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BIOLOGIC THERAPY IN PEDIATRIC RHEUMATOLOGY

Abstract

The article presents data on unique worldwide experience of biologic agents use in pediatric rheumatology. 433 children with different types of juvenile arthritis (JA) were treated with biologic drugs in Rheumatological Department of Scientific Center of Children’s Health, Russian Academy of Medical Sciences from November 2002 to September 2010: 270 patients received infliximab, 74 — adalimumab, 55 — rituximab, 34 — tocilizumab. Results of a study showed that differentiated biological therapy unlike classic immunosuppressive agents (methotrexate, cyclosporine, leflunomide, etc.) results in clinical and laboratory remission in 70% patients with JA and decrease of disease’s activity in 20% of children in one year. Treatment with genetically engineered biologic drugs increase quality of life of children with JA and their families, provides normal growth and development of patients, and changes a prognosis of this previously incurable autoimmune disease.

About the Authors

A. A. Baranov
Scientific Center of Children’s Health, Russian Academy of Medical Sciences, Moscow I.M. Sechenov First Moscow State Medical University


Ye. I. Alekseyeva
Scientific Center of Children’s Health, Russian Academy of Medical Sciences, Moscow I.M. Sechenov First Moscow State Medical University
Russian Federation


S. I. Valiyeva
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


Ye. G. Chistyakova
Scientific Center of Children’s Health, Russian Academy of Medical Sciences, Moscow I.M. Sechenov First Moscow State Medical University
Russian Federation


T. V. Sleptsova
Scientific Center of Children’s Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


Ye. V. Mitenko
Scientific Center of Children’s Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


References

1. Cassidy J., Petty R. Texbook of paediatric rheumatology. — Elsevier Saunders, 2005.

2. Алексеева Е. И., Литвицкий П. Ф. Ювенильный ревматоидный артрит: этиология, патогенез, клиника, алгоритмы диагностики и лечения. — М.: Веди, 2007. — 368 с.

3. Horneff G., Augustin S. Medical treatment of juvenile idiopathic arthritis // Med. Monatsschr. Pharm. — 2008; 31 (9): 326–336.

4. Hashkes P. J., Laxer R. M Medical treatment of juvenile idiopathic arthritis // JAMA. — 2005; 294: 1671–1684.

5. Minden K., Niewerth M., Listing J. et al. Long-term outcome in patients with juvenile rheumatoid arthritis // Arthritis Rheum. — 2002; 46: 2392–2401.

6. Feldman M., Brennan F., Maini R. N. Role of cytokines in rheumatoid arthritis // Annu. Rev. Immunol. — 1996; 14: 397–440.

7. Насонов Е. Л. Фармакотерапия ревматоидного артрита в эру генно-инженерных биологических препаратов // Терапевтический архив. — 2007; 5: 5–8.

8. Насонов Е. Л. Фармакотерапия ревматоидного артрита — взгляд в 21 век // Клиническая медицина. — 2005; 6: 8–12.

9. Kuek A., Hazleman B. L., Ostor A. J. K. Immune-mediated inflammatory diseases (IMIDs) and biologic therapy: a medical revolution // Postgrad. Med. J. — 2007; 83: 251–269.

10. Насонов Е. Л. Фактор некроза опухоли — новая мишень для противовоспалительной терапии ревматоидного артрита // Русский медицинский журнал. — 2000; 8 (17): 718–722.

11. Ackermann C., Kavanaugh A. Tumor necrosis factor as a therapeutic target of rheumatologic disease // Expert. Opin. Ther. Targets. — 2007; 11: 1369–1384.

12. Smolen J. S., Han C., van der Heijde D. M. et al. Radiographic changes in rheumatoid arthritis patients attaining different disease activity states with methotrexate monotherapy and infliximab plus methotrexate: the impacts of remission and tumour necrosis factor blockade // Ann. Rheum. Dis. — 2009; 68 (6): 823–827.

