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Adalimumab in childrens

Achille Marino, Feliciana Real-Fernández, Paolo Rovero, Teresa Giani, Ilaria Pagnini, Rolando Cimaz, Gabriele Simonini
Adalimumab is a TNF-α blocker antibody similar in structure and function to natural human IgG1. Even if adalimumab is fully humanized, the development of anti-drug antibodies has been reported in several inflammatory conditions. The objective of our study was to assess the presence of anti-adalimumab antibodies (AAA) and their clinical relevance in a cohort of juvenile idiopathic arthritis (JIA) patients on adalimumab. This is a prospective observational cohort study recruiting JIA children. Experiments were performed using a validated surface plasmon resonance (SPR)-based optical assay (Biacore® T100)...
March 5, 2018: Clinical Rheumatology
Iris Deitch, Radgonde Amer, Oren Tomkins-Netzer, Zohar Habot-Wilner, Ronit Friling, Ron Neumann, Michal Kramer
PURPOSE: This study aimed to report the clinical outcome of children with uveitis treated with anti-tumor necrosis factor alpha (TNF-α) agents. METHODS: This included a retrospective cohort study. Children with uveitis treated with infliximab or adalimumab in 2008-2014 at five dedicated uveitis clinics were identified by database search. Their medical records were reviewed for demographic data, clinical presentation, ocular complications, and visual outcome. Systemic side effects and the steroid-sparing effect of treatment were documented...
February 18, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
Marianne Lerch, Carlo Mainetti, Benedetta Terziroli Beretta-Piccoli, Thomas Harr
Recognition and timely adequate treatment of erythema multiforme remain a major challenge. In this review, current diagnostic guidelines, potential pitfalls, and modern/novel treatment options are summarized with the aim to help clinicians with diagnostic and therapeutic decision-making. The diagnosis of erythema multiforme, that has an acute, self-limiting course, is based on its typical clinical picture of targetoid erythematous lesions with predominant acral localization as well as histological findings...
February 2018: Clinical Reviews in Allergy & Immunology
Marina Aloi, Matteo Bramuzzo, Serena Arrigo, Claudio Romano, Giulia D'Arcangelo, Doriana Lacorte, Simona Gatti, Maria Teresa Illiceto, Francesca Zucconi, Dario Dilillo, Giovanna Zuin, Daniela Knafelz, Alberto Ravelli, Salvatore Cucchiara, Patrizia Alvisi
OBJECTIVES: The aim of this study was to evaluate the effectiveness and safety of adalimumab (ADA) in children with ulcerative colitis (UC) previously treated with infliximab (IFX). METHODS: Retrospective study including children with UC from a national registry who received ADA therapy. The primary endpoint was the rate of corticosteroid (CS) free remission at week 52. Secondary outcomes were: the rate of sustained clinical remission, primary non-response and loss of response at weeks 12, 30, and 52 and rate of mucosal healing (MH) and side effects at week 52...
January 6, 2018: Journal of Pediatric Gastroenterology and Nutrition
Paolo Gisondi, Micol Del Giglio, Giampiero Girolomoni
Psoriasis is a common disease, which has a considerable impact on patients and the health care system. Treatment approaches to the disease may be various because some issues are not definitely addressed. Moreover, the therapeutic paradigms are continuously changing because of the recent approval of new treatments for psoriasis such as interleukin (IL)-17 inhibitors and apremilast. In this review, the factors influencing psoriasis severity, the indications for systemic treatments, the overall parameters to be considered in the treatment choice, life style interventions, and the recommendations for the use, screening, and monitoring of systemic therapies available including acitretin, cyclosporine, methotrexate, apremilast, adalimumab, etanercept, infliximab, secukinumab, ixekizumab, and ustekinumab are discussed...
November 16, 2017: International Journal of Molecular Sciences
Ana Duarte, Teumzghi Mebrahtu, Pedro Saramago Goncalves, Melissa Harden, Ruth Murphy, Stephen Palmer, Nerys Woolacott, Mark Rodgers, Claire Rothery
BACKGROUND: Psoriasis is a chronic inflammatory disease that predominantly affects the skin. Adalimumab (HUMIRA®, AbbVie, Maidenhead, UK), etanercept (Enbrel®, Pfizer, New York, NY, USA) and ustekinumab (STELARA®, Janssen Biotech, Inc., Titusville, NJ, USA) are the three biological treatments currently licensed for psoriasis in children. OBJECTIVE: To determine the clinical effectiveness and cost-effectiveness of adalimumab, etanercept and ustekinumab within their respective licensed indications for the treatment of plaque psoriasis in children and young people...
November 2017: Health Technology Assessment: HTA
Colleen K Correll, Danielle R Bullock, Rachel M Cafferty, Richard K Vehe
Weekly adalimumab dosing is used to treat juvenile idiopathic arthritis (JIA), uveitis, and other pediatric rheumatic diseases, but the safety of such dosing has not previously been studied. A retrospective chart review was conducted to assess the safety of weekly adalimumab. Demographic and clinical data were collected. Basic descriptive analysis was performed to assess for adverse events from weekly adalimumab. Sixty-nine patients at the University of Minnesota or Gillette Children's Hospital were identified as treated with weekly adalimumab...
