treatment non-active stage was registered in all the patients. Remission stage was established in 85% of children in 9 months, in all the patients — in 12 months. Etanercept was well-tolerated and the majority of side-effects were mild or moderate, reversible and did not interfere the treatment.

1. Lee D. M., Weinblatt M. E. Rheumatoid arthritis. Lanсet. 2001; 358: 903–911.

2. Насонов Е. Л. Фактор некроза опухоли альфа — новая мишень для противовоспалительной терапии ревматоидного артрита. РМЖ. 2000; 8 (17): 718–722.

3. Hehlgans T., Mannel D. N. The TNF–TNF receptors system. Biol. Chem. 2002; 383: 1581–1585.

4. MacEwan D. J. TNF receptor subtype signaling: differences and cellular consequences. Cell Signal. 2002; 14: 477–492.

5. Chen G., Goeddel D. V. TNF-RI signaling: a beautiful pathway. Science. 2002; 296: 1634–1635.

6. Каратеев Д. Е. Современный взгляд на проблему быстропрогрессирующего ревматоидного артрита. Совр. ревматол. 2010; 2: 37–42.

7. Сигидин Я. А., Лукина Г. В. Биологическая терапия в ревматологии. 2-е изд., доп. М.: Практическая медицина. 2009. 245 с.

8. Bergman M., Furfaro N. Individualizing therapy for rheumatoid arthritis: New strategies for maximizing treatment outcomes. 2010 PCE Updates in Rheumatology. 2010; 3 (2): 1–12.

9. Smolen J., Aletaha D., Bijlsma J. W. J. et al. Treating rheumatoid arthritis to target: recommendations of an international task force. Ann. Rheum. Dis. 2010; 69: 631–637.

10. Денисова Р. В., Алексеева Е. И., Альбицкий В. Ю. Качество жизни больных ювенильным ревматоидным артритом в условиях лечения химерными моноклональными антителами к ФНО а. Вопр. совр. педиатрии. 2009; 8 (3): 18–26.

11. Abe T., Takeuchi T., Miyasaka N. A multicenter, double-blind, randomized, placebo controlled trial of infliximab combined with low dose methotrexate in Japanese patients with rheumatoid arthritis. J. Rheumatol. 2006; 33 (1): 37–43.

12. Van der Laken C. J., Voskuyl A. E., Roos J. C. Imaging and serum analysis of immune complex formation of radiolabelled infliximab and anti-infliximab in responders and non-responders to therapy for rheumatoid arthritis. Ann. Rheum. 2007; 66: 253–256.

13. Bukhari M. A., Wiles N. J., Lunt M. et al. Influence of diseasemodifying therapy on radiographic outcome in inflammatory polyarthritis at five years: results from a large observational inception study. Arthritis Rheum. 2003; 48: 46–53.

14. Cassidy J. T., Petty R. E., Laxer R. M., Lindsley C. B. Textbook of pediatric rheumatology. 6th ed. Philadelphia: Saunders Elsevier. 2010. 794 p.

15. Nam J., Villeneuve E., Emery P. The role of biomarkers in the management of patients with rheumatoid arthritis. Curr. Rheumatol. Rep. 2009; 11: 371–377.

16. Deighton C., O’Mahony R., Tosh J. et al. Management of rheumatoid arthritis: summary of NICE guidance. BMJ. 2009; 338: 702.

17. Goekoop-Ruiterman Y. P. M., de Vries-Bouwstra J. K., Allaart C. F. et al. Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): a randomized, controlled trial. Arthritis Rheum. 2005; 52: 3381–3390.

18. Soubrier M., Puechal X., Sibilia J. et al. Evaluation of two strategies (initial methotrexate monotherapy vs its combination with adalimumab) in management of early active rheumatoid arthritis: data from the GUEPARD trial. Rheumatology (Oxford). 2009; 48: 1429–1434.

19. van Vollenhoven R. F. Treatment of rheumatoid arthritis: state of the art 2009. Nat. Rev. Rheumatol. 2009; 5: 531–541.