13. Takeuchi T., Yamanaka H., Inoue E. et al. Retrospective clinical study on the notable efficacy and related factors of infliximab therapy in a rheumatoid arthritis management group in Japan: one-year outcome of joint destruction (RECONFIRM-2J) // Mod. Rheumatol. — 2008; 18 (5): 447–454.

14. Pavelka K., Gatterova J., Tegzova D. et al. Radiographic progression of rheumatoid arthritis in patients from the Czech National Registry receiving infliximab treatment // Clin. Exp. Rheumatol. — 2007; 25 (4): 540–555.

15. Takeuchi T. Indications for and use of biologics in early rheumatoid arthritis based on the evidence // Nippon Rinsho. — 2009; 67 (5): 1043–1049.

16. Van der Kooij S. M., le Cessie S., Goekoop-Ruiterman Y. P. et al. Clinical and radiological efficacy of initial delayed treatment with infliximab plus methotrexate in patients with early rheumatoid arthritis // Ann. Rheum. Dis. — 2009; 68 (7): 1153–1158.

17. Sfikakis P. P. The first decade of biologic TNF antagonists in clinical practice: lessons learned, unresolved issues and future directions // Curr. Dir. Autoimmun. — 2010; 11: 180–210.

18. Ruperto N., Lovell D. J., Cuttica R. et al. Long-term efficacy and safety of infliximab plus methotrexate for the treatment of polyarticular course juvenile rheumatoid arthritis: findings from an open-label treatment extension // Ann. Rheum. Dis. — 2009. URL: http://ard. bmj.com/content/early/2009/04/29/ard.2008.100354.full.pdf

19. Furst D. E., Schiff M. H., Fleischmann R. M. et al. Adahmumab, a fully human anti tumor necrosis factor a monoclonal antibody, and concomitant standard antirheumatic therapy for the treatment of rheumatoid arthritis results of STAR (Safety Trial of Adahmumab in Rheumatoid Arthritis) // J. Rheumatol. — 2003; 30: 2563–2571.

20. Weinblatt M. E., Keystone E. C., Furst D. E. et al. Adalimumab, a fully human anti-tumor necrosis factor a monoclonal antibody, for the treatment of rheumatoid arthritis in patients taking concomitant methotrexate the ARMADA trial // Arthritis Rheum. — 2003; 48: 35–45.

21. Keystone E. C., Kavanaugh A. F., Sharp J. T. et al. Radiographic, clinical, and functional outcomes of treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy a randomized, placebo-controlled, 52-week trial // Arthritis Rheum. — 2004; 50: 1400–1411.

22. Van de Putte L. B., Atkins C., Malaise M. et al. Efficacy and safety of adalimumab as monotherapy in patients with rheumatoid arthritis for whom previous disease modifying antirheumatic drug treatment has failed // Ann. Rheum. Dis. — 2004; 63 (5): 508–516.

23. Katsicas M. M., Russo R. A. Use of adalimumab in patients with juvenile idiopathic arthritis refractory to etanercept and/or infliximab // Clin. Rheumatol. — 2009; 28 (8): 985–8.

24. Feher J., Lengyel G. Effectiveness and safety of biological therapy with adalimumab // Orv. Hetil. — 2009; 150 (26): 1215–22.

25. Duckers G., Niehues T. The importance of biologicals in the treatment of SoJIA // Z. Rheumatol. — 2010; 69 (6): 505–515.

26. Horneff G. Juvenile arthritides // Z. Rheumatol. — 2010; 69 (8): 719–736.

27. Breedveld F. C., Weisman M. H., Kavanaugh A. F. et al. The PREMIER study a multicenter, randomized, double blind clinical trial of combination therapy with adalimumab plus methotrexate versus methotrexate alone or adalimumab alone in patients with early, aggressive rheumatoid arthritis who had not had previous methotrexate treatment // Arthritis Rheum. — 2006; 54: 26–37.

28. Лучихина Е. Л., Каратеев Д. Е., Насонов Е. Л. Первый опыт применения адалимумаба в России: предварительные результаты 24-недельного открытого исследования // Научно-практическая ревматология. — 2008; 5: 28–32.

