Abstract
Aim: to carry out a retrospective analysis of efficacy and safety of tocilizumab treatment in children with severe resistant forms of systemic juvenile idiopathic arthritis. Patients and methods : 75 patients (35 girls and 40 boys) aged 8,8 (6; 12) years old with severe systemic juvenile idiopathic arthritis resistant to routine immunosuppressive therapy were included to the study. The mean duration of the disease before tocilizumab administration was 3,2 (1,9; 5,2) years. The diagnose was made based on the ILAR criteria. All patients were performed standard clinical and laboratory examination. The efficacy of treatment was assessed according to the pediatric criteria for improvement of the American College of Rheumatology. The frequency of achievement of non-active stage and medicinal remission of the disease were considered to be the target characteristics of the treatment efficacy. Results : in 6 months of treatment non-active stage of the disease was recorded in 64% of patients, in 12 months — in 73% of patients. Undesirable effects were represented by mild and moderate infections as well as changes in certain laboratory indexes: leucopenia, granulocytopenia, increased transaminase activity. Conclusions : tocilizumab is a highly effective drug in treatment of patients with the most severe systemic form of juvenile arthritis resistant to steroids, methotrexate, cyclosporine, as well as combined immunosuppressive therapy and anti-TNF and anti-B cell therapy.
Highlights
Alekseyeva Yekaterina Iosifovna, PhD, MD, professor, Head of Rheumatological Department, National Center of Children’s Health, Russian Academy of Medical Sciences, Dean of Pediatric Faculty, I.M
Patients and methods: 75 patients (35 girls and 40 boys) aged 8,8 (6; 12) years old with severe systemic juvenile idiopathic arthritis resistant to routine immunosuppressive therapy were included to the study
The diagnose was made based on the ILAR criteria
Summary
Ретроспективный анализ эффективности и безопасности тоцилизумаба у больных тяжелым системным ювенильным идиопатическим артритом: 12 месяцев наблюдения. Цель исследования: провести ретроспективный анализ эффективности и безопасности лечения тоцилизумабом детей с тяжелым рефрактерным системным ювенильным идиопатическим артритом. Участники и методы исследования: результаты лечения оценивали у 75 пациентов (35 девочек и 40 мальчиков) в возрасте 8,8 (6; 12) лет с тяжелым системным ювенильным идиопатическим артритом, рефрактерным к стандартной иммуносупрессивной терапии, со средней длительностью болезни до назначения тоцилизумаба 3,2 (1,9; 5,2) года. Целевыми показателями эффективности проводимой терапии считали частоту достижения стадии неактивной болезни и лекарственной ремиссии заболевания. Результаты: через 6 мес лечения статус неактивной болезни был зарегистрирован у 64%, а через 12 мес — у 73% пациентов. Выводы: тоцилизумаб высокоэффективен у больных самым тяжелым системным вариантом ювенильного артрита, рефрактерным к лечению глюкокортикоидами, метотрексатом, циклоспорином, а также к комбинированной иммуносупрессивной, анти-ФНО и анти-В-клеточной терапии.
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