Biological therapies for the treatment of juvenile idiopathic arthritis: Lessons from the adult and pediatric experiences

Matthew L Stoll, Alisa C GotteDepartment of Pediatrics, Division of Rheumatology, UT Southwestern Medical Center, Dallas, TX, USAAbstract: Biologics have advanced the therapy of adult and pediatric arthritis. They have been linked to rare serious adverse outcomes, but the actual risk of these events...

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Autores principales: Matthew L Stoll, Alisa C Gotte
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2008
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Acceso en línea:https://doaj.org/article/95739b8c0040412b8576486b3028f6c4
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spelling oai:doaj.org-article:95739b8c0040412b8576486b3028f6c42021-12-02T01:04:11ZBiological therapies for the treatment of juvenile idiopathic arthritis: Lessons from the adult and pediatric experiences1177-54751177-5491https://doaj.org/article/95739b8c0040412b8576486b3028f6c42008-06-01T00:00:00Zhttp://www.dovepress.com/biological-therapies-for-the-treatment-of-juvenile-idiopathic-arthriti-a1729https://doaj.org/toc/1177-5475https://doaj.org/toc/1177-5491Matthew L Stoll, Alisa C GotteDepartment of Pediatrics, Division of Rheumatology, UT Southwestern Medical Center, Dallas, TX, USAAbstract: Biologics have advanced the therapy of adult and pediatric arthritis. They have been linked to rare serious adverse outcomes, but the actual risk of these events is controversial in adults, and largely unknown in pediatrics. Because of the paucity of safety and efficacy data in children, pediatric rheumatologists often rely on the adult literature. Herein, we reviewed the adult and pediatric literature on five classes of medicines: Tumor necrosis factor (TNF) inhibitors, anakinra, rituximab, abatacept, and tocilizumab. For efficacy, we reviewed randomized controlled studies in adults, but did include lesser qualities of evidence for pediatrics. For safety, we utilized prospective and retrospective studies, rarely including reports from other inflammatory conditions. The review included studies on rheumatoid arthritis and spondyloarthritis, as well as juvenile idiopathic arthritis. Overall, we found that the TNF inhibitors have generally been found safe and effective in adult and pediatric use, although risks of infections and other adverse events are discussed. Anakinra, rituximab, abatacept, and tocilizumab have also shown positive results in adult trials, but there is minimal pediatric data published with the exception of small studies involving the subgroup of children with systemic onset juvenile idiopathic arthritis, in whom anakinra and tocilizumab may be effective therapies.Keywords: juvenile idiopathic arthritis, biologics, rheumatoid arthritis Matthew L StollAlisa C GotteDove Medical PressarticleMedicine (General)R5-920ENBiologics: Targets & Therapy, Vol 2008, Iss Issue 2, Pp 229-252 (2008)
institution DOAJ
collection DOAJ
language EN
topic Medicine (General)
R5-920
spellingShingle Medicine (General)
R5-920
Matthew L Stoll
Alisa C Gotte
Biological therapies for the treatment of juvenile idiopathic arthritis: Lessons from the adult and pediatric experiences
description Matthew L Stoll, Alisa C GotteDepartment of Pediatrics, Division of Rheumatology, UT Southwestern Medical Center, Dallas, TX, USAAbstract: Biologics have advanced the therapy of adult and pediatric arthritis. They have been linked to rare serious adverse outcomes, but the actual risk of these events is controversial in adults, and largely unknown in pediatrics. Because of the paucity of safety and efficacy data in children, pediatric rheumatologists often rely on the adult literature. Herein, we reviewed the adult and pediatric literature on five classes of medicines: Tumor necrosis factor (TNF) inhibitors, anakinra, rituximab, abatacept, and tocilizumab. For efficacy, we reviewed randomized controlled studies in adults, but did include lesser qualities of evidence for pediatrics. For safety, we utilized prospective and retrospective studies, rarely including reports from other inflammatory conditions. The review included studies on rheumatoid arthritis and spondyloarthritis, as well as juvenile idiopathic arthritis. Overall, we found that the TNF inhibitors have generally been found safe and effective in adult and pediatric use, although risks of infections and other adverse events are discussed. Anakinra, rituximab, abatacept, and tocilizumab have also shown positive results in adult trials, but there is minimal pediatric data published with the exception of small studies involving the subgroup of children with systemic onset juvenile idiopathic arthritis, in whom anakinra and tocilizumab may be effective therapies.Keywords: juvenile idiopathic arthritis, biologics, rheumatoid arthritis
format article
author Matthew L Stoll
Alisa C Gotte
author_facet Matthew L Stoll
Alisa C Gotte
author_sort Matthew L Stoll
title Biological therapies for the treatment of juvenile idiopathic arthritis: Lessons from the adult and pediatric experiences
title_short Biological therapies for the treatment of juvenile idiopathic arthritis: Lessons from the adult and pediatric experiences
title_full Biological therapies for the treatment of juvenile idiopathic arthritis: Lessons from the adult and pediatric experiences
title_fullStr Biological therapies for the treatment of juvenile idiopathic arthritis: Lessons from the adult and pediatric experiences
title_full_unstemmed Biological therapies for the treatment of juvenile idiopathic arthritis: Lessons from the adult and pediatric experiences
title_sort biological therapies for the treatment of juvenile idiopathic arthritis: lessons from the adult and pediatric experiences
publisher Dove Medical Press
publishDate 2008
url https://doaj.org/article/95739b8c0040412b8576486b3028f6c4
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