ALGORITHM OF DIAGNOSTICS AND TREATMENT OF JUVENILE ARTHRITIS

The theme of the article is one of the most wide-spread rheumatologic diseases — juvenile arthritis (JA). It highlights main questions on epidemiology, classification, pathogenesis of the disease. Authors describe clinical symptoms of different types of JA, diagnostics and differential diagnosis. There is a part of an article with information on drugs used in patients with JA and the algorithm of differentiated treatment of a disease is presented. Authors paid special attention to approaches to biological therapy, conditions for the treatment and management of patients treated with genetically engineered biological drugs.Key words: children, juvenile rheumatoid arthritis, juvenile arthritis, treatment, infliximab, adalimumab, etanercept, rituximab, abatacept, tocilizumab.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(6):78-104

PROSPECT IN TREATMENT OF JUVENILE RHEUMATOID ARTHRITIS WITH ADALIMUMAB

This review is dedicated to treatment of rheumatoid diseases in adults and children with one of TNF blockers adalimumab. The data from single, open9labeled, and multicenter double blinded placebo controlled studies of effectiveness and safety of adalimumab is presented. Analysis of many published information showed high activity and safety of adalimumab for treatment of rheumatoid arthritis, ankylosing spondylitis, rheumatoid uveitis in adults and children.Key words: children, rheumatoid arthritis, juvenile rheumatoid arthritis, uveitis, treatment, adalimumab.</strong

RESULTS OF AN OPEN, MONOCENTERED NON-RANDOMISED, WITHOUT CONTROL GROUP, OBSERVATIONAL QUALITY OF LIFE EVALUATION STUDY IN PATIENTS WITH IDIOPATHIC JUVENILE ARTHRITIS TREATED WITH ETARNECEPT IN COMBINATION WITH METHOTREXATE

Study objective — to evaluate etarnecept influence on quality of life of idiopathic juvenile arthritis patients’ quality of life. 25 patients with poly- and oligoarthritides aged 8 (6; 11) years. Before etarnecept use quality of life of all patients was significantly lower that that of healthy children judging upon children’s own opinion and that of their parents. No longer that after 1 month since the beginning of etarnecept treatment 92% of patients claimed significant increase in their quality of life (according to patients’ opinion, total score increase from 53 to 59, from 49 to 60, according to parents (p &lt; 0,001). After 12 months of treatment 68 % of patients had quality of life similar to the one of healthy children.Key words: juvenile idiopathic arthritis, etarnecept, methotrexate, quality of life, efficacy, safety. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (6): 26–34.)</p

EXPERIENCE OF RITUXIMAB APPLICATION ON A PATIENT, SUFFERING FROM JUVENILE RHEUMATOID ARTHRITIS

The article describes the run of the severe systemic juvenile rheumatoid arthritis, which is resistant to the standard antirheumatic therapy. The disease was characterized by such systemic implications of the disease, as: fever, rash, pericarditis, lymphadenopathy, hepatomegaly accompanied by the generalized joint syndrome and high laboratory indices of activity. Introduction of rituximab into the treatment scheme allowed the researchers to decrease the general activity of the disease, arrest the systemic implications, improve functional status of the joints, and normalize the laboratory indices of activity. The effect duration was 5 months and 4 months after the first and second course of treatment by rituximab accordingly. The treatment results prove the perspective of rituximab application with in the complex therapy for the patients, suffering from juvenile rheumatoid arthritis. However, it is necessary to conduct further research to identify the location of antibodies to cd 20+ within the therapy scheme of this disease. Key words: children, treatment, rituximab, juvenile rheumatoid arthritis

PROSPECT IN TREATMENT OF JUVENILE RHEUMATOID ARTHRITIS WITH ADALIMUMAB

This review is dedicated to treatment of rheumatoid diseases in adults and children with one of TNF blockers adalimumab. The data from single, open9labeled, and multicenter double blinded placebo controlled studies of effectiveness and safety of adalimumab is presented. Analysis of many published information showed high activity and safety of adalimumab for treatment of rheumatoid arthritis, ankylosing spondylitis, rheumatoid uveitis in adults and children.Key words: children, rheumatoid arthritis, juvenile rheumatoid arthritis, uveitis, treatment, adalimumab