29. Ruperto N., Lovell D. J., Goodman S. et al. Long-term efficacy and safety of adalimumab in children with juvenile rheumatoid arthritis (JRA): data over two years of treatment in a phase III study. Abstract presented at: 8th Annual European League Against Rheumatism (EULAR 2007), June 13–16. — Barcelona, Spain, 2007. Abstract THU0195.

30. Benezra D., Cohen E., Maftzir G. Uveitis in children and adolescents // Br. J. Ophthalmol. — 2006; 89: 444–448.

31. Biester S., Deuter C., Michels H. et al. Adalimumab in the therapy of uveitis in childhood // Br. J. Ophthalmol. — 2007; 91 (3): 319–324.

32. Zhang Z., Bridges S. L. J. Pathogenesis of rheumatoid arthritis: role of B lymphocytes // Rheum. Dis. Clin. North. Am. — 2001; 27: 335–353.

33. Насонов Е. Л. Новые направления терапии ревматоидного артрита: перспективы применения моноклональных антител к В лимфоцитам (ритуксимаб) // РМЖ. — 2006; 25: 1778–1782.

34. Насонов Е. Л. Перспективы применения ритуксимаба при аутоиммунных заболеваниях человека // РМЖ. — 2007; 15 (26): 1958–1963.

35. Smolen J. S., Betteridge N., Breedveld F. C. et al. Consensus statement on the use of rituximab in patients with rheumatoid arthritis // Ann. Rheum. Dis. — 2007; 66: 143–150.

36. Finckh A., Ciurea A., Brulhart L. et al. B cell depletion may be more effective than switching to an alternative anti-tumor necrosis factor agent in rheumatoid arthritis patients with inadequate response to anti-tumor necrosis factor agents // Arthritis Rheum. — 2007; 56: 1417–1423.

37. Youinou P., Jamin C., Saraux A. B-cell: a logical target for treatment of rheumatoid arthritis // Clin. Exp. Rheumatol. — 2007; 25: 318–328.

38. Browning J. L. B-cell move to centre stage: novel opportunities for autoimmune disease treatment // Nature Rev. — 2006; 5: 564–576.

39. Bizzaro N., Tozzoli R., Shoenfeld Y. Are we at stage to predict autoimmune rheumatic diseases? // Arthritis Rheum. — 2009; 56: 1736–1744.

40. Edwards J. C. W., Cambridge G., Leandro M. J. B-cell depletion therapy in rheumatic disease // Best. Pract. Res. Clin. Rheumatol. — 2006; 20: 915–928.

41. Siddiqui M. A. The efficacy and tolerability of newer biologics agents in rheumatoid arthritis: best current evidence // Curr. Opin. Rheumatol. — 2007; 19 (3): 308–318.

42. Kishimoto T. The biology of interleukin 6 // Blood. — 1989; 74: 1–10.

43. Akira S., Kishimoto T., Taga T. Interleukin 6 in biology and medicine // Adv. Immunol. — 1993; 54: 1–78.

44. Castell J. V., Gomez-Lechon M. J., David M. et al. Recombinant human interleukin 6 (IL-6/BSF-2/HSF) regulates the synthesis of acute phase proteins in human hepatocytes // FEBS Lett. — 1988; 232: 347–350.

45. Bergman G. J., Hochberg M. C., Boers M. et al. Indirect comparison of tocilizumab and other biologic agents in patients with rheuma toid arthritis and inadequate response to disease-modifying anti rheumatic drugs // Semin. Arthritis. Rheum. — 2010; 39 (6): 425–441.

46. Nam J. L., Winthrop K. L., van Vollenhoven R. F. et al. Current evidence for the management of rheumatoid arthritis with biological disease-modifying antirheumatic drugs: a systematic literature review informing the EULAR recommendations for the management of RA // Ann. Rheum. Dis. — 2010; 69 (6): 976–986.

