PReS-FINAL-2044: TNF-alpha inhibitors in treatment of children with systemic form of juvenile idiopathic arthritis

Methods 32 patients with the systemic form of JIA were enrolled in the study. 19 patients received infliximaband 13 received etanercept. All patients had high degree (III) of disease activity. Average disease duration was 7,2 ± 3,3 years. Before administration of TNF-alpha inhibitors, all patients received conventional immunosupressive therapy with 2 or more drugs. In the beginning of the disease, systemic manifestations, such as fever, hepatomegaly, lymphadenopathy, leukocytosis, were observed in 100% of children, rash in 53% in both groups, persistent joint syndrome in the infliximab treatment group was seen in 84% of patients, in the etanercept group in 73% of children. At the moment of prescription of TNF alpha inhibitors, the mean number of active joints in the whole group was 20 ± 5, the number of joints with restriction of function 25 ± 7, ESR 38 ± 12, C-reactive protein 6,2 ± 3,4. The drugs were used in standard doses. For assessment of efficacy of performed therapy, “pediatric” criteria of the American College of Rheumatology were used: 30%, 50% and 70% therapy response, that is ACR pedi-30,-50,-70,-90. The criteria ACR pedi were assessed 6 and 12 months after the therapy beginning. Achievement of ACR pedi-30,-50 was regarded as an insufficient response reaction to the therapy being conducted, ACR pedi-70 and higher as a good response reaction (achievement of medicament remission or low disease activity).