Download PDF
Arthritis und Rheuma 2006; 26(06): 355-363
DOI: 10.1055/s-0037-1620085
Kinderrheumatologie
Schattauer GmbH

Therapie der juvenilen idiopathischen Arthritis mit TNF-α-Antagonisten

Möglichkeiten und GrenzenTreatment of juvenile idiopathic arthritis with TNF-α antagonistsoptions and limitations
Gerd Horneff
1   Asklepios Klinik Sankt Augustin; Zentrum für Neonatologie und Allgemeine Pädiatrie
› Author Affiliations
Further Information

Publication History

Publication Date:
23 December 2017 (online)

    Permissions and Reprints

Zusammenfassung

Die Diagnose „juvenile idiopathische Arthritis” steht für eine heterogene Gruppe von Erkrankungen im Kindes- und Jugendalter mit den gemeinsamen Merkmalen einer chronischen Arthritis unklarer Ätiologie mit Unterschieden in der Verteilung und Anzahl betroffener Gelenke, im Auftreten extraartikulärer Manifestationen, wie z. B. einer chronischen Uveitis, und in der Prognose. Sowohl die Akuität auch das Risiko für einen persistierenden oder destruierenden Verlauf bestimmen Art und Notwendigkeit der medikamentösen Kombinationstherapie. Über eine profunde Entzündungshemmung ermöglichen neue Therapiestrategien unter Einsatz von Tumornekrosefaktor-α-Antagonisten der weit überwiegenden Mehrheit der Patienten bei überraschend guter Verträglichkeit eine Krankheitsverbesserung mit Verminderung subjektiver Beschwerden, Morgensteifigkeit, Gelenkschmerzen, Müdigkeit/Fatigue, Verhinderung von Knorpel- und Knochendestruktionen und Aufholwachstum. Nicht alle Manifestationen der juvenilen idiopathischen Arthritis lassen sich in gleicher Zuverlässigkeit behandeln, zudem bestehen Risiken und Limitierungen der Therapie. Die vorliegende Übersicht soll die aktuelle Situation des Einsatzes von Tumornekrosefaktor-α-Antagonisten bei der juvenilen idiopathischen Arthritis darstellen.

Summary

The term „juvenile idiopathic arthritis” (JIA) stands for a group of heterogeneous chronic inflammatory diseases which have in common chronic persistent arthritis of unknown aetiology but are differentiable with regard to the distribution and the number of affected joints, the occurrence of extraarticular manifestations, especially of uveitis, and the prognosis. The intensity of drug therapy will be determined by the acuity as well as the estimated risk for a persistent and destructive course. The availability of Tumor Necrosis Factor-α antagonists enables a profound inhibition of inflammation leading to improvement of signs and symptoms of the disease, preventing the risk for cartilage and bone destruction and inducing catch up growth in the majority of patients with a surprisingly low toxicity. However, not all manifestations of JIA can be treated equally effective. Furthermore, there may be limitations and unknown risks on the long run. The aim of this report is to introduce the current therapeutic options of blocking Tumor Necrosis Factor-α in juvenile idiopathic arthritis.

Schlüsselwörter

Juvenile idiopathische Arthritis - Adalimumab - Etanercept - Infliximab - Uveitis

