TY  - JOUR
TI  - The necessity, efficacy and safety of biologics in juvenile idiopathic arthritis
AB  - OBJECTIVE: Juvenile idiopathic arthritis (JIA) is the most common cause of chronic arthritis in children. Biologics havechanged the faith of children with rheumatic diseases. The main objective of this study was to demonstrate the rate of usage,efficacy and safety of biologics in JIA subtypes.METHODS: This retrospective observational cohort study was conducted between May 2010 and September 2017. All children with the diagnosis of JIA and children under a biological agent treatment were recorded into the local registry system.Age, gender, JIA subtype, medications used, the clinical status of the patient, tuberculosis screening results, and side effectsobserved under biologics were retrieved from the registry.RESULTS: There were 405 patients with the diagnosis of JIA in the cohort. Biologics were used in 123 (30.3%) JIA patients. Subtype frequencies of JIA patients were as follows: persistent oligoarticular JIA (33.6%), enthesitis-related arthritis(29.2%), systemic JIA (13%), rheumatoid factor (RF)-negative polyarticular JIA (13%), extended oligoarticular JIA (4.2%),RF-positive polyarticular JIA (3.4%), psoriatic arthritis (1.8%) and unclassified arthritis (1.8%). The rate of biologic use washigh in extended oligoarticular JIA (64.7% of the cases), RF-positive polyarticular JIA (57.1%), psoriatic arthritis (57.1%), RFnegative polyarticular JIA (41.5%), and in systemic JIA (39.6%). Enthesitis-related arthritis (27.1%), persistent oligoarticularJIA (17.6%) and unclassified arthritis (16.6%) patients were the cases that needed a biologic agent in the last order. At thelast control, 78.9% of the cases were in remission, while 21.1% of them were active despite biologic treatment. Isoniazidprophylaxis was used in 30.8% of the patients. None of the patients developed active tuberculosis infection under prophylaxis. Adverse events were observed in 18.6% of patients under biologics as recurrent uncomplicated upper respiratory tractinfections being the most common.CONCLUSION: Biologics are safe and effective treatment options in children with JIA. Most of the JIA patients with polyarticular involvement require biologics earlier in the disease course. The risk of tuberculosis infection seems not to be increasedafter appropriate screening and prophylaxis.
AU  - Karadağ, Şerife Gül
AU  - Aktay Ayaz, Nuray
AU  - Tanatar, Ayşe
AU  - Çakan, Mustafa
DO  - 10.14744/nci.2019.57873
PY  - 2020
JO  - İstanbul Kuzey Klinikleri
VL  - 7
IS  - 2
SN  - 2148-4902
SP  - 118
EP  - 123
DB  - TRDizin
UR  - http://search/yayin/detay/357602
ER  -