engleski

How to treat patients after serious adverse effects caused by TNF inhibitors?

Abstract: Biological agents are widely used in a treatment of autoimmune rheumatic disorders. We report on serious adverse events during treatment with anti – tumour necrosis factor (anti – TNF) antibody in two of our patients with juvenile idiopathic arthritis (JIA): one was treated with a biological agent due to juvenile idiopathic arthritis complicated by uveitis, developing miliary tuberculosis during treatment. After treatment with antituberculotics, she completely recovered. Her basic illness is currently in remission. Another patient was treated due to juvenile spondyloarthritis and developed an inflammatory process of central nervous system (CNS) with serious neurological deficits. He was treated with high dose corticosteroids, followed by slowly tapering doses of corticosteroids. His neurological deficits improved, but are still present. Similar cases have been described previously, but there are no any recommendations of how to treat patient's arthritis afterwards. We would like to emphasise the need of developing guidelines for further treatment of arthritis after an occurrence of serious adverse effects during a treatment with biological agents.

Rheumatology ; Arthritis, Juvenile ; Tumor Necrosis Factor-alpha adverse effects ; Neurologic Manifestations ; Tuberculosis, Miliary

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