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Adalimumab in pediatrics

Edouard J Louis, Walter Reinisch, David A Schwartz, Robert Löfberg, Anne M Robinson, Sofie Berg, Anthony W Wang, Jen-Fue Maa, Bidan Huang, Brandee Pappalardo
INTRODUCTION: Extraintestinal manifestations (EIMs) in patients with Crohn's disease (CD) are common and associated with additional morbidity. This study aimed to evaluate the effect of adalimumab therapy on EIM resolution and identify potential predictors of EIM resolution in adult and pediatric patients with moderate to severe CD. METHODS: EIM data were pooled from 11 induction, maintenance, and open-label extension studies of adalimumab. Resolution of EIMs was evaluated at approximately 6 months and 1 year...
March 7, 2018: Advances in Therapy
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
Victoria M Merrick, Kajal Mortier, Linda J Williams, Rafeeq Muhammed, Marcus K H Auth, Mamoun Elawad, John M E Fell, R Mark Beattie, Sabarinathan Loganathan, Franco Torrente, Mary-Anne Morris, Charles Charlton, Nick M Croft, Astor Rodrigues, Mark Furman, Babu Vadamalayan, Huw Jenkins, Veena Zamvar, Sally G Mitton, Sonny Chong, Mike Cosgrove, Anthony Akobeng, David C Wilson, Richard K Russell
OBJECTIVE: The aim of this study was to measure the effectiveness, safety, and use of anti-tumor necrosis Factor (TNF) therapy in pediatric inflammatory bowel disease in the United Kingdom (UK). METHODS: Prospective UK audit of patients newly starting anti-TNF therapy. Disease severity was assessed using Physician Global Assessment +/or the Paediatric Crohn Disease Activity Index. RESULTS: A total of 37 centers participated (23/25 specialist pediatric inflammatory bowel disease sites)...
February 2018: Journal of Pediatric Gastroenterology and Nutrition
Faekah Gohar, Janneke Anink, Halima Moncrieffe, Lisette W A Van Suijlekom-Smit, Femke H M Prince, Marion A J van Rossum, Koert M Dolman, Esther P A H Hoppenreijs, Rebecca Ten Cate, Simona Ursu, Lucy R Wedderburn, Gerd Horneff, Michael Frosch, Dirk Foell, Dirk Holzinger
OBJECTIVE: Around one-third of patients with juvenile idiopathic arthritis (JIA) fail to respond to first-line methotrexate (MTX) or anti-tumor necrosis factor (TNF) therapy, with even fewer achieving ≥ American College of Rheumatology Pediatric 70% criteria for response (ACRpedi70), though individual responses cannot yet be accurately predicted. Because change in serum S100-protein myeloid-related protein complex 8/14 (MRP8/14) is associated with therapeutic response, we tested granulocyte-specific S100-protein S100A12 as a potential biomarker for treatment response...
January 15, 2018: Journal of Rheumatology
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
C Chiaverini
The year 2017 in pediatric dermatology was marked by several consensus recommendations and meta analyzes on childhood psoriasis, atopic dermatitis or PHACE syndrome, case series on the role of anti-JAK treatment in adolescent with alopecia areata, sirolimus for vascular malformations, ivermectine for rosacea, inhibitors of MEK for type 1 neurofibromatosis or on the side effects of the oral isotretinoin for acne or propranolol for immature hemangioma. Only few randomized controlled studies have been published on the interest of adalimumab in the treatment of psoriasis or topical sirolimus for angiofibroma in tuberous sclerosis complex for example...
December 2017: Annales de Dermatologie et de Vénéréologie
Serena Pastore, Samuele Naviglio, Arianna Canuto, Loredana Lepore, Stefano Martelossi, Alessandro Ventura, Andrea Taddio
OBJECTIVES: Anti-tumor necrosis factor alpha (anti-TNF-α) agents are generally well tolerated, yet they can be associated with serious adverse events (SAEs) in a minority of patients. We examined the incidence of SAEs in a pediatric referral center for chronic rheumatologic and gastroenterological inflammatory disorders. METHODS: Retrospective analysis of SAEs occurring during treatment with anti-TNF-α agents in patients with juvenile idiopathic arthritis (JIA) (n = 78)  or pediatric-onset inflammatory bowel disease (IBD) (n = 105) seen at the Institute for Maternal and Child Health IRCCS "Burlo Garofolo" in Trieste, Italy, between June 2001 and February 2016...