Keywords

Juvenile idiopathic arthritis - Adalimumab - Etanercept - Infliximab - Uveitis
 

  • Literatur

  • 1 Armbrust W., Kamphuis SS., Wolfs TW.. et al. Tuberculosis in a nine-year-old girl treated with infliximab for systemic juvenile idiopathic arthritis. Rheumatology 2004; 43: 527-9.
    CrossrefPubMedGoogle Scholar
  • 2 Banares A., Abasolo L., Maccaron P.. et al. Treatment of refractory posterior uveitis with anti-TNF-alpha (infliximab). Arthritis Rheum 2001; 44: 90S.
    Google Scholar
  • 3 Billiau AD., Cornillie F., Wouters C.. Infliximab for systemic onset juvenile idiopathic arthritis: experience in 3 children. J Rheumatol 2002; 29: 1111-4.
    Google Scholar
  • 4 Bloom BJ.. Development of diabetes mellitus during etanercept therapy in a child with systemic onset juvenile rheumatoid arthritis. Arthritis Rheum 2000; 43: 2606-8.
    CrossrefPubMedGoogle Scholar
  • 5 Brunner HI., Tomasi AL., Sherrard TM.. et al. Effectiveness and safety of etanercept for the treatment of juvenile rheumatoid arthritis (JRA) in clinical practice. Arthritis Rheum 2001; 44: 292S.
    Google Scholar
  • 6 El-Shabrawi Y., Graz JH.. Anti-TNF therapy with infliximab in the treatment of acute anterior uveitis – a one year follow up. Arthritis Rheum 2001; 44: 123S.
    Google Scholar
  • 7 Fantini F.. et al. Infliximab in the treatment of refractory JIA. Pres Meeting Abstract. Ann Rheum Dis 2000; 9: 741.
    Google Scholar
  • 8 Giannini EH., Ruperto N., Raveli A.. et al. Preliminary definition of improvement in juvenile arthritis. Arthritis Rheum 1997; 40: 1202-9.
    CrossrefPubMedGoogle Scholar
  • 9 Haibel H., Rudwaleit M., Brandt HC.. et al. Adalimumab reduces spinal symptoms in active anky-losing spondylitis: clinical and magnetic resonance imaging results of a fifty-two-week open-label trial. Arthritis Rheum 2006; 54: 678-81.
    CrossrefPubMedGoogle Scholar
  • 10 Honkanen VEA., Ztynjäla P., Vähäsalo P.. et al. Infliximab in juvenile arthritis: 1 Year follow up. Arthritis Rheum 2002; 46: S480.
    Google Scholar
  • 11 Horneff G., Schmeling H., Biedermann T.. et al. The German Etanercept Registry for Treatment of Juvenile Idiopathic Arthritis (JIA). Ann Rheum Dis 2004; 63: 1638-44.
    CrossrefPubMedGoogle Scholar
  • 12 Horneff GR., Burgos-Vargas R.. TNF-α-antagonists for the treatment of juvenile-onset spondylarthritides. Clin Exp Rheumatol 2002; 20 (Suppl. 20) Suppl. S137-S42.
    PubMedGoogle Scholar
  • 13 Horneff G., Ruperto N., Martini A., Carcereri R.. Behandlung von Kindern mit juveniler rheumatoider Arthritis (JRA) mit Adalimumab – Studienergebnisse nach 48 Wochen. Z Rheumatol 2006; 65: S6.
    CrossrefPubMedGoogle Scholar
  • 14 Kahn PJ., Weiss M., Imundo LF.. et al. Favorable Response to Higher Dose Infliximab in Refractory Uveitis: Eleven Cases. Arthritis Rheum 2004; 50: 92S.
    Google Scholar
  • 15 Keystone EC., Kavanaugh AF., Sharp JT.. et al. Radiographic, clinical, and functional outcomes of treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy: a randomized, placebo-controlled, 52-week trial. Arthritis Rheum 2004; 50: 1400-11.
    CrossrefPubMedGoogle Scholar
  • 16 Kietz DA., Permuelller PH., Moore TL.. Clinical response to Etanercept in polyarticular course juvenile rheumatoid arthritis. J Rheumatol 2001; 28: 360-2.
    Google Scholar
  • 17 Kimura Y., Imundo LF., Li SC.. High dose infliximab in the treatment of resistant systemic JRA. Arthritis Rheum 2001; 44: 272S.
    Google Scholar
  • 18 Lahdenne P., Vahasalo P., Honkanen V.. Infliximab or etanercept in the treatment of children with refractory juvenile idiopathic arthritis: an open label study. Ann Rheum Dis 2003; 62: 245-7.
    CrossrefPubMedGoogle Scholar
  • 19 Lovell DJ., Giannini EH., Reiff A.. et al. Etanercept in children with polyarticular juvenile rheumatoid arthritis. N Engl J Med 2000; 342: 763-9.
    CrossrefPubMedGoogle Scholar
