engleski

Intaarticular infliximab therapy in patients with with juvenile idiopathic arthritis - the role of PD-MSUS in monitoring therapy response

Objectives: Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children, with heterogeneous clinical features. Although therapeutic options are wide and in majority of children symptoms improve with combination of nonsteroidal anti- inflammatory and disease modifying drugs, there are a number of patients who are not responding to conventional therapy and who do not meet criteria for systemic biologics, namely anti TNF alpha. Those patients are potential candidates for intraarticular therapy with biologics aind in this report we present the results of intra-articular infliximab treatment in a series of patients diagnosed with oligoarthritis subtype of JIA. Methods: Twenty patients (30 joints) were treated with intraarticular infliximab and monitored by power Doppler musculoskeletal ultrasound according to OMERACT and juvenile arthritis disease activity score (JADAS 10) before intraarticular application and during the follow up period of 18 months (0, 1, 12, 18 months). Results: The results showed statistically significant improvement in PD-MSUS measures and JADAS in both B mode and power Doppler mode scores (p<0.001, p<0.001 respectively) in patients treated with i.a. infliximab with persistent response in fiftheen patients. JADAS score as well as the ultrasound scores were significantly reduced during the followup up period. Conclusion: This study showed promising results, good safety and potential for clinical benefit of intraarticular infliximab treatment in selected group of patients with oligoarthritis subtype of JIA.

juvenile idiopathic arthritis ; intraarticular infliximab ; JADAS ; PD-MSUS

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