MODERN JUVENILE IDIOPATHIC ARTHRITIS THERAPY OF WITH THE USE OF BIOLOGICAL MEDICATIONS IN A REGIONAL CHILDREN”S 3 LEVEL HOSPITAL - RESULTS AND PROBLEMS
Rubrics: PEDIATRICS
Authors:
2.
Irkutsk State Medical Academy of Postgraduate Education
(Head of the Department of Pediatrics)
Irkutsk, Irkutsk region, Russian Federation
Irkutsk, Irkutsk region, Russian Federation
Type:
Article
Pages:
from 102
to 106
Status:
Published
Received:
20.12.2017
Accepted:
18.01.2018
Published:
18.01.2018
Subject area:
UDK 61 Медицина. Охрана здоровья
Language:
Russian, English
Keywords:
juvenile idiopathic arthritis, genetically engineered biological drugs, adverse events
Abstract (English):
Background. Juvenile idiopathic arthritis is accompanied by severe functional disabilities refractory to standard treat- ment with methotrexate. Recently introduced genetic engineering has significantly improved the functional state of the patients with persistent disease and stopped the progressive destruction of joints. However, the risk of adverse reactions against the background of this type of therapy requires further study. Aims: to analyze the efficiency of the genetically engineered drugs applied at juvenile arthritis and undesirable effects of this treatment. Materials and methods. Long-term (7 years) observations of 141 patients aged from 8 months to 18 with juvenile idiopathic arthritis. Results. The article summarizes the experience of successful application of genetically engineered biological preparations (tocilizumab, abatacept, etanercept, adalimumab) in 33 patients out of 141 patients with juvenile arthritis observed in Irkutsk. Serious infections were not registered, but we detected cases of managed neutropenia in 2 out of 12 patients re- ceiving tocilizumab. In one case (3 %) out of 33 patients receiving genetically engineered drugs, the drug was withdrawn because of the risk of tuberculosis. Rare cases of secondary inefficiency of such drugs as abatacept, etanercept, adalimumab have been revealed. The tactics of treating children with undesirable reactions to genetically engineered drugs is described. Conclusions. Genetic engineering therapy has shown a good effect in improving clinical and functional indices and stopping joint destructive damage. However, when using genetically engineered drugs in treatment, the safety issues should be evaluated. Nevertheless, in our study there were no serious adverse events.
Background. Juvenile idiopathic arthritis is accompanied by severe functional disabilities refractory to standard treat- ment with methotrexate. Recently introduced genetic engineering has significantly improved the functional state of the patients with persistent disease and stopped the progressive destruction of joints. However, the risk of adverse reactions against the background of this type of therapy requires further study. Aims: to analyze the efficiency of the genetically engineered drugs applied at juvenile arthritis and undesirable effects of this treatment. Materials and methods. Long-term (7 years) observations of 141 patients aged from 8 months to 18 with juvenile idiopathic arthritis. Results. The article summarizes the experience of successful application of genetically engineered biological preparations (tocilizumab, abatacept, etanercept, adalimumab) in 33 patients out of 141 patients with juvenile arthritis observed in Irkutsk. Serious infections were not registered, but we detected cases of managed neutropenia in 2 out of 12 patients re- ceiving tocilizumab. In one case (3 %) out of 33 patients receiving genetically engineered drugs, the drug was withdrawn because of the risk of tuberculosis. Rare cases of secondary inefficiency of such drugs as abatacept, etanercept, adalimumab have been revealed. The tactics of treating children with undesirable reactions to genetically engineered drugs is described. Conclusions. Genetic engineering therapy has shown a good effect in improving clinical and functional indices and stopping joint destructive damage. However, when using genetically engineered drugs in treatment, the safety issues should be evaluated. Nevertheless, in our study there were no serious adverse events.
Keywords:
juvenile idiopathic arthritis, genetically engineered biological drugs, adverse events
juvenile idiopathic arthritis, genetically engineered biological drugs, adverse events
1. Matyunova, Bregel' - pediatriya
