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Comparable Efficacy of Abatacept Used as First-line or Second-line Biological Agent for Severe Juvenile Idiopathic Arthritis-related Uveitis.
Birolo, Carolina; Zannin, Maria Elisabetta; Arsenyeva, Svetlana; Cimaz, Rolando; Miserocchi, Elisabetta; Dubko, Margarita; Deslandre, Chantal Job; Falcini, Fernanda; Alessio, Maria; La Torre, Francesco; Denisova, Ekaterina; Martini, Giorgia; Nikishina, Irina; Zulian, Francesco.
Afiliação
  • Birolo C; From the Department of Pediatrics, Rheumatology Unit, University of Padua, Padua, Italy; Scientific Research Institute of Rheumatology RAMS, Moscow, Russian Federation; A. Meyer Children's Hospital, Rheumatology Unit, and Department of Internal Medicine, Section of Rheumatology, University of Floren
  • Zannin ME; C. Birolo, MD, Resident in Pediatrics, Department of Pediatrics, Rheumatology Unit, University of Padua; M.E. Zannin, MD, PhD, Assistant Professor of Ophthalmology, Department of Pediatrics, Rheumatology Unit, University of Padua; S. Arsenyeva, MD, PhD, Associate Professor of Ophthalmology, Scientif
  • Arsenyeva S; From the Department of Pediatrics, Rheumatology Unit, University of Padua, Padua, Italy; Scientific Research Institute of Rheumatology RAMS, Moscow, Russian Federation; A. Meyer Children's Hospital, Rheumatology Unit, and Department of Internal Medicine, Section of Rheumatology, University of Floren
  • Cimaz R; C. Birolo, MD, Resident in Pediatrics, Department of Pediatrics, Rheumatology Unit, University of Padua; M.E. Zannin, MD, PhD, Assistant Professor of Ophthalmology, Department of Pediatrics, Rheumatology Unit, University of Padua; S. Arsenyeva, MD, PhD, Associate Professor of Ophthalmology, Scientif
  • Miserocchi E; From the Department of Pediatrics, Rheumatology Unit, University of Padua, Padua, Italy; Scientific Research Institute of Rheumatology RAMS, Moscow, Russian Federation; A. Meyer Children's Hospital, Rheumatology Unit, and Department of Internal Medicine, Section of Rheumatology, University of Floren
  • Dubko M; C. Birolo, MD, Resident in Pediatrics, Department of Pediatrics, Rheumatology Unit, University of Padua; M.E. Zannin, MD, PhD, Assistant Professor of Ophthalmology, Department of Pediatrics, Rheumatology Unit, University of Padua; S. Arsenyeva, MD, PhD, Associate Professor of Ophthalmology, Scientif
  • Deslandre CJ; From the Department of Pediatrics, Rheumatology Unit, University of Padua, Padua, Italy; Scientific Research Institute of Rheumatology RAMS, Moscow, Russian Federation; A. Meyer Children's Hospital, Rheumatology Unit, and Department of Internal Medicine, Section of Rheumatology, University of Floren
  • Falcini F; C. Birolo, MD, Resident in Pediatrics, Department of Pediatrics, Rheumatology Unit, University of Padua; M.E. Zannin, MD, PhD, Assistant Professor of Ophthalmology, Department of Pediatrics, Rheumatology Unit, University of Padua; S. Arsenyeva, MD, PhD, Associate Professor of Ophthalmology, Scientif
  • Alessio M; From the Department of Pediatrics, Rheumatology Unit, University of Padua, Padua, Italy; Scientific Research Institute of Rheumatology RAMS, Moscow, Russian Federation; A. Meyer Children's Hospital, Rheumatology Unit, and Department of Internal Medicine, Section of Rheumatology, University of Floren
  • La Torre F; C. Birolo, MD, Resident in Pediatrics, Department of Pediatrics, Rheumatology Unit, University of Padua; M.E. Zannin, MD, PhD, Assistant Professor of Ophthalmology, Department of Pediatrics, Rheumatology Unit, University of Padua; S. Arsenyeva, MD, PhD, Associate Professor of Ophthalmology, Scientif
  • Denisova E; From the Department of Pediatrics, Rheumatology Unit, University of Padua, Padua, Italy; Scientific Research Institute of Rheumatology RAMS, Moscow, Russian Federation; A. Meyer Children's Hospital, Rheumatology Unit, and Department of Internal Medicine, Section of Rheumatology, University of Floren
  • Martini G; C. Birolo, MD, Resident in Pediatrics, Department of Pediatrics, Rheumatology Unit, University of Padua; M.E. Zannin, MD, PhD, Assistant Professor of Ophthalmology, Department of Pediatrics, Rheumatology Unit, University of Padua; S. Arsenyeva, MD, PhD, Associate Professor of Ophthalmology, Scientif
  • Nikishina I; From the Department of Pediatrics, Rheumatology Unit, University of Padua, Padua, Italy; Scientific Research Institute of Rheumatology RAMS, Moscow, Russian Federation; A. Meyer Children's Hospital, Rheumatology Unit, and Department of Internal Medicine, Section of Rheumatology, University of Floren
  • Zulian F; C. Birolo, MD, Resident in Pediatrics, Department of Pediatrics, Rheumatology Unit, University of Padua; M.E. Zannin, MD, PhD, Assistant Professor of Ophthalmology, Department of Pediatrics, Rheumatology Unit, University of Padua; S. Arsenyeva, MD, PhD, Associate Professor of Ophthalmology, Scientif
J Rheumatol ; 43(11): 2068-2073, 2016 11.
Article em En | MEDLINE | ID: mdl-27633826
ABSTRACT