December 6, 2017: Paediatric Drugs
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
Pardis Zaboli, Mohammad Abdollahi, Shilan Mozaffari, Shekoufeh Nikfar
Medical treatment for fistulizing Crohn's disease (FCD) is changing rapidly over the time by the introduction of novel therapeutic medicines, while no global consensus is available. This study aims to accomplish a systematic review and meta-analysis on the efficacy of tumor necrosis factor-alpha antibodies (anti-TNF-α antibodies) versus placebo in FCD. A systematic review of published literature was carried out till December 2016, and a meta-analysis of identified studies was done. Data have been explored from PubMed, Scopus, Cochrane Library Database, and Web of Science...
July 2017: Journal of Research in Pharmacy Practice
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
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
I Foeldvari, K Walscheid, A Heiligenhaus
BACKGROUND: Uveitis is the most common extra-articular manifestation of juvenile idiopathic arthritis (JIA). It occurs, according to German registry data, in around 12% of JIA patients and can lead to a loss of vision, especially in cases of delayed diagnosis and/or inadequate therapy. OBJECTIVE: A review of current aspects of diagnosis and therapy was carried out. MATERIAL AND METHODS: This is a review article of the current literature. RESULTS: The risk of uveitis is significantly elevated in patients with an oligoarticular course of JIA, ANA positivity and young age at onset of JIA...
October 2017: Zeitschrift Für Rheumatologie
Jashin J Wu, W C Valdecantos
<p>Psoriasis is a common, inflammatory disease that manifests itself as lesions on the skin, which greatly impacts the physical and psychological wellbeing of those affected. The current goal of treatment in psoriasis is to improve the signs and symptoms of disease, whilst minimizing the burden of disease on patient health-related quality of life. Psoriasis can also be associated with other comorbidities such as joint disease, cardiovascular disease, and depression, which can add to the complexity of treatment...
August 1, 2017: Journal of Drugs in Dermatology: JDD
Sanjai Jalaj, Kristen Dunbar, Ashley Campbell, Michael Kazim
The authors describe a 9-year-old female who presented with swelling, proptosis, and tenderness of the right upper eyelid and MRI imaging demonstrating right lacrimal gland enlargement. After failing treatment with corticosteroids, the patient underwent a biopsy that was consistent with IgG4-related orbital disease. She was subsequently successfully treated with adalimumab (TNF-α inhibitor). This is the first case report of the successful use of a TNF-α inhibitor for the treatment of IgG4-related orbital disease in a child...
July 10, 2017: Ophthalmic Plastic and Reconstructive Surgery
Nikos N Markomichelakis, Evaggelia K Aissopou, Stelios Maselos, Ilknur Tugal-Tutkun, Petros P Sfikakis
PURPOSE: Relapsing ocular inflammation occurs in about 70% of patients with Behçet's disease (BD) and can lead to permanent loss of vision. Neovascularization of the optic disc (NVD) or elsewhere in the retina (NVE) is a relatively uncommon but severe complication that lacks standardized treatment. METHODS: We report on the therapeutic use of anti-TNF monoclonal antibodies for BD-associated NVD and NVE in one pediatric patient (subcutaneous adalimumab) and one young man (intravenous infliximab)...
July 12, 2017: Ocular Immunology and Inflammation
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
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.)
Thomas D Walters, William A Faubion, Anne M Griffiths, Robert N Baldassano, Johanna Escher, Frank M Ruemmele, Jeffrey S Hyams, Andreas Lazar, Samantha Eichner, Bidan Huang, Yao Li, Roopal B Thakkar
BACKGROUND: Growth failure is common in children with Crohn's disease. The effect of adalimumab (ADA), a fully human antitumor necrosis factor antagonist, on height velocity in pediatric patients with baseline (BL) linear growth impairment in the IMAgINE 1 trial is presented. METHODS: This analysis included female and male patients with growth potential (bone age ≤13 and ≤14 yr, respectively), with BL Pediatric Crohn's disease Activity Index >30, and who failed or were intolerant to conventional therapy...
March 15, 2017: Inflammatory Bowel Diseases
Magnus Svensson, Eva Lindberg, Jonas F Ludvigsson
Biological treatments in pediatric IBD In Sweden, there are an estimated 1 500 pediatric IBD patients. We sent out a survey regarding the use of biological treatments in pediatric IBD to pediatric gastroenterologists in Sweden. Of 1 098 recorded IBD patients, 17% had ongoing treatment with biological drugs. The drugs used were almost exclusively infliximab and adalimumab, i.e. anti-TNF-alpha. Use of biologics varied among responders. Anaphylactic reactions and other types of infusion reactions were the most frequent side effects...
February 21, 2017: Läkartidningen
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