COMPARATIVE EVALUATION OF THE EFFICIENCY AND SAFETY OF TREATING CHILDREN WITH POLYARTICULARY JUVENILE IDIOPATHIC ARTHRITIS WITH METHOTREXATE AND WITH METHOTREXATE COMBINED WITH TOCILIZUMAB
https://doi.org/10.15690/pf.v12i2.1279
Abstract
Substantiation. The Juvenile Idiopathic Arthritis (JIA) is the most frequent rheumatic disease at children and is characterized by primary damage of joints, and also pathology of other bodies and fabrics with formation of polyorgan insufficiency of various degree of expressiveness. Research objective. A comparative assessment of efficiency and safety of a tocilizumab in a combination with a methotrexate in comparison with therapeutic efficiency only a methotrexate at patients with polyarticulary option of JIA. Methods. Kliniko-laboratory, biochemical, immunological methods of a blood test in dynamics of a disease against the carried-out therapy were used. Results. Tocilizumab in combination with a methotrexate has the expressed anti-inflammatory effect at the children sick with polyarticulary option of JIA. At treatment only a methotrexate efficiency of the carried-out therapy was much lower and not always than the effective. Conclusion. Tocilizumab is a perspective preparation for treatment of juvenile arthritis, refractory to standard immunosupressivе therapy.
About the Authors
V. A. Kel'tsevRussian Federation
L. I. Grebenkina
Russian Federation
E. D. Moiseeva
Russian Federation
References
1. Cassidy J.T., Petty R.E., Laxer R.M., Lindsley C.B. Textbook of pediatric rheumatology. 6th edn. Philadelphia: Saunders Elsevier. 2011. 794 p.
2. Baranov A.A., Alexeeva E.I., Denisova R.V., Valieva S.I., Bzarova T.M., Isaeva K.B., Sleptsova T.V., Mitenko E.V., Chistyakova E.G., Fetisova A.N. Retrospective analysis of efficacy and safety of tocilizumab in patients with severe systemic juvenile idiopathic arthritis: 12 months follow-up. Voprosy sovremennoi pediatrii = Current pediatrics. 2013; 12 (2): 26−34.
3. Alexeeva E.I., Litvitskii P.F. Yuvenil'nyi revmatoidnyi artrit: etiologiya, patogenez, klinika, algoritmy diagnostiki i lecheniya [Juvenile rheumatoid arthritis: etiology, pathogenesis, clinical algorithms for diagnosis and treatment]. Moscow, Vedi, 2007. 368 p.
4. Kel'tsev V.A. Yuvenil'nyi idiopaticheskii artrit [Juvenile Idiopathic Arthritis]. Samara, OOO «IPK «Sodruzhestvo», 2005. 214 p.
5. Kel'tsev V.A. Klinicheskaya artrologiya (rukovodstvo dlya vrachei) [Clinical Arthrology (Manual for Physicians)]. Samara, OOO «IPK «Sodruzhestvo», 2010. 616 p.
6. Hashkes P.J., Laxer R.M. Medical treatment of juvenile idiopathic arthritis. JAMA. 2005; 294: 1671−1684.
7. Ravelli A., Martini A. Juvenile idiopathic arthritis. Lancet. 2007; 369: 767−78.
8. Schett G. Review: Immune cells and mediators of inflammatory arthritis. Autoimmunity. 2008; 41: 224−229.
9. Alexeeva E., Denisova R., Valieva S. Tocilizumab therapy in children with systemic juvenile idiopathic arthritis. Russian experience. Ann Rheum. Dis. 2013; 72 (Suppl. 3): 736.
10. Lomakina O.L., Alexeeva E.I., Valieva S.N., Bzarova T.M, Denisova R.V., Sleptsova T.V. Clinical case of the use of tocilizumab in patients with early onset of systemic juvenile idiopathic arthritis. Voprosy sovremennoi pediatrii = Current pediatrics. 2014; 13 (5): 100−103.
11. ImagawaT., Ozawa R., Miyamae T., Mori M., Nerome Y., Imanaka N. Efficacy and safety in 48-week treatment of tocilizumab in children with polyaticular course JIA with polyarticlar or olygoarticular onset. Ann Rheum Dis. 2007; 66 (Suppl. II): 550.
12. Yokota S., Imagawa T., MiyamaeT. Safety and efficacy of up to three years of continuous tocilizumab therapy in children with systemic-onset juvenile idiopathic arthritis [SAT0536]. Ann Rheum Dis. 2009; 68 (Suppl. 3): 715.
13. Inaba Y., Aoki C., Ozawa R. Radiologic evaluation of large joints during tocilizumab treatment in children with systemic juvenile idiopathic arthritis [SAT0555]. Ann Rheum Dis. 2009; 68 (Suppl. 3): 720.
14. Yokota S., ImagawaT., Mori M., MiyamaeT., Aihara Y., Takei S., Iwata N., Umebayashi H., MurataT., Miyoshi M., Tomiita M., Nishimoto N., Kishimoto T. Efficacy and safety of tocilizumab in patients with systemic-onset juvenile idiopathic arthritis: a randomized, double-blind, placebo-controlled, withdrawal phase III trial. Lancet. 2008; 371: 998−1006.
15. Quartier P., Maire D., Souabni L. Efficacy and safety of tocilizumab in systemic onset juvenile idiopathic arthritis in french centers [FRI0462]. Ann Rheum Dis. 2009; 68 (Suppl. 3): 506.
16. De Benedetti R., Brunner H.I., Ruperto N., Kenwright A., Wright S., Calvo I., Cuttica R., Ravelli A., Schneider R., Woo P. Wou-ters С Efficacy and safety of Tocilizumab in Patients with Systemic Juvenile Idiopathic Arthritis (SJIA): 12-week data from the phase 3 tender trial [0P0273]. Ann Rheum Dis. 2010; 69 (Suppl. 3): 146.
17. De Benedetti F., Brunner H.I., Ruperto N., Kenwright A., Wrights., Calvo I., Cuttica R., Ravelli A., Schneider R., Woo P., Wouters С. Efficacy and Safety of Tocilizumab (TCZ) in Patients with Systemic Juvenile Idiopathic Arthritis (sJIA): TENDER 52-Week Data [OP0006]. Ann Rheum Dis. 2011; 70 (Suppl. 3): 67.
18. De Benedetti F., Brunner H.I., Ruperto N., Kenwright A., Wright S., Calvo I. et al. Randomized trial of tocilizumab in systemic juvenile idiopathic arthritis. N Engl J Med. 2012; 367: 2385−2395.
19. De Benedetti F., Brunner H., Ruperto N. et al. Efficacy and safety of tocilizumab (TCZ) in patients with systemic juvenile idiopathic arthritis (sJIA): 2-year data from tender, a phase 3 clinical trial. Ann Rheum Dis. 2012; 71 (Suppl. 3): 425.
Review
For citations:
Kel'tsev V.A., Grebenkina L.I., Moiseeva E.D. COMPARATIVE EVALUATION OF THE EFFICIENCY AND SAFETY OF TREATING CHILDREN WITH POLYARTICULARY JUVENILE IDIOPATHIC ARTHRITIS WITH METHOTREXATE AND WITH METHOTREXATE COMBINED WITH TOCILIZUMAB. Pediatric pharmacology. 2015;12(2):166-172. https://doi.org/10.15690/pf.v12i2.1279