Efficacy of genetically engineered biological agents in the treatment of uveitis associated with rheumatic diseases in children
https://doi.org/10.14412/1995-4484-2012-1119
Abstract
The efficiency of incorporating genetically engineered biological agents (GEBAs) into a combination treatment regimen for rheumatic diseases (RD) (juvenile idiopathic arthritis, Behcet's disease) in relation to associated uveitis of varying severity was studied in 92 children aged 2 to 17 years. The follow-up lasted 1.5 to 49 months. Twenty-three patients took consecutively 2 to 5 GEBAs. When infliximab was used, remission of uveitis occurred in 21% of 38 children and the disease activity and/or recurrence rates reduced in an additional 21%. These were in 45 and 38.6% of 44 patients on adalimumab (ADA) and in 27.8 and 27.8% of 18 patients on abatacept, respectively. There was an association of the efficiency of therapy with the severity of uveitis at the start of treatment. The use of ADA induced a steady remission of panuveitis resistant to therapy with glucocorticoids and cyclosporine in both patients with Behcet's disease. One of 4 rituximab-treated patients achieved a steady remission. Tocilizumab therapy caused an exacerbation of uveitis in 1 patient. The postoperative period showed no inflammatory complications in most cases (37 operations, 26 eyes, 20 patients). No local adverse reactions were seen; systemic reactions occurred in 14% of the patients, this caused GEBAs to be discontinued in 7%. There is evidence for a need for further investigations into the efficacy of GEBAs in RD-associated uveitis in children in order to define success criteria, differentiated indications, and therapy regimens.
References
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For citations:
Neroyev V.V., Katargina L.A., Denisova E.V., Starikova A.V., Lyubimova N.V. Efficacy of genetically engineered biological agents in the treatment of uveitis associated with rheumatic diseases in children. Rheumatology Science and Practice. 2012;50(4):91-95. (In Russ.) https://doi.org/10.14412/1995-4484-2012-1119
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