PMID- 17981916
OWN - NLM
STAT- MEDLINE
DCOM- 20080811
LR  - 20151119
IS  - 1468-2060 (Electronic)
IS  - 0003-4967 (Linking)
VI  - 67
IP  - 8
DP  - 2008 Aug
TI  - Focus on adverse events of tumour necrosis factor alpha blockade in juvenile 
      idiopathic arthritis in an open monocentric long-term prospective study of 163 
      patients.
PG  - 1145-52
AB  - OBJECTIVE: To report adverse events (AEs) seen in a large cohort of patients with 
      juvenile idiopathic arthritis (JIA) treated with tumour necrosis factor 
      (TNF)alpha blockers (infliximab and etanercept). METHODS: All patients with JIA 
      treated with infliximab or etanercept at the Paediatric Rheumatologic Centre of 
      the G Pini Institute (Milan, Italy) from November 1999 to February 2006, were 
      enrolled in an open, single-centre, long-term prospective study RESULTS: In all, 
      163 patients (68 infliximab, 95 etanercept) were enrolled. Mean (SD) age of onset 
      was 6.4 (4.8) years, mean age 17.1 (9.2) years, mean therapy duration 22.9 (17.6) 
      months. A total of 45 patients (32 infliximab, 13 etanercept) failed to respond 
      to or did not tolerate the first therapy and switched to a second one. In all, 
      208 treatments (81 infliximab, 127 etanercept) were performed. A total of 71 AEs 
      occurred in 51 (62.9%) patients on infliximab and led to discontinuation in 26 
      (32.1%); 133 AEs occurred in 69 (54.3%) patients on etanercept and led to 
      discontinuation in 18 (14.2%). Some AEs, such as thrombocytopoenia, 
      neuropsychiatric disorders, new onset of Crohn disease and new onset or flare-up 
      of chronic iridocyclitis (CIC), are unusual and have rarely been described 
      before, yet proved to be significant in frequency and/or clinically noteworthy in 
      the large population we followed. CONCLUSIONS: In our 6-year study, anti-TNFalpha 
      agents infliximab and etanercept were well tolerated and safe, and were 
      associated with only few serious, but all reversible, AEs. However, such 
      inhibitors are associated with various and numerous AEs. Children and young 
      adults affected by JIA should be carefully monitored so as to limit the risk of 
      AEs during anti-TNFalpha therapy as much as possible.
FAU - Gerloni, V
AU  - Gerloni V
AD  - Department of Rheumatology, Istituto Ortopedico Gaetano Pini, Milan, Italy. 
      gerloni@gpini.it
FAU - Pontikaki, I
AU  - Pontikaki I
FAU - Gattinara, M
AU  - Gattinara M
FAU - Fantini, F
AU  - Fantini F
LA  - eng
PT  - Journal Article
DEP - 20071102
PL  - England
TA  - Ann Rheum Dis
JT  - Annals of the rheumatic diseases
JID - 0372355
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Receptors, Tumor Necrosis Factor)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - B72HH48FLU (Infliximab)
RN  - OP401G7OJC (Etanercept)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antibodies, Monoclonal/*adverse effects/therapeutic use
MH  - Antirheumatic Agents/*adverse effects/therapeutic use
MH  - Arthritis, Juvenile/*drug therapy
MH  - Child
MH  - Crohn Disease/chemically induced
MH  - Drug Administration Schedule
MH  - Etanercept
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Immunoglobulin G/*adverse effects/therapeutic use
MH  - Infliximab
MH  - Iridocyclitis/chemically induced
MH  - Male
MH  - Receptors, Tumor Necrosis Factor/therapeutic use
MH  - Statistics, Nonparametric
MH  - Thrombocytopenia/chemically induced
MH  - Treatment Outcome
MH  - Tumor Necrosis Factor-alpha/*antagonists & inhibitors
EDAT- 2007/11/06 09:00
MHDA- 2008/08/12 09:00
CRDT- 2007/11/06 09:00
PHST- 2007/11/06 09:00 [pubmed]
PHST- 2008/08/12 09:00 [medline]
PHST- 2007/11/06 09:00 [entrez]
AID - ard.2007.069484 [pii]
AID - 10.1136/ard.2007.069484 [doi]
PST - ppublish
SO  - Ann Rheum Dis. 2008 Aug;67(8):1145-52. doi: 10.1136/ard.2007.069484. Epub 2007 
      Nov 2.