Vol. 13 No. 2 (2021): Archives of Public Health
Clinical Science

Evaluation of pediatric patients with јuvenile idiopathic arthritis treated with biological therapy Tocilizumab (Actemra)

Marija Neskovska-Sumenkovska
University Clinic for Children’s Diseases; Ss. Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Aspazija Sofijanova
University Clinic for Children’s Diseases; Ss. Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Rozana Kacarska
University Clinic for Children’s Diseases; Ss. Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Konstandina Kuzevska-Maneva
University Clinic for Children’s Diseases; Ss. Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Beti Gjurkova Angelovska
University Clinic for Children’s Diseases; Ss. Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Valentina Jovanovska
University Clinic for Children’s Diseases; Ss. Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia

Published 2021-11-20

Keywords

  • juvenile idiopathic arthritis,
  • Tocilizumab,
  • children

How to Cite

1.
Neskovska-Sumenkovska M, Sofijanova A, Kacarska R, Kuzevska-Maneva K, Gjurkova Angelovska B, Jovanovska V. Evaluation of pediatric patients with јuvenile idiopathic arthritis treated with biological therapy Tocilizumab (Actemra). Arch Pub Health [Internet]. 2021 Nov. 20 [cited 2024 Mar. 28];13(2):62-8. Available from: https://www.id-press.eu/aph/article/view/6016

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.

 

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References

  1. Ravelli A, Martini A.Juvenile idiopathic arthritis.Lancet 2007;369:767-778. DOI: https://doi.org/10.1016/S0140-6736(07)60363-8
  2. Martini A,LovellDJ.Juvenile idiopathic arthritis:state of the art and future perspectives.Ann Rheum Dis 2010;69:1260-1263. DOI: https://doi.org/10.1136/ard.2010.133033
  3. Petty RE,Sauthwood TR,Manners P et al.International League of Associations for rheumatology classification of juvenile idiopathic arthritis:second revision,Edmonton,2001.J Rheumatol2004;31:390-2
  4. Ravelli A, Martini A. Methotrexate in juvenile idiopathic arthritis:answers and questions.J Rheumatol2000;27:1830-3
  5. Silverman E,MouyR,SpiegelL,et al.Leflunomide or methotrexate for juvenile rheumatoid arthritis.NEngl J Med 2000;342:763-9
  6. Maini RN,TaylorPC,SzechinskiJ,Pavelka K, BrolJ,BalintG,et al. CHARISMA Study Group Double-blind randomized controlled clinical trial of the interleukin-6 receptor antagonist,tocilizumab,in European patients with rheumatoid arthritis who had incomplete response to methotrexte.Arthritis Rheum 2006;54(9):2817-29. DOI: https://doi.org/10.1002/art.22033
  7. Brunner HI,RupertoN,ZuberZetal. Efficacy and safety of tocilizumab in patients with polyarticular-course juvenile idiopathic arthritis:results from phase 3,randomised,double-blind withdrawal trial.Ann RheumDis2015;74:1110-1117.
  8. Emery P, Keystone E, Tony HP, Cantagrel A, van Vollenhoven R, Sanchez A, et al. IL-6 receptor inhibition with tocilizumab improves treatment outcomes in patients with rheumatoid arthritis refractory to anti-tumour necrosis factor biologicals: results from a 24-week multicentrerandomised placebo-controlled trial. Ann Rheum Dis 2008;67(11):1516-23. DOI: https://doi.org/10.1136/ard.2008.092932
  9. Fleischmann R, Burgos-VargasR, AmbsP, AlecockE, Kremer J. LITHE:tocilizumab inhibits radiographic progression and improves physical function in rheumatoid arthritis (RA)patients (Pts)at 2 Yrs with increasing clinical efficacy over time.Arthritis Rheum2009;60(10): S238-S239.
  10. Gjurkova-Angelovska B, Kacarska R, Kuzevska-Maneva K, Jovanovska V, Neskovska Sumenkovska M. Juvenile idiopathic arthritis - case reports and modern therapeutic treatment. Arch Pub Health 2014; 6(1):30-33
  11. Yokota S,Imagawa T, Mori M, et al. Efficacy and safety of tocilizumab in patients with systemic-onset juvenile idiopathic arthritis: a randomised,double-blind,placebo controlled,with-drawal phase III trial. Lancet 2008;371:998-1006. DOI: https://doi.org/10.1016/S0140-6736(08)60454-7
  12. Macaubas C, Nguyen K, Milojevic D, et al. Oligoarticular and polyarticular JIA:epidemiology and pathogenesis. Nat Rev Rheumatol 2009;5:616-26 DOI: https://doi.org/10.1038/nrrheum.2009.209
  13. Al-MatarMJ, Petty RE, TuckerLB, Malleson PN, Schroeder ML, Cabral DA. The early pattern of joint involment predicts disease progression in children with oligoarticuar (pauciarticular) juvenile arthritis. Arthritis Rheum 2002;46:2708-2715. DOI: https://doi.org/10.1002/art.10544
  14. Kafedziska I, Mishevska Perchinkova S, Antova D, Kotevska Nikolova M, Stojanovska A, Guchev F. ML28133- A Multicenter,OpenLabel,Long-term extensions study of Wa19926 to describe safety during treatment with Tocilizumab in patients with early,moderate to severe Rheumatoid arthritis MacMed Review2017;71(2):83-90 DOI: https://doi.org/10.1515/mmr-2017-0015
  15. Kafedziska I, Mishevska Perchinkova S, Antova D, Kotevska Nikolova M, Stojanovska A, Guchev F. Multicenter, Open-Label, Long-term extension to describe the safety of Tocilizumab in patients with early, moderate to severe rheumatoid arthritis. Amercian Journal of Internal Medicine 2020;8(3):125-132. DOI: https://doi.org/10.11648/j.ajim.20200803.16
  16. Sonkar GK, Usha U, Singhs. Is HLAB27 a useful test in the diagnosis of juvenile spondiloarthropaties? Singapore Med J 2008;49:795-799
  17. Angeles-Han ST, McCracken C, Yeh S, Jang SR, Jenkins K, Cope S, et al. HLA associations in a cohort of children with juvenile idiopathic arthritis with and without uveitis. Invest Ophthalmol Vis Sci 2015;56(10):6043-8.-6048 DOI: https://doi.org/10.1167/iovs.15-17168
  18. Watts R, Clunie G, Hall F, Marshall T. Rheumatology: Oxford University Press 2009.