47. Papagoras C., Voulgari P. V., Drosos A. A. Strategies after the failure of the first anti-tumor necrosis factor alpha agent in rheumatoid arthritis // Autoimmun. Rev. — 2010; 9 (8): 574–582.

48. Jones G. The AMBITION trial: tocilizumab monotherapy for rheumatoid arthritis // Expert Rev. Clin. Immunol. — 2010; 6 (2): 189–195.

49. Frey N., Grange S., Woodworth T. Population pharmacokinetic analysis of tocilizumab in patients with rheumatoid arthritis // J. Clin. Pharmacol. — 2010; 50 (7): 754–766. 50. Hirabayashi Y., Ishii T., Harigae H. Clinical efficacy of tocilizumab in patients with active rheumatoid arthritis in real clinical practice // Rheumatol. Int. — 2010; 30 (8): 1041–1048.

50. De Benedetti F. Targeting interleukin 6 in pediatric rheumatic diseases // Curr. Opin. Rheumatol. — 2009; 21 (5): 533–537.

51. Tamura T., Udagawa N., Takahashi N. et al. Soluble interleukin 6 receptor triggers osteoclast formation by interleukin 6 // Proc. Natl. Acad. Sci. USA. — 1993; 90: 11924–11928.

52. Mihara M., Kasutani K., Okazaki M. et. al. Tocilizumab inhibits signal transduction mediated by both mIL-6R and sIL-6R, but not by the receptors of other members of IL-6 cytokine family // Int. Immunopharmacol. — 2005; 5 (12): 1731–1740.

53. Nishimoto N., Yoshizaki K., Maeda K. et al. Toxicity, pharmacokinetics, and dose-finding study of repetitive treatment with the humanized anti-interleukin 6 receptor antibody MRA in rheumatoid arthritis: phase I/II clinical study // J. Rheumatology. — 2003; 30 (7): 1426–1435.

54. Алексеева Е. И., Бзарова Т. М., Валиева С. И. и др. Перспективы анти-ФНО-терапии в ревматологической практике // Вопросы современной педиатрии. — 2008; 7 (1): 56–66.

55. Алексеева Е. И., Алексеева А. М., Валиева С. И. и др. Влияние инфликсимаба на клинические и лабораторные показатели активности при различных вариантах юношеского артрита // Вопросы современной педиатрии. — 2008; 7 (2): 42–54.

56. Алексеева Е. И., Козлова А. Л., Валиева С. И. и др. Эффективность инфликсимаба у больных ювенильным анкилозирующим спондилоартритом // Вопросы современной педиатрии. — 2009; 8 (2): 20–26.

57. Алексеева Е. И., Слепцова Т. В., Валиева С. И. и др. Эффективность и безопасность инфликсимаба у больных ранним ювенильным ревматоидным артритом // Вопросы современной педиатрии. — 2009; 8 (4): 42–50.

58. Лисицин А. О., Алексеева Е. И., Бзарова Т. М. и др. Опыт применения адалимумаба у больной юношеским полиартритом с поражением глаз // Вопросы современной педиатрии. — 2008; 7 (5): 115–120.

59. Алексеева Е. И., Лисицин А. О., Карагулян Н. А. и соавт. Адалимумаб новые возможности лечения ювенильного артрита // Вопросы современной педиатрии. — 2009; 8 (3): 88–94.

60. Алексеева Е. И., Валиева С. И., Бзарова Т. М. и др. Эффективность и безопасность повторных курсов лечения ритуксимабом тяжелого рефрактерного ювенильного ревматоидного артрита // Вопросы современной педиатрии. — 2009; 8 (5): 51–57.


Review

For citations:


Baranov A.A., Alekseyeva Ye.I., Valiyeva S.I., Bzarova T.M., Denisova R.V., Chistyakova Ye.G., Sleptsova T.V., Mitenko Ye.V. BIOLOGIC THERAPY IN PEDIATRIC RHEUMATOLOGY. Current Pediatrics. 2011;10(1):5-16. (In Russ.)

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