PRACTICE OF INFLIXIMAB TREATMENT OF A PATIENT WITH SEVERE POLIARTICULAR JUVENILE RHEUMATOID ARTHRITIS

This article contains observation of severe poliarticular variant of juvenile rheumatoid arthritis, resistant to glucocorticoid treatment and classic immunosuppressive therapy. There is a description of biologic treatment — with chimeriс antibodies to TNF α — infliximab in a patient with protracted aggressive arthritis (duration of the disease more than 5 years). After 6 weeks of treatment there was a considerable decrease in pain syndrome and joint exudation, morning constraint was arrested completely. After 30 days of treatment an inactive phase of the disease was achieved, movements were restored in 15 from 23 affected joints. We managed to stop intraarticular injections with glucocorticoids. Clinical case shown can serve as an example of high efficacy of infliximab in patient with protracted juvenile rheumathoid arthritis and testifies to the availability of a further treatment of patients with aggressive juvenile rheumatoid arthritis, that are resistant to classic immunosuppressive treatment, with TNF α blockers. Key words: children, juvenile rheumatoid arthritis, treatment, infliximab, TNF α inhibitors. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (5): 170–175.

PRACTICE OF INFLIXIMAB TREATMENT OF A PATIENT WITH SEVERE POLIARTICULAR JUVENILE RHEUMATOID ARTHRITIS

This article contains observation of severe poliarticular variant of juvenile rheumatoid arthritis, resistant to glucocorticoid treatment and classic immunosuppressive therapy. There is a description of biologic treatment — with chimeriс antibodies to TNF α — infliximab in a patient with protracted aggressive arthritis (duration of the disease more than 5 years). After 6 weeks of treatment there was a considerable decrease in pain syndrome and joint exudation, morning constraint was arrested completely. After 30 days of treatment an inactive phase of the disease was achieved, movements were restored in 15 from 23 affected joints. We managed to stop intraarticular injections with glucocorticoids. Clinical case shown can serve as an example of high efficacy of infliximab in patient with protracted juvenile rheumathoid arthritis and testifies to the availability of a further treatment of patients with aggressive juvenile rheumatoid arthritis, that are resistant to classic immunosuppressive treatment, with TNF α blockers. Key words: children, juvenile rheumatoid arthritis, treatment, infliximab, TNF α inhibitors. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (5): 170–175.)</em

EXPERIENCE OF TREATMENT WITH RITUXIMAB IN PATIENT WITH JUVENILE POLYARTERITIS

The article presents a case report of severe course of nodular polyarteritis. The disease was highly active, aggressive, and refractory to treatment with corticosteroids and cyclophosphamide combined with plasmapheresis and drugs for microcirculation improvement. The treatment with chimerical anti-CD20 monoclonal antibodies — rituximab — was successful. Symptoms of intoxication and tromboangiatic syndrome decreased in 4 weeks. Disease was stopped up to 16th week. The case report demonstrates high efficacy of rituximab: patient with severe nodular polyarteritis remains clinical and laboratory remission during 52 weeks.Key words: children, nodular polyarteritis, rituximab.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 193–200

THERAPEUTIC CAPABILITIES OF ETHANERCEPT IN TREATMENT OF SYSTEMIC JUVENILE RHEUMATOID ARTHRITIS

The article presents a clinical case of severe systemic juvenile rheumatoid arthritis, refractory to traditional immunosuppressive treatment and with insufficient efficacy of chimeric homogenous anti-TNF-a antibodies. The patient received 2 courses of anti-Blymphocyte’s- CD20-antibodies that helped to arrest all systemic manifestations of the disease. Articular syndrome was arrested only with the help of soluble receptors to TNF a — ethanercept, given in following dose — 0.4 mg per kg of body mass. The patient has been on treatment with ethanercept for 24 weeks. Joint tenderness and exudation were diminished already after the first 4 weeks of treatment, also there was a dramatic increase in joint motion range. After 6 months of therapy we have managed to improve the patients and his family quality of life.Key words: children, juvenile rheumatoid arthritis, ethanercept, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3): 141–149

TOCILIZUMAB EFFICACY AND SAFETY IN PATIENTS WITH SEVERE SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS

This article contains results of the research of tocilizumab treatment efficacy and safety in 39 patients with severe systemic juvenile idiopathic arthritis, resistant to standard immunosuppressive treatment. Tocilizumab efficacy analysis has shown 50% of patients with inactive disease after 6 months of treatment, and 57% of patients with inactive disease after 12 months. Among adverse events were mild and moderate infections and such laboratory abnormalities as low leukocyte and neutrophiles count.Key words: children, juvenile idiopathic arthritis, systemic arthritis, tocilizumab, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3): 24–32)</span

TOCILIZUMAB EFFICACY AND SAFETY IN PATIENTS WITH SEVERE SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS

This article contains results of the research of tocilizumab treatment efficacy and safety in 39 patients with severe systemic juvenile idiopathic arthritis, resistant to standard immunosuppressive treatment. Tocilizumab efficacy analysis has shown 50% of patients with inactive disease after 6 months of treatment, and 57% of patients with inactive disease after 12 months. Among adverse events were mild and moderate infections and such laboratory abnormalities as low leukocyte and neutrophiles count.Key words: children, juvenile idiopathic arthritis, systemic arthritis, tocilizumab, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3): 24–32

EFFICACY OF ETANERCEPT IN CHILD WITH SEVERE POLYARTICULAR TYPE OF JUVENILE RHEUMATOID ARTHRITIS

The article presents a case report of severe and prolonged polyarticular rheumatoid arthritis resistant to the treatment with classic immunosuppressive agents, nonsteroidal anti-inflammatory drugs and corticosteroids. Authors describe successful treatment with soluble receptors to TNF _ — etanercept 0.4 mg for 1 kg of body weight during 36 weeks. Pain and exudative inflammation in joints lessened and the range of motions in joints increased in 4 weeks after the beginning of treatment. 9 months of treatment significantly increased the quality of life of a child and parents.Key words: children, juvenile rheumatoid arthritis, etanercept.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 184–192)</span

EFFICACY OF ETANERCEPT IN CHILD WITH SEVERE POLYARTICULAR TYPE OF JUVENILE RHEUMATOID ARTHRITIS

The article presents a case report of severe and prolonged polyarticular rheumatoid arthritis resistant to the treatment with classic immunosuppressive agents, nonsteroidal anti-inflammatory drugs and corticosteroids. Authors describe successful treatment with soluble receptors to TNF _ — etanercept 0.4 mg for 1 kg of body weight during 36 weeks. Pain and exudative inflammation in joints lessened and the range of motions in joints increased in 4 weeks after the beginning of treatment. 9 months of treatment significantly increased the quality of life of a child and parents.Key words: children, juvenile rheumatoid arthritis, etanercept.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 184–192