November 4, 2017: Clinical Rheumatology
Natalia Nedelkopoulou, Babu Vadamalayan, Diego Vergani, Giorgina Mieli-Vergani
OBJECTIVES: Inflammatory bowel disease (IBD) and autoimmune liver disease (AILD) are closely associated, the former often dictating progression of the latter. Antibodies to tumor necrosis factor alpha (anti-TNFα) are effective in the management of IBD, but may cause liver injury. METHODS: Retrospective review of medical records of patients with juvenile AILD who received anti-TNFα for IBD to evaluate the safety and efficacy of anti-TNFα. RESULTS: Eleven patients (6 boys), ages 9 to 15 years (median 13 years) were identified...
January 2018: Journal of Pediatric Gastroenterology and Nutrition
Arjun B Sood, Sheila T Angeles-Han
There are no standardized treatment protocols for pediatric non-infectious uveitis. Topical corticosteroids are the typical first-line agent, although systemic corticosteroids are used in intermediate, posterior and panuveitic uveitis. Corticosteroids are not considered to be long-term therapy due to potential ocular and systemic side effects. In children with severe and/or refractory uveitis, timely management with higher dose disease-modifying antirheumatic drugs (DMARDs) and biologic agents is important...
March 2017: Current Treatment Options in Rheumatology
Inge M G J Bronckers, Marieke M B Seyger, Dennis P West, Irene Lara-Corrales, Megha Tollefson, Wynnis L Tom, Marcia Hogeling, Leah Belazarian, Claus Zachariae, Emmanuel Mahé, Elaine Siegfried, Sandra Philipp, Zsuzsanna Szalai, Ruth Ann Vleugels, Kristen Holland, Ruth Murphy, Eulalia Baselga, Kelly Cordoro, Jo Lambert, Alex Alexopoulos, Ulrich Mrowietz, Wietske Kievit, Amy S Paller
Importance: Use of systemic therapies for moderate to severe psoriasis in children is increasing, but comparative data on their use and toxicities are limited. Objective: To assess patterns of use and relative risks of systemic agents for moderate to severe psoriasis in children. Design, Setting, and Participants: A retrospective review was conducted at 20 centers in North America and Europe, and included all consecutive children with moderate to severe psoriasis who used systemic medications or phototherapy for at least 3 months from December 1, 1990, to September 16, 2014...
November 1, 2017: JAMA Dermatology
Giuseppe Murdaca, Simone Negrini, Ottavia Magnani, Elena Penza, Marco Pellecchio, Rossella Gulli, Paola Mandich, Francesco Puppo
TNF-α inhibitors have demonstrated efficacy both as monotherapy and in combination with disease-modifying anti-rheumatic drugs (DMARDs) in the treatment of chronic inflammatory immune-mediated diseases such as rheumatoid arthritis, Crohn's disease, ulcerative colitis, ankylosing spondylitis (AS), psoriasis (Ps) and/or psoriatic arthritis (PsA) and may be administered off-label to treat disseminated granuloma annulare, systemic lupus erythematosus and systemic sclerosis. There are several TNF-α inhibitors available for clinical use including infliximab, adalimumab, golimumab, certolizumab pegol and etanercept...
August 24, 2017: Modern Rheumatology
Anna Belloni Fortina, Federico Bardazzi, Samantha Berti, Claudia Carnevale, Vito Di Lernia, Maya El Hachem, Iria Neri, Carlo Mario Gelmetti, Viviana Lora, Carlo Mazzatenta, Mirella Milioto, Gaia Moretta, Annalisa Patrizi, Ketty Peris, Alberto Villani
This article provides comprehensive recommendations for the systemic treatment of severe pediatric psoriasis based on evidence obtained from a systematic review of the literature and the consensus opinion of expert dermatologists and pediatricians. For each systemic treatment, the grade of recommendation (A, B, C) based on the treatment's approval by the European Medicines Agency for childhood psoriasis and the experts' opinions is discussed. The grade of recommendation for narrow-band-ultraviolet B phototherapy, cyclosporine, and retinoids is C, while that for methotrexate is C/B...
October 2017: European Journal of Pediatrics
Vito Di Lernia
Most systemic therapies have not been systematically investigated in moderate to severe childhood plaque psoriasis. Evidence on the efficacy and safety of systemic treatments is limited and therapeutic guidelines are lacking. Recently adalimumab, a fully human monoclonal antibody that binds tumor necrosis factor (TNF)- alpha, was investigated in childhood psoriasis. Adalimumab is licensed for many inflammatory conditions including chronic plaque psoriasis in adults. Areas covered: A randomized phase III study published provided favourable efficacy and safety data of adalimumab in childhood psoriasis...
