Abstract | PURPOSE OF REVIEW: RECENT FINDINGS: The results of a pivotal trial of infliximab in polyarticular juvenile idiopathic arthritis suggested efficacy, but the primary outcome was not significantly different from placebo. Important information regarding dosing in children was obtained, however. A pivotal trial of adalimumab did prove efficacy, and resulted in U.S. Food and Drug Administration (FDA) approval. The monoclonal antibodies to tumor necrosis factor appear to be more effective in treating chronic uveitis associated with juvenile idiopathic arthritis than etanercept. Anti-IL-1 and anti-IL-6 therapy, particularly for systemic disease patients, looks very promising, as well. The costimulation modifier abatacept was shown to be effective and relatively well tolerated in the short term, also resulting in FDA approval this year. Continued experience with these agents and appropriate systems-based methods such as formal registries, to complement existing FDA procedures for monitoring safety, will improve our ability to identify short-term and long-term toxicities of these new agents. SUMMARY: As experience is gained, and longer-term safety is demonstrated, it is likely that biologics will be introduced as therapy earlier in the course of patients who inadequately respond to conventional disease-modifying antirheumatic drugs.
|
Authors | Norman T Ilowite |
Journal | Current opinion in rheumatology
(Curr Opin Rheumatol)
Vol. 20
Issue 5
Pg. 613-8
(Sep 2008)
ISSN: 1531-6963 [Electronic] United States |
PMID | 18698187
(Publication Type: Journal Article, Review)
|
Chemical References |
- Antibodies, Monoclonal
- Antirheumatic Agents
- Biological Products
|
Topics |
- Antibodies, Monoclonal
(therapeutic use)
- Antirheumatic Agents
(therapeutic use)
- Arthritis, Juvenile
(drug therapy)
- Biological Products
(therapeutic use)
- Child
- Humans
|