RESULTS OF AN OPEN, MONOCENTERED NON-RANDOMISED, WITHOUT CONTROL GROUP, OBSERVATIONAL QUALITY OF LIFE EVALUATION STUDY IN PATIENTS WITH IDIOPATHIC JUVENILE ARTHRITIS TREATED WITH ETARNECEPT IN COMBINATION WITH METHOTREXATE

Study objective — to evaluate etarnecept influence on quality of life of idiopathic juvenile arthritis patients’ quality of life. 25 patients with poly- and oligoarthritides aged 8 (6; 11) years. Before etarnecept use quality of life of all patients was significantly lower that that of healthy children judging upon children’s own opinion and that of their parents. No longer that after 1 month since the beginning of etarnecept treatment 92% of patients claimed significant increase in their quality of life (according to patients’ opinion, total score increase from 53 to 59, from 49 to 60, according to parents (p &lt; 0,001). After 12 months of treatment 68 % of patients had quality of life similar to the one of healthy children.Key words: juvenile idiopathic arthritis, etarnecept, methotrexate, quality of life, efficacy, safety. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (6): 26–34.

EXPERIENCE OF TREATMENT OF PATIENT WITH JUVENILE SERONEGATIVE POLYARTHRITIS WITH MEDICATION CONTAINING GLUCOSAMINE AND EXTRACTS OF ZINGIBER OFFICINALE

A case report on a severe course of juvenile seronegative polyarthritis is presented in this article. Successful treatment with «zinaxin» containing glucosamine and extracts of zingiber officinale, made with lipocap technology as an alternative to nonsteroidal anti9inflammatory drugs was performed is patient with developed adverse event to the medicaments (increase of plasma levels of alanine aminotransferase and aspartate amino transferase five times a much compared to norm), combined with quadrotherapy of duodenal ulcer. Patient had a good status, pain syndrome and morning joint stiffness were absent during treatment with «zinaxin with glucosamine» daily and dsintoxication course (2 months) in conditions of withdrawal of immunosuppressive treatment. activity of disease had 0–1 grade according to examination data.Key words: children, juvenile arthritis, pain syndrome.</strong

EXPERIENCE OF TREATMENT OF PATIENT WITH JUVENILE SERONEGATIVE POLYARTHRITIS WITH MEDICATION CONTAINING GLUCOSAMINE AND EXTRACTS OF ZINGIBER OFFICINALE

A case report on a severe course of juvenile seronegative polyarthritis is presented in this article. Successful treatment with «zinaxin» containing glucosamine and extracts of zingiber officinale, made with lipocap technology as an alternative to nonsteroidal anti9inflammatory drugs was performed is patient with developed adverse event to the medicaments (increase of plasma levels of alanine aminotransferase and aspartate amino transferase five times a much compared to norm), combined with quadrotherapy of duodenal ulcer. Patient had a good status, pain syndrome and morning joint stiffness were absent during treatment with «zinaxin with glucosamine» daily and dsintoxication course (2 months) in conditions of withdrawal of immunosuppressive treatment. activity of disease had 0–1 grade according to examination data.Key words: children, juvenile arthritis, pain syndrome

RITUXIMAB: NEW RESOURCES OF MANAGEMENT OF SEVERE REFRACTORY JUVENILE RHEUMATOID ARTHRITIS

The management of severe juvenile rheumatoid arthritis (JRA) is a complicated problem. The efficacy and safety of Rituximab was investigated in 32 infliximabrefractory patients with different types of JRA, who had failed standard immunosuppressive therapy. Rituximab induced remission in 52% of patients. Rituximab was well tolerated, some patients experienced infusionbrelated adverse events, infections of upper airways and neutropenias. It's recommended to carry out a management of patients with JRA in specialized rheumatological centers with modern diagnostic and medicamental technologies because of subsequent adverse events.Key words: children, management, rituximab, B cells, juvenile rheumatoid arthritis

ANTI-TNF THERAPY PERSPECTIVES IN RHEUMATOLOGIC PRACTICE

The overview is dedicated to the application of anti TNF medication to treat rheumatoid diseases among adults and children. The researchers provided for the data on the individual, open and multicentered, double, blind, placebobcontrolled research of infliximab, etanercept, adalimumab efficacy. The research findings witnessed high efficacy and safety of anti TNF therapy in both adult and children rheumatologic practice.Key words: infliximab, etanercept, adalimumab, children, treatment, juvenile rheumatoid arthritis, rheumatoid arthritis