  • 20 Lovell DJ., Reiff A., Jones OY.. et al. Long-term safety and efficacy of etanercept in children with polyarticular-course juvenile rheumatoid arthritis. Arthritis Rheum 2006; 54: 1987-94.
    CrossrefPubMedGoogle Scholar
  • 21 Lovell DJ., Ruperto N., Cuttica R.. et al. Comparison of safety, efficacy and pharmacokinetics for 3 and 6 mg/kg Infliximab plus Methotrexate therapy in JRA patients. Arthritis Rheum 2005; 52: 724S.
    Google Scholar
  • 22 Lovell DJ., Ruperto N., Goodman S.. et al. Preliminary Data from the Study of Adalimumab in Children with Juvenile Idiopathic Arthritis (JIA). 2004 Annual Scientific meeting of the American College of Rheumatology, October 16–21, San Antonio, USA..
    Google Scholar
  • 23 Masatioglu S., Gogus F., Cevirgen D.. et al. Infliximab in the treatment of refractory juvenile idiopathic arthritis. Arthritis Rheum 2002; 46: S481.
    Google Scholar
  • 24 Mease PJ., Gladman DD., Ritchlin CT.. et al. Adalimumab Effectiveness in Psoriatic Arthritis Trial Study Group. Adalimumab for the treatment of patients with moderately to severely active psoriatic arthritis: results of a double-blind, randomized, placebo-controlled trial. Arthritis Rheum 2005; 52: 3279-89.
    CrossrefPubMedGoogle Scholar
  • 25 Mohan N., Edwards ET., Cupps TR.. et al. Demyelination occurring during anti-tumor necrosis factor alpha therapy for inflammatory arthritides. Arthritis Rheum 2001; Dec 44 (12) 2862-9.
    CrossrefPubMedGoogle Scholar
  • 26 Petty RE., Southwood TR., Baum J.. et al. Revision of the proposed criteria for juvenile idiopathic arthritis: Durban 1997. J Rheumatol 1998; 25: 1991-4.
    Google Scholar
  • 27 Pontikaki I., Gerloni V., Gattinara M.. et al. Side effects of anti-TNFalpha therapy in juvenile idiopathic arthritis. Reumatismo 2006; Jan-Mar 58 (01) 31-8.
    PubMedGoogle Scholar
  • 28 Quartier P., Taupin P., Bourdeaut F.. et al. Efficacy of etanercept for the treatment of juvenile idiopathic arthritis according to the onset type. Arthritis Rheum 2003; 48: 1093-1101.
    CrossrefPubMedGoogle Scholar
  • 29 Reiff A., Henrickson M.. Prolonged efficacy of etanercept in refractory juvenile ankylosing spondylitis. Arthritis Rheum 2001; 44: 292S.
    Google Scholar
  • 30 Reiff A., Takei S., Sadeghi S.. et al. Etanercept therapy in children with treatment-resistant uveitis. Arthritis Rheum 2001; 44: 1411-5.
    CrossrefPubMedGoogle Scholar
  • 31 Ruperto N., Lovell DJ., Goodman S.. et al. 48 week data from the study of Adalimumab in Children with Juvenile Rheumatoid Arthritis (JRA). EULAR Amsterdam 21.-24.6.06. Ann Rheum Dis 2006; 65 (Suppl. 01) Suppl 56.
    Google Scholar
  • 32 Saurenmann R., Rose J., Tyrell P.. The Effect of Anti-TNFα Treatment in Children With Uveitis Arthritis Rheum. 2004; 50: S92.
    Google Scholar
  • 33 Schmeling H., Horneff G.. Etanercept and uveitis in patients with juvenile idiopathic arthritis. Rheumatology 2005; 44: 1008-11.
    CrossrefPubMedGoogle Scholar
  • 34 Schmeling H., Mathony K., John V.. et al. Combination of etanercept and methotrexate for the treatment of refractory juvenile idiopathic arthritis – a pilot study. Ann Rheum Dis 2001; 60: 410-2.
    CrossrefPubMedGoogle Scholar
  • 35 Sicotte NL., Voskuhl RR.. Onset of multiple sclerosis associated with anti-TNF therapy. Neurology 2001; 57: 1885-8.
    CrossrefPubMedGoogle Scholar
  • 36 Smith JA., Thompson DJS., Whitcup SM.. et al. A randomised, placebo-controlled, double-masked clinical trial of etanercept for the treatment of uveitis associated with juvenile idiopathic arthritis. Arthritis Rheum 2005; 53: 18-23.
    CrossrefPubMedGoogle Scholar
  • 37 Tutar E., Ekici F., Nacar N.. et al. Delayed maculopapular, urticarial rash due to infliximab in two children with systemic onset juvenile idiopathic arthritis. Rheumatology (Oxford) 2004; 43: 674-5.
    CrossrefPubMedGoogle Scholar