August 22, 2017: Expert Opinion on Biological Therapy
Jan Däbritz, Patrick Gerner, Axel Enninger, Martin Claßen, Michael Radke
BACKGROUND: The incidence of inflammatory bowel disease (IBD) in childhood and adolescence is 5-11 cases per 100 000 persons per year, corresponding to a new diagnosis of IBD in 800-1470 patients in Germany each year. METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed, including guidelines from Germany and abroad. RESULTS: Children and adolescents with IBD often have extensive involvement and an aggressive course of disease...
May 12, 2017: Deutsches Ärzteblatt International
James E Frampton
Golimumab (Simponi®), a fully human monoclonal antibody against tumour necrosis factor-alpha (TNFα), is given once monthly by subcutaneous injection. In the EU, golimumab is approved as monotherapy and/or in combination with methotrexate for the treatment of inflammatory arthritis, including rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis [comprising ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA)] in adults, and polyarticular juvenile idiopathic arthritis (pJIA) in children...
June 2017: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
Rotem Sigall Boneh, Chen Sarbagili Shabat, Henit Yanai, Irit Chermesh, Sivan Ben Avraham, Mona Boaz, Arie Levine
Background: Loss of response [LoR] to biologics in Crohn's disease [CD] is a significant clinical problem. Dietary therapy as a treatment strategy in this setting has not been previously reported. We report the use of dietary strategies using enteral nutrition coupled with the Crohn's Disease Exclusion Diet [CDED] for LoR to infliximab or adalimumab as a single-centre experience. Methods: Patients with LoR to a biologic despite dose escalation or combination therapy were treated with partial enteral nutrition [PEN] by a polymeric formula and the CDED for 12 weeks...
October 1, 2017: Journal of Crohn's & Colitis
C H Smith, Z K Jabbar-Lopez, Z Z Yiu, T Bale, A D Burden, L C Coates, M Cruickshank, T Hadoke, E MacMahon, R Murphy, C Nelson-Piercy, C M Owen, R Parslew, E Peleva, E Pottinger, E J Samarasekera, J Stoddart, C Strudwicke, V A Venning, R B Warren, L S Exton, M F Mohd Mustapa
No abstract text is available yet for this article.
September 2017: British Journal of Dermatology
Kim Papp, Diamant Thaçi, Danielle Marcoux, Lisa Weibel, Sandra Philipp, Pierre-Dominique Ghislain, Ian Landells, Peter Hoeger, Carol Kotkin, Kristina Unnebrink, Marieke Seyger, David Williams
BACKGROUND: Adalimumab is indicated for the treatment of moderate to severe psoriasis in adults. We assessed the efficacy and safety of adalimumab in children and adolescents with severe plaque psoriasis. METHODS: This randomised, double-blind, multiperiod, phase 3 trial was done at 38 clinics in 13 countries. Patients (aged ≥4 to <18 years) with severe plaque psoriasis who had not responded to topical therapy were randomly assigned with an interactive voice or web-response system (1:1:1) to receive adalimumab 0·8 mg/kg or 0·4 mg/kg subcutaneously at week 0, then every other week starting at week 1, or oral methotrexate once weekly (0·1-0·4 mg/kg) for 16 weeks...
July 1, 2017: Lancet
Athimalaipet V Ramanan, Andrew D Dick, Ashley P Jones, Andrew McKay, Paula R Williamson, Sandrine Compeyrot-Lacassagne, Ben Hardwick, Helen Hickey, Dyfrig Hughes, Patricia Woo, Diana Benton, Clive Edelsten, Michael W Beresford
BACKGROUND: Adalimumab, a fully human anti-tumor necrosis factor α monoclonal antibody, is effective in the treatment of juvenile idiopathic arthritis (JIA). We tested the efficacy of adalimumab in the treatment of JIA-associated uveitis. METHODS: In this multicenter, double-blind, randomized, placebo-controlled trial, we assessed the efficacy and safety of adalimumab in children and adolescents 2 years of age or older who had active JIA-associated uveitis. Patients who were taking a stable dose of methotrexate were randomly assigned in a 2:1 ratio to receive either adalimumab (at a dose of 20 mg or 40 mg, according to body weight) or placebo, administered subcutaneously every 2 weeks...
April 27, 2017: New England Journal of Medicine
Víctor Manuel Navas-López, Gemma Pujol Muncunill, Enrique Llerena, María Navalón Rubio, David Gil-Ortega, Vicente Varea-Calderón, Carlos Sierra Salinas, Javier Martin-de-Carpi
BACKGROUND AND OBJECTIVES: Adalimumab (ADA), a monoclonal humanised anti-TNF antibody, is usually prescribed as a second-line treatment in paediatric Crohn's disease (CD) patients who have become unresponsive or developed intolerance to infliximab (IFX). In the case series reported, more than 70% of patients had initially been treated with IFX. Data on short- and long-term effectiveness of ADA in anti-TNF naïve patients is limited. The aim of this study is to describe our experience with ADA as a first-line anti-TNF in paediatric CD patients...
April 20, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
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