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Therapeutic experience with infliximab in a patient with polyarticular juvenile idiopathic arthritis and uveitis

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Abstract

A pediatric patient with prolonged seronegative polyarticular juvenile idiopathic arthritis (JIA) and concomitant aggressive, anterior uveitis refractory to any conventional antirheumatic therapy was treated with infliximab. Arthritis and C-reactive protein (CRP) values showed prompt positive effects but, after 6 weeks, returned gradually to initial values despite ongoing therapy. In contrast, a more sustained therapeutic effect was observed on the uveitis, with increased visual acuity and reduced inflammatory signs of the affected eye. However, this benefit was also lost at week 30, after which infliximab had to be discontinued due to side effects. To conclude, in polyarticular seronegative JIA, infliximab showed a transient beneficial effect which was more pronounced on uveitis than arthritis.

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References

  1. Feldmann M, Maini RN (1999) The role of cytokines in the pathogenesis of rheumatoid arthritis. Rheumatology (Oxford) 38 [Suppl 2]:3–7

    Google Scholar 

  2. Mangge H, Schauenstein K (1998) Cytokines in juvenile rheumatoid arthritis. Cytokine 10:471–480

    Article  CAS  PubMed  Google Scholar 

  3. Mangge H, Kenzian H, Gallistl S, Neuwirth G, Kaulfersch W, Beaufort F, Muntean W, Schauenstein K (1995) Serum cytokines in juvenile rheumatoid arthritis (JRA). Correlation with conventional inflammatory parameters and clinical subtypes. Arthritis Rheum 38:211–219

    CAS  PubMed  Google Scholar 

  4. Lipsky PE, Van-der-Heijde DM, St-Clair EW, Furst DE, Breedveld FC, Kalden JR (2000) Infliximab and MTX in the treatment of rheumatoid arthritis. Anti-tumor necrosis factor trial with concomitant therapy study group. N Engl J Med 343:1594–1602

    CAS  PubMed  Google Scholar 

  5. Geborek P, Crnkic M, Petersson F, Saxne T (2002) Etanercept, infliximab, and leflunomide in established rheumatoid arthritis: clinical experience using a structured follow up programme in southern Sweden. Ann Rheum Dis 61:793–798

    Article  CAS  PubMed  Google Scholar 

  6. Sfikakis PP, Theodossiadis PG, Katsiari CG, Kaklamanis P, Markomichelakis NN (2001) Effect of infliximab on sight-threatening panuveitis in Behçet's disease. Lancet 358:295–296

    Article  CAS  PubMed  Google Scholar 

  7. Serrano MS, Schmidt-Sommerfeld E, Kilbaugh TJ, Brown RF, Udall JN Jr, Mannick EE (2001) Use of infliximab in pediatric patients with inflammatory bowel disease. Ann Pharmacother 35:823–828

    Article  CAS  PubMed  Google Scholar 

  8. Hyams JS, Markowitz J, Wyllie R (2000) Use of Infliximab in the treatment of Crohn's disease in children and adolescents. J Pediatr 137:192–196

    Article  CAS  Google Scholar 

  9. Petty RE, Southwood TR, Baum J, Bhettay E, Glass DN, Manners P, Maldonado-Cocco J, Suarez-Almazor M, Orozco-Alcala J, Prieur AM (1998) Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban 1997. J Rheumatol 25:1991–1994

    CAS  PubMed  Google Scholar 

  10. Thorne JE, Brucker AJ (2000) Choroidal white lesions as an early manifestation of sarcoidosis. Retina 20:8–15

    CAS  PubMed  Google Scholar 

  11. Kietz DA, Pepmueller PH, Moore TL (2002) Therapeutic use of etanercept in polyarticular course juvenile idiopathic arthritis over a two year period. Ann Rheum Dis 61:171–173

    Article  CAS  PubMed  Google Scholar 

  12. Gerloni V, Pontikaki I, Desiati F, Lupi E, Gattinara M, Fantini F (2001) Evaluation of disease activity, disability and quality of life in patients with persistently active refractory juvenile chronic arthritis after one year treatment with monoclonal anti-tumor necrosis factor-α antibody (infliximab). Abstract 165, Arthritis Rheum 44:80

    Google Scholar 

  13. Honkanen V, Lappi M, Koskinen L, Lindahl P, Lahdenne P (2001) Infliximab treatment in the refractory chronic uveitis of juvenile idiopathic arthritis (JIA). Abstract 1438, Arthritis Rheum 44:292

    Google Scholar 

  14. Smith JR, Levinson RD, Holland GN, Jabs DA, Robinson MR, Whitcup SM, Rosenbaum JT (2001) Differential efficacy of tumor necrosis factor inhibition in the management of inflammatory eye disease and associated rheumatic disease. Arthritis Rheum 45:252–257

    Article  CAS  PubMed  Google Scholar 

  15. El-Shabrawi Y, Hermann S (2002) Anti-tumor necrosis factor-alpha therapy with infliximab as an alternative to corticosteroids in the treatment of human leukocyte antigen B27-associated acute anterior uveitis. Ophthalmology 10:2342–2346

    Article  Google Scholar 

  16. Prevoo M, van Riel P, Van't Hof, van Rijswijk M, van Leeuwen M, Kuper H, van de Putte L (1993) Validity and reliability of joint indices. A longitudinal study in patients with recent onset rheumatoid arthritis. Br J Rheumatol 32:589–594

    CAS  PubMed  Google Scholar 

  17. Goossens PH, Verburg RJ, Breedveld FC (2001) Remission of Behçet's syndrome with tumour necrosis factor alpha blocking therapy. Ann Rheum Dis 60:637

    Article  CAS  PubMed  Google Scholar 

  18. Reiff A, Takei S, Sadeghi S, Stout A, Shaham B, Bernstein B, Gallagher K, Stout T (2002) Etanercept in children with treatment-resistant uveitis. Arthritis Rheum 44:1411–1415

    Article  Google Scholar 

  19. Bloch-Michel E, Nussenblatt RB (1987) International uveitis study group recommendations for the evaluation of intraocular inflammatory diseases. Am J Ophthalmol 103:234–235

    CAS  PubMed  Google Scholar 

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Correspondence to Harald Mangge.

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Mangge, H., Heinzl, B., Grubbauer, HM. et al. Therapeutic experience with infliximab in a patient with polyarticular juvenile idiopathic arthritis and uveitis. Rheumatol Int 23, 258–261 (2003). https://doi.org/10.1007/s00296-003-0308-1

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  • DOI: https://doi.org/10.1007/s00296-003-0308-1

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