EFFECTIVENESS AND SAFETY OF INFLIXIMAB IN PATIENTS WITH EARLY AND LATE JUVENILE RHEUMATOID ARTHRITIS
Abstract
The article presents results of a study of effectiveness and safety of infliximab — monoclonal antibodies to the tumor necrotizing factor (TNF) in treatment of 100 patients11 months — 17 years old with early and late articular types of juvenile rheumatoid arthritis. The duration of treatment was 3 months — 2 years. Infliximap was delivered intravenously by scheme: infusion on 0, 2nd, 6th weeks and then every 8th week. The single dose of infliximab in patients with early rheumatoid arthritis was 6.7 (5.5; 9.0) mg/kg, with late type — 6.0 (5.0; 7.0) mg/kg of body weight. 102 weeks of treatment with anti-TNF-agent provided development of clinical remission, decrease and normalization of laboratory tests of disease’s activity, total restoration of joint’s function, increase of quality of life (on 97% in patients with early type, and 72% 0 in ones with late type). The drug was abolished in 39 (39%) of patients, 23% — due to the development of secondary inefficiency, and 11% — due to the development of unfavorable effects.
Key words: children, early and late rheumatoid arthritis, treatment, infliximab.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(3):30-42)
About the Authors
Е.I. AlexeevaRussian Federation
T.V. Sleptsova
Russian Federation
S.I. Valieva
Russian Federation
T.M. Bzarova
Russian Federation
R.V. Denisova
Russian Federation
A.O. Lisitsyn
Russian Federation
References
1. Cassidy J., Petty R., eds. Textbook of paediatric rheumatology. 2nd end. New York: Churchill Livigstone. 2002.
2. Алексеева Е.И., Литвицкий П.Ф. Ювенильный ревматоидный артрит: этиология, патогенез, клиника, алгоритмы диагностики и лечения. М.: Веди. 2007.
3. Алексеева Е.И. Ревматические болезни и их влияние на качество жизни детей и их семей. Качество жизни. Медицина. 2008; 1: 14–17.
4. Horneff G., Augustin S. Medical treatment of juvenile idiopathic arthritis. Med. Monatsschr. Pharm. 2008; 31: 326–336.
5. Hashkes P.J., Laxer R.M. Medical treatment of juvenile idiopathic arthritis. JAMA. 2005; 294: 1671–1684.
6. Ravelli A., Martini A. Juvenile idiopathic arthritis. Lancet. 2007; 369: 767–778.
7. Schett G. Review: Immune cells and mediators of inflammatory arthritis. Autoimmunity. 2008; 41: 224–229.
8. Алексеева Е.И., Шахбазян И.Е. Принципы патогенетической терапии тяжелых системных вариантов ювенильного ревматоидного артрита. Аутоиммунные заболевания. М. 2002. 127 с.
9. El–Gabalawy H.S., Lipsky P.E. Why do we not have a cure for rheumatoid arthritis? Arthritis Res. 2004; 4 (2): 297–301.
10. Foster H.E., Marshall N., Myers A., Dunklet P., Griffiths I.D. Outcome in adults with juvenile idiopathic arthritis: a quality of life study. Arthritis Rheum. 2003; 48: 767–775.
11. Lomater C., Gerloni V., Gattinara M., Mazzotti J. Cimaz R., Fantini F. Systemic onset juvenile rheumatoid arthritis: a retrospective study of 80 consecutive patients followed for 10 years. J. Rheumatol. 2000; 27: 491–496.
12. Minden K., Niewerth M., Listing J. et al. Long-term outcome in patients with juvenile rheumatoid arthritis. Arthritis Rheum. 2002; 46: 2392–2401.
13. Woo P., Wilkinson N., Prieur A.M. et al. Open label phase 2 trial of single, ascending doses of MRA in Caucasian children with severe systemic juvenile idiopathic arthritis: proof of principle of efficacy of IL-6 receptor blocade in this type of arthritis and demonstration of prolonged clinical improvement. Arthritis Res. Ther. 2005; 7: 1281–1288.
14. Feldman M., Brennan F., Maini R.N. Role of cytokines in rheumatoid arthritis. Ann. Rev. Immunol. 1996; 14: 397-440.
15. Насонов Е.Л. Фактор некроза опухоли α – новая мишень для противовоспалительной терапии ревматоидного артрита. Российский медицинский журнал. 2000; 8 (17).
16. Bradley J.R. TNF-mediated inflammatory disease. J. Pathol. 2008; 214: 149–160.
17. Ackermann C., Kavanaugh A. Tumor necrosis factor as a therapeutic target of rheumatologic disease. Expert Opin. Ther. Targets. 2007; 11: 1369–1384.
