Abstract
Juvenile idiopathic arthritis (JIA) is the most common chronic disease in childhood. It manifests a heterogenic group of symptoms of arthritis, lasting at least 6 weeks and it appears before the age of 16. Patients who had no good therapeutic response to conventional therapy with Methotrexate were treated with biological therapy. The aim of this paper was to evaluate 9 patients who were receiving Tocilizumab at the Department of Rheumocardiology, University Clinic of Pediatric Diseases in Skopje. Materials and methods: Our study included 9 patients treated at our Department with biological therapy with Tocilizumab. Prior to initiation of the biological therapy, all patients underwent laboratory investigations, purified protein derivative (PPD) skin test for tuberculosis, X ray of the lungs and heart, and analysis of hepatitis markers. All patients were treated with amp. Actemra (tocilizumab) 8 mg/kg/tt i.v. Two of the patients had a severe form of the disease (one with severe systemic form and one with severe oligoarticular form of JIA). All presented patients had clinical remission of the disease. Conclusion: Therapy with tocilizumab in patients with juvenile idiopathic arthritis is a good therapeutic choice. The results obtained in our study have shown a significant therapeutic effect of tocilizumab even in severe forms of the disease.
Highlights
Juvenile idiopathic arthritis is the most common chronic disease in childhood
Juvenile idiopathic arthritis is divided in 7 subgroups according to International League of Associations for Rheumatology (ILAR) classification: 1. Oligoarticular arthritis - arthritis of one to four joints in the first 6 months from the beginning of the disease, ate as DMARD4,5
All patients were treated according to the International League of Associations for Rheumatology (ILAR) classification criteria
Summary
Juvenile idiopathic arthritis is the most common chronic disease in childhood. It is manifested with a hetеrogenic group of symptoms of arthritis, lasting at least 6 weeks, which appear before the age of 16 1,2. Oligoarticular arthritis - arthritis of one to four joints in the first 6 months from the beginning of the disease (there are persistent and extended forms of this type), ate as DMARD (disease-modified antirheumatic drug)[4,5]. Patients who have had no good response to therapy with Methotrexate are candidates for biological therapy (Biological DMARDS). Components of biological therapy have endogen proteins who induced the immune response in the body, especially through the cytokine pathway . The aim of this paper was to evaluate pediatric patients who received biological therapy with Tocilizumab. Rheumatoid factor (RF) positive polyarticular arthritis – arthritis of five or more joints in the first 6 months from the beginning of the disease; RF is positive in the last three months
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