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Current Rheumatology Reports

Erschienen in:

01.11.2014 | PEDIATRIC RHEUMATOLOGY (S OZEN, SECTION EDITOR)

Judicious Use of Biologicals in Juvenile Idiopathic Arthritis

verfasst von: Yongdong Zhao, Carol Wallace

Erschienen in: Current Rheumatology Reports | Ausgabe 11/2014

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Abstract

Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disorder that may cause joint destruction. Biological treatments targeting specific cytokines and cell interactions have transformed the outcomes of JIA. This review focuses on the selection of patients for and the timing and selection of biological treatment in JIA. Tumor necrosis factor (TNF) inhibitors remain the first choice for polyarticular JIA, followed by abatacept and tocilizumab. Monoclonal-antibody TNF inhibitors and abatacept are usually chosen for methotrexate-resistant uveitis. Recent clinical trials of canakinumab, rilonacept, and tocilizumab have obtained great improvement in both systemic and arthritic features in chronic systemic JIA patients. Current guidelines support the early use of a short-acting IL-1 antagonist for macrophage activation syndrome, a life-threatening complication. TREAT and ACUTE studies suggest that a therapeutic window of opportunity during early disease may exist in JIA. Early initiation of biological therapy may be associated with slower progression of joint damage and longer remission.

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Titel: Judicious Use of Biologicals in Juvenile Idiopathic Arthritis
verfasst von: Yongdong Zhao
Carol Wallace
Publikationsdatum: 01.11.2014
Verlag: Springer US
Erschienen in: Current Rheumatology Reports / Ausgabe 11/2014
Print ISSN: 1523-3774
Elektronische ISSN: 1534-6307
DOI: https://doi.org/10.1007/s11926-014-0454-3

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The Nature of In Vivo Mechanical Signals That Influence Cartilage Health and Progression to Knee Osteoarthritis