OBJECTIVE:

Abatacept (ABA) has recently been proposed as second-line treatment in patients with juvenile idiopathic arthritis (JIA)-associated uveitis refractory to anti-tumor necrosis factor-α (anti-TNF) agents, but little is known about its efficacy as a first-line approach. The aim of the present study was to compare the safety and efficacy of ABA as a first-line biological agent (ABA-1) with that of ABA as a second-line treatment after 1 or more anti-TNF agents (ABA-2), in patients with severe JIA-related uveitis.

METHODS:

In this multicenter study, we collected data on patients with severe JIA-related uveitis treated with ABA as a first-line or second-line biological agent. Changes in frequency of uveitis flares/year and ocular complications before and after ABA treatment, clinical remission, and side effects were recorded.

RESULTS:

Thirty-five patients with a mean age of 10.8 years were treated with ABA for a mean period of 19.6 months. In 4 patients, ABA administration was discontinued, owing to inefficacy on arthritis in 3 cases and allergic reaction in 1. Thirty-one patients, 14 in the ABA-1 group and 17 in the ABA-2 group, completed the 12-month followup period; of these, 17 (54.8%) had clinical remission. The mean frequency of uveitis flares decreased from 4.1 to 1.2 in the ABA-1 group (p = 0.002) and from 3.7 to 1.2 in the ABA-2 group (p = 0.004). Preexisting ocular complications improved or remained stable in all but 5 patients, all in the ABA-2 group. No significant difference was found between the efficacy of the 2 treatment modalities. ABA confirmed its good safety profile.

CONCLUSION:

ABA, used as first-line biological treatment or after 1 or more anti-TNF agents, induces a comparable improvement in severe refractory JIA-related uveitis.
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Base de dados: MEDLINE Assunto principal: Artrite Juvenil / Uveíte / Antirreumáticos / Abatacepte / Imunossupressores Idioma: En Ano de publicação: 2016 Tipo de documento: Article
Buscar no Google
Imprimir
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PubMed Links

Base de dados: MEDLINE Assunto principal: Artrite Juvenil / Uveíte / Antirreumáticos / Abatacepte / Imunossupressores Idioma: En Ano de publicação: 2016 Tipo de documento: Article