Abatacept for severe anti-TNF-alfa refractory JIA-associated uveitis: one year follow-up
نویسندگان
چکیده
Introduction Uveitis in JIA can be severe and immunosoppressive therapies may not be sufficient. Anti-TNF-alfa agents (Infliximab, Adalimumab) have been proposed. The percentage of success is different among series and no controlled trials have been published yet. Abatacept, a selective T-cell co-stimulation modulator, has been shown to be a valid alternative to anti-TNF-alfa agents in patients with refractory uveitis (Angels-Han S.2008; Zulian 2010).
منابع مشابه
A phase II trial protocol of Tocilizumab in anti-TNF refractory patients with JIA-associated uveitis (the APTITUDE trial)
Background: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children. Children with JIA are at risk of intraocular inflammation (uveitis). In the initial stages of mild-moderate inflammation uveitis is asymptomatic. Most children with mild-moderate uveitis are managed on topical steroid drops with or without systemic methotrexate (MTX). When children with moderate-se...
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Introduction Uveitis is one of the most serious manifestations of Juvenile Idiopathic Arthritis (JIA), with the potential to cause severe sight-threatening ocular complications. The first line treatment consists of topical and oral steroids with DMARDs therapy for more severe cases, including immunosuppressive and anti-TNFa agents. Abatacept (CTLA-4 immunoglobulin) is a soluble, fully human fus...
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Results Therapy of JIA-associated uveitis is guided by the severity of inflammation and complications. Topical corticosteroids are generally used as the initial treatment. Severe uveitis is commonly treated with immunosuppressive drugs. Methotrexate is presently the first-choice agent. If uveitis is not responding, another immunosuppressive agent or biological is applied. Currently, adalimumab ...
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Methods 10 children aged 4 – 12 years with anterior uveitis associated with JIA were treated by Abatacept in standard infusions pattern and doses. Indication for using Abataceptwas ineffectiveness of standard therapy of arthritis and/or uveitis. 6 patients were suffering from polyarticular variants, 4 – oligoarticular JIA. Abatacept was combined with Methotrexate in 9, Sulfasalazin in 1 and low...
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BACKGROUND Nonetheless biologic modifier therapies are available treatment strategies for sight-threatening uveitis in children, the lack of evidence from head-to-head randomized controlled studies limits our understanding of timing of therapy when to commence therapy, which agent to choose and how long to continue treatment, and, in case of failure, if switching to another anti-TNF-α strategy ...
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