RESUMEN
PURPOSE: To evaluate the safety and efficiency of adalimumab in children with severe refractory JIA with primary inefficiency, partial effect or loss of the effectiveness of other biologicals. PATIENTS AND METHODS: The article presents the results of the retrospective observational study of the efficacy and safety of adalimumab in 68 patients aged 10 (3, 17) years with various embodiments of JIA, with the primary inefficiency or partial or loss of the effectiveness of other biologicals. JIA diagnosis established on the basis of criteria ILAR (International League of Associations for Rheumatology). RESULTS: Efficacy was assessed during 1 year in 68 and 2 years--in 56 patients . At the 24th week we observed the improvement by criteria AKR 30, 50.70 in 100, 91 and 74% of patients, respectively, and at the 52th week--in 100, 96 and 90%, respectively. Inactive disease status was recorded in 55.8, 66.1 and 98.2% of study participants after 6 months, 1 and 2 years, respectively. Remission was achieved in 55.8 and 96.4% of patients after 1 and 2 years of observation, respectively. CONCLUSIONS: Adalimumab was effective and well tolerated by patients with primary inefficiency, partial and loss of efficiency of other biologicals. In clinical practice, patients with non-systemic JIA transition to the second TNF-alpha blocker can restore the biological effect of the first drug without increasing the frequency of infectious AEs.
Asunto(s)
Anticuerpos Monoclonales Humanizados/inmunología , Artritis Juvenil/tratamiento farmacológico , Factores Biológicos/uso terapéutico , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Adalimumab , Adolescente , Anticuerpos Monoclonales Humanizados/uso terapéutico , Antirreumáticos/uso terapéutico , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Masculino , Estudios Retrospectivos , Resultado del Tratamiento , Factor de Necrosis Tumoral alfa/inmunologíaRESUMEN
This article presents the unique experience of Research Centre of Children's Health in the treatment of 438 children with juvenile rheumatoid arthritis using biological preparations, viz. infliximab (270), adalimumab (55), ethanercept (25), rituximab (74), and tocilizumab (34). It is shown that differential biological therapy, unlike treatment with classical immunodepressants (methotrexate, cyclosporine, leflunomide, etc.), permits to achieve clinico-laboratory remission in 70% and markedly decrease activity of the disease in 20% of the patients within 1 year after the onset. It is concluded that treatment with gene-engineered drugs improves the quality of life of the children and their families, normal growth and development of the patients and affects prognosis of this formerly incurable chronic autoimmune disease.