A successful treatment of juvenile idiopathic arthritis with rituximab: A report of two cases

Berrada, Khalid; Abourazzak, Fatima Ezzahra; Mezouar, Imane El; Lazrak, F.; Aradoini, Nacira; Tahiri, Latifa; Harzy, Taoufik

doi:10.5152/eurjrheumatol.2014.140049

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…In terms of oligo-JIA and RF- poly-JIA, especially those that have ANA, there is considerable evidence that rituximab treatment may be a worthwhile treatment option. Several case studies have demonstrated that rituximab therapy can produce sustained clinical improvement in patients with refractory disease (98–100). Currently, rituximab is often only considered following the failure of first-line treatments such as TNF inhibitors and methotrexate in both pediatric and adult disease.…”

Section: B Cell Targeted-therapies In Pediatric Rheumatic Diseasementioning

confidence: 99%

B Cells as a Therapeutic Target in Paediatric Rheumatic Disease

Wilkinson

Rosser

2019

Front. Immunol.

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B cells carry out a central role in the pathogenesis of autoimmune disease. In addition to the production of autoantibodies, B cells can contribute to disease development by presenting autoantigens to autoreactive T cells and by secreting pro-inflammatory cytokines and chemokines which leads to the amplification of the inflammatory response. Targeting both the antibody-dependent and antibody-independent function of B cells in adult rheumatic disease has led to the advent of B cell targeted therapies in clinical practice. To date, whether B cell depletion could also be utilized for the treatment of pediatric disease is relatively under explored. In this review, we will discuss the role of B cells in the pathogenesis of the pediatric rheumatic diseases Juvenile Idiopathic Arthritis (JIA), Juvenile Systemic Lupus Erythematosus (JSLE) and Juvenile Dermatomyositis (JDM). We will also explore the rationale behind the use of B cell-targeted therapies in pediatric rheumatic disease by highlighting new case studies that points to their efficacy in JIA, JSLE, and JDM.

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Section: B Cell Targeted-therapies In Pediatric Rheumatic Diseasementioning

confidence: 99%

B Cells as a Therapeutic Target in Paediatric Rheumatic Disease

Wilkinson

Rosser

2019

Front. Immunol.

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“…In our patient, a variety of steroid-sparing agents with different mechanisms of action have been employed with limited or no clinical success. Some of these agents were used in line with current treatment recommendations, but many were used based on anecdotal reports [24][25][26][27][28]. Finally, due to signs of systemic inflammation characterized by increased inflammatory markers (CRP and ESR) and cytokines (IL-6 and TNF-alfa), which is indicative for the activation of JAK/STAT pathway, treatment with tofacitinib, a first generation JAK inhibitor, was initiated with a good clinical response.…”

Section: Discussionmentioning

confidence: 99%

Beyond the guidelines management of juvenile idiopathic arthritis: a case report of a girl with polyarticular disease refractory to multiple treatment options and Leri Weill syndrome

et al. 2021

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Background The last two decades brought new treatment options and high quality guidelines into the paediatric rheumatologic practice. Nevertheless, a number of patients still present a diagnostic and therapeutic challenge due to combination of vague symptoms and unresponsiveness to available treatment modalities. Case presentation We report a case of sixteen years old girl suffering from polyarticular type of juvenile idiopathic arthritis refractory to multiple treatment options. She first presented at the age of 4 with swelling and contractures of both knees. Her symptoms were initially unresponsive to nonsteroidal anti-inflammatory drugs and progressed despite treatment with intraarticular and systemic glucocorticoids and methotrexate. Throughout the years, she received several biologics together with continuous administration of nonsteroidal anti-inflammatory drugs and disease modifying anti-rheumatic drugs as well as intraarticular and systemic glucocorticoids in disease flares. However, none of this options provided a permanent remission, so various other modalities, as well as other possible diagnoses were constantly being considered. Eventually she became dependent on a daily dose of systemic glucocorticoids. In 2018, the treatment with Janus kinase inhibitor tofacitinib was initiated, which led to gradual amelioration of musculoskeletal symptoms, improvement of inflammatory markers and overall well-being, as well as to the weaning of systemic glucocorticoids. As the swelling of the wrists subsided for the first time in many years, Madelung’s deformity was noticed, first clinically, and later radiographically as well. Genetic analysis revealed short-stature homeobox gene deficiency and confirmed the diagnosis of Leri Weill syndrome. Conclusions This case report emphasizes the need for reporting refractory, complicated cases from everyday clinical practice in order to build-up the overall knowledge and share experience which is complementary to available guidelines. Individual reports of difficult to treat cases, especially when additional diagnoses are involved, can be helpful for physicians treating patients with common rheumatological diseases such as juvenile idiopathic arthritis.

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“…Biologics are genetically engineered drugs that work by selectively blocking the effects of cytokines. [11][12][13][14][15][16][17][18][19] Multiple biologics have been approved for the treatment of rheumatoid arthritis (RA) in adult patients. 22,23 The use of biologics in pediatric population are still limited in Indonesia.…”

Section: Lapsusmentioning

confidence: 99%

Interleukin-6 receptor antagonist use in systemic juvenile idiopathic arthritis: a case report

Mayasari¹,

Wati²,

Santosa³

2018

medicina

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Systemic onset Juvenile Idiopathic Arthritis (JIA) accounts for approximately 4-15% of JIA, and has the worst prognosis. Treatment option in SJIA is still limited. Interleukin-6 receptor antagonist is the second line therapy, has been used widely in adult rheumatoid arthritis patients, but no report of pediatric population in Indonesia. To report the efficacy of interleukin-6 receptor antagonist-Tocilizumab in difficult to treat-SJIA management. An 11-years old boy was diagnosed with SJIA and treated with Ibuprofen, then switched to high dose pulse steroid therapy, continued by weekly methotrexate for 6 weeks, however flare up color the clinical manifestation. Following ACR Guideline 2013, tocilizumab every 2 weeks was started. After 4 weeks, the MD Global scores reduced from 10.7 to 3, ACR 70 was achieved, no systemic manifestations were found with normal lab result. Tocilizumab shows beneficial effects in SJIA patient

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A successful treatment of juvenile idiopathic arthritis with rituximab: A report of two cases

Cited by 5 publications

References 14 publications

B Cells as a Therapeutic Target in Paediatric Rheumatic Disease

B Cells as a Therapeutic Target in Paediatric Rheumatic Disease

Beyond the guidelines management of juvenile idiopathic arthritis: a case report of a girl with polyarticular disease refractory to multiple treatment options and Leri Weill syndrome

Interleukin-6 receptor antagonist use in systemic juvenile idiopathic arthritis: a case report

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