18. 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.
19. 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.
20. Pavelka K., Gatterová J., Tegzová 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.
21. Алексеева Е.И., Бзарова Т.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): 22–29.
22. Алексеева Е.И., Алексеева А.М., Валиева С.И. и др. Влияние инфликсимаба на динамику функционального класса и рентгенологические изменения хрящевой и костной ткани суставов у больных с различными вариантами ювенильного артрита. Вопросы современной педиатрии. 2008; 7 (4): 30–44.
23. Billiau A.D., Cornillie F., Wouters C. Infliximab for systemic onset juvenile idiopathic arthritis: experience in 3 children. J. Rheumatol. 2002; 29: 1111–1114.
24. Honkanen V.E., Tynjala P., Vahasalo P., et al. Infliximab in juvenile arthritis: 1-year follow-up. American College of Rheumatology 66th, Annual Scientific Meeting. New Orleans. 2002. 1272 р.
25. Kimura Y, Imundo LF, Li SC. High dose infliximab in the treatment of resistant systemic juvenile rheumatoid arthritis. American College of Rheumatology 65th, Annual Scientific Meeting. San Francisco. 2001. 1316 р.
26. Vougiouka O., Rizou S., Grafakou O. Infliximab and etanercept in the treatment of juvenile idiopathic arthritis. The Athens experience. Ann. Rheum. Dis. 2001; 60: 1117–1152 (Abstract P. 176).
27. Corona F., Scarazatti M., Dell’erra L., et al. Active refractory juvenile idiopathic arthritis: treatment with infliximab. Efficacy and safety. Ital. J. Pediatr. 2004; 30: 165-168.
28. Mangge H., Heinzl B., Grubbauer H.M., et al. Therapeutic experience with infliximab in a patient with polyarticular juvenile idiopathic arthritis and uveitis. Rheumatol Int. 2003; 23: 258–261.
29. Olsen N.J, Stein C.M. New drugs for rheumatoid arthritis. New Engl. J. Med. 2004; 350 (21): 2167–2179.
30. Alexeyeva E.I., Valieva S.I., Bzarova T.M. et al. Effictivity and safety of anti-TNF therapy in the treatment of active refractory juvenile rheumatoid arthritis. Ann. Rheum. Dis. 2006; 65: 173–191.
31. Алексеева Е.И., Бзарова Т.М., Валиева С.И. и др. Эффективность лечения инфликсимабом суставных вариантов ювенильного ревматоидного артрита. Тезисы докладов XIII Российского национального конгресса «Человек и лекарство». М. 2006. С. 351–352.
32. Денисова Р.В., Алексеева Е.И., Альбицкий В.Ю. и др. Качество жизни больных ювенильным артритом в условиях лечения химерными моноклональными антителами к ФНО α. Вопросы современной педиатрии. 2009; 8 (3): 18–26.
33. Lovell D.J., Ruperto N., Cuttica R. et al. Randomized trial of infliximab plus methotrexate for the treatment of polyarticular juvenile rheumatoid arthritis [poster]. American College of Rheumatology 68th, Annual Scientific Meeting. San Antonio. 2004 (Poster 523).
34. Allaart C.F., Breedveld F.C., Dijkmans B.A. et al. Treatment of recent-onset rheumatoid arthritis: lessons from the Best study. J. Rheumatol. Suppl. 2007; 80 (10): 25–33.
35. 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.
36. Quinn M.A., Conaghan P.G., O`Connor P.G. et al. Very early treatment with infliximab in addition to methotrexate in early, poor-prognosis rheumatoid arthritis reduced magnetic resonance imaging evidence of synovitis and damage, with sustained benefit after infliximab withdrawal: results from a twelve month randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2005; 52 (1): 27–35.
37. Takeuchi T. Indications for and use of biologics in early rheumatoid arthritis based on the evidence. Nippon Rinsho. 2009; 67 (5): 1043–1049.
38. Steinbrocker O., Traeger C.H., Batterman R.C. Therapeutic criteria in rheumatoid arthritis. J. Am. Med. Assoc. 1949; 140: 659–662.
39. Wallace C.A., Ruperto N., Gannini E. et al. Preliminary criteria for clinical remission for select categories of juvenile idiopathic arthritis. J. Rheumatol. 2004; 31 (11): 2290–2294.
Review
For citations:
Alexeeva Е., Sleptsova T., Valieva S., Bzarova T., Denisova R., Lisitsyn A. EFFECTIVENESS AND SAFETY OF INFLIXIMAB IN PATIENTS WITH EARLY AND LATE JUVENILE RHEUMATOID ARTHRITIS. Current Pediatrics. 2010;9(3):30-42.
Email this article 
