Preview

Current Pediatrics

Advanced search

EFFECTIVENESS AND SAFETY OF RECOMBINANT HUMAN GRANULOCYTIC COLONY-STIMULATING FACTOR IN TREATMENT OF GRANULOCYTOPENIA DEVELOPED DURING IMMUNOSUPPRESSIVE THERAPY IN PATIENTS WITH JUVENILE RHEUMATOID ARTHRITIS

Abstract

Treatment of patients with severe clinical course of juvenile rheumatoid arthritis (JRA) is difficult problem. During the last years genetically engineered biological drugs are used equally with traditional immunosuppressive agents in treatment of severe forms of juvenile arthritis. High effectiveness of these drugs can be accompanied with development of unfavorable effects, for example, febrile neutropenia. The article presents results of a study of effectiveness and safety of recombinant human granulocytic colony-stimulating factor — filgrastim (Leucostim) — in treatment of granulocytopenia developed during immunosuppressive therapy in 16 patients with JRA. It was shown that administration of filgrastim arrests leucopenia in 100% of patients and granulocytopenia — in 93% of patients in 24 hours after first injection. High effectiveness of drug was combined with good tolerability and safety.
Key words: children, treatment, granulocytopenia, filgrastim, juvenile rheumatoid arthritis.
(Voprosy sovremennoi pediatrii — Current Pediatrics. – 2010;9(4):94-100)

About the Authors

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


E.L. Semikina
Scientific Center of Children’s Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


K.B. Isaeva
Scientific Center of Children’s Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


A.O. Lisitsyn
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


E.G. Chistyakova
Scientific Center of Children’s Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


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


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


References

1. Cassidy J., Petty R., eds. Texbook of paediatric rheumatology, 5th Ed. Elsevier Saunders. 2005.

2. Алексеева Е.И., Литвицкий П.Ф. Ювенильный ревматоидный артрит. Этиология. Патогенез. Клиника. Алгоритмы диагностики и лечения. Руководство для врачей, преподавателей, научных сотрудников. Под редакцией Баранова А.А. М. 2007. С. 325–339.

3. Woo P., Southwood T.R., Prieur A.M. Randomized, placebo-controlled, crossover trial of low-dose oral methotrexate in children with extended oligoarticular or systemic arthritis. Arthritis Rheum. 2000; 43(8): 1849–1857.

4. Насонов Е.Л. Ритуксимаб в лечении ревматических болезней. Научно-практическая ревматология. 2008; 1 (Приложение): 3–10.

5. 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.

6. 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.

7. 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. 2010; 9(5): 14–45.

8. Иванова Л.Ф., Багирова Н.С., Дмитриева Н.В. Профилактика и лечение фебрильных нейтропений у детей с острыми лейкозами. Методические рекомендации. М.: РОНЦ им. Н.Н. Блохина РАМН. 2002.

9. American Society of Clinical Oncology recommendations for the use of hematopoietic colony–stimulating factors: evidence based clinical practice guidelines. J. Clin. Oncol. 1994; 12: 2471–2508.

10. Bodey G.P., Buckley M., Sathe Y.S., Freireich E.J. Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann. Intern. Med. 1966; 64(2): 328–340.

11. Glauser M.P., Pizzo P.A. Management of infections in immunocompromised patients. NY: W.B. Saunders Comp. Ltd. 2000. 473 р.

12. Hughes W.T., Armstrong D., Bodey G.P. et al. http://www.ncbi.nlm.nih.gov/pubmed?term=%22Bow%20EJ%22%5BAuthor%5D2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin. Infect. Dis. 2002; 34 (6): 730–751.

13. Finberg R.W., Talcott J.A. Fever and neutropenia. How to use a new treatment strategy. N. Eng. J. Med. 1999; 341: 362–363.

14. Pizzo P.A. Fever in immunosuppressed patients. N. Eng. J. Med. 1999; 341: 893–900.

15. Scevola D. La profilassi antibiotica nella practica chirurgica e medica. Micom. 1998. 128 р.

16. The textbook of febrile neutripenia. Rolston K.V.I., Rubienstein E.B. 2001. 341 р.

17. Viscoli C. The evolution of the empirical management of fever and neutropenia in cancer patients. J. Antimicrob. Chemother. 1998; 41 (Suppl. D): 65–80.

18. Wood MJ. Viral infections in neutropenia-current problems and chemotherapeutic control. J. Antimicrob. Chemother. 1998; 41(Suppl D): 81–93.

19. Масчан А.А., Фечина Л.Г., Хлебникова О.П. и др. Эффективность и безопасность применения отечественного биоаналога филграстима для лечения и профилактики нейтропений у детей. Вопросы современной педиатрии. 2010; 9 (1): 18–26.


Review

For citations:


Alexeeva E., Valieva S., Bzarova T., Semikina E., Isaeva K., Lisitsyn A., Denisova R., Chistyakova E., Sleptsova T., Mitenko E. EFFECTIVENESS AND SAFETY OF RECOMBINANT HUMAN GRANULOCYTIC COLONY-STIMULATING FACTOR IN TREATMENT OF GRANULOCYTOPENIA DEVELOPED DURING IMMUNOSUPPRESSIVE THERAPY IN PATIENTS WITH JUVENILE RHEUMATOID ARTHRITIS. Current Pediatrics. 2010;9(4):94-100.

Views: 529


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