20. Hyrich K. L., Lunt M., Watson K. D. et al. British Society for Rheumatology Biologics Register. Outcomes after switching from one anti-tumor necrosis factor alpha agent to a second anti-tumor necrosis factor alpha agent in patients with rheumatoid arthritis: results from a large UK national cohort study. Arthritis Rheum. 2007; 56: 13–20.

21. Pincus T., Yazici Y., van Vollenhoven R. Why are only 50% of courses of anti-tumor necrosis factor agents continued for only 2 years in some setting? Need for longterm observations in standart care to complement clinical trials. J. Rheumatol. 2006; 33: 2372–2375.

22. Tanjala P., Vahasalo P., Honkanen V. et al. Drug survival of the first and second course of anti-tumour necrosis factor agents in juvenile idiopathic arthritis. Ann. Rheum. Dis. 2009; 68: 552–557.

23. Otten M. N., Prince F. H., Armbrust W. et al. Effectiveness and safety of a second and third biological agent after failing etanercept in juvenile idiopathic arthritis: results from the Dutch National ABC Register. ARD Online First. Published on June 23, 2012 as 10.1136/annrheumdis –2011–201060.

24. Алексеева Е. И., Бзарова Т. М., Валиева С. И. Эффективность и безопасность человеческих моноклональных антител к ФНО у детей с ювенильным идиопатическим артритом при первичной и вторичной неэффективности других генно-инженерных биологических препаратов. Вопр. совр. педиатрии. 2012; 11 (4): 82–88.

25. Коваленко В. М., Шуба Н. М., Борткевич О. П. и др. Застосування антагоністів фактора некрозу пухлин в лікуванні хворих на ревматичні захворювання суглобів (ревматоїдний артрит, анкілозивний спондилоартрит, псоріатична артропатія). Метод. Рекомендації. Київ. 2008. 40 с.

26. Ostergaard M., Unkerskov J., Linde L. et al. Low remission rates but long drug survival in rheumatoid arthritis patients treated with infliximab or etanercept: results from the nationwide Danish DANBIOdatabase. Scand J. Rheumatol. 2007; 36: 151–154.

27. Blom M., Kievit W., Fransen J. et al. The reason for discontinuation of the first tumor necrosis factor (TNF) blocking agent does not influence the effect of a second TNF blocking agent in patients with rheumatoid arthritis. J. Rheumatol. 2009; 36: 2171–2177.

28. Scrivo R., Conti F., Spinelli F. R. et al. Switching between TNFalpha antagonists in rheumatoid arthritis: personal experience and review of the literature. Reumatismo. 2009; 61: 107–117.

29. Hyrich K. L., Lunt M., Watson K. D. et al. British Society for Rheumatology Biologics Register. Outcomes after switching from one anti-tumor necrosis factor alpha agent to a second anti-tumor necrosis factor alpha agent in patients with rheumatoid arthritis: results from a large UK national cohort study. Arthritis Rheum. 2007; 56: 13–20.

30. Smolen J. S., Kay J., Doyle M. K. et al.; GO-AFTER study investigators. Golimumab in patients with active rheumatoid arthritis after treatment with tumour necrosisin patients with active rheumatoid arthritis after treatment with tumour necrosis factor alpha inhibitors (GO-AFTER study): a multicentre, randomised, double-blind, placebo-controlled, phase III trial. Lancet. 2009; 374: 210–221.

31. Horneff G., De Bock F., Foeldvari I., Girschick H. J., Michels H., Moebius D. et al. Safety and efficacy of combination of etanercept and methotrexate compared to treatment with etanercept only in patients with juvenile idiopathic arthritis (JIA): preliminary data from the German JIA Registry. Ann. Rheum. Dis. 2009; 68 (4): 519–525.

32. Lovell D. J., Reiff A., Ilowite N. T., Wallace C. A. et al. Safety and efficacy of up to eight years of continuous etanercept therapy in patients with juvenile rheumatoid arthritis. Arthritis Rheum. 2008; 58 (5): 1496–1504.