Radiological improvement by tocilizumab in polyarticular juvenile idiopathic arthritis
Recent advances in biologic therapy have enabled reduction of the progression of destructive arthritis in rheumatoid arthritis. Once destroyed, however, the affected bones and cartilage are not fully repaired. We describe the case of an 8‐year‐old girl with anti‐citrullinated peptide antibody (ACPA)...
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| Veröffentlicht in: | Pediatrics international 2015-04, Vol.57 (2), p.307-310 |
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| creator | Tozawa, Yusuke Fujita, Shouji Abe, Shuji Kitamura, Koichi Kobayashi, Ichiro |
| description | Recent advances in biologic therapy have enabled reduction of the progression of destructive arthritis in rheumatoid arthritis. Once destroyed, however, the affected bones and cartilage are not fully repaired. We describe the case of an 8‐year‐old girl with anti‐citrullinated peptide antibody (ACPA)‐positive polyarticular juvenile idiopathic arthritis (p‐JIA). Destructive arthritis progressed during combination therapy with infliximab, methotrexate, mizoribine and prednisolone. Clinical remission was achieved, however, after switching the biologic agent to tocilizumab, a humanized monoclonal antibody to interleukin‐6 receptor. Both bone erosion and bone marrow edema on magnetic resonance imaging were repaired in association with restoration of joint spaces. Furthermore, there was no relapse of arthritis on weekly methotrexate alone for 2 years after discontinuation of the tocilizumab. Tocilizumab led to radiological repair of both bone and cartilage destruction and long‐term biologics‐free remission in a patient with ACPA‐positive p‐JIA, and should be considered for tumor necrosis factor inhibitor‐resistant cases. |
| doi_str_mv | 10.1111/ped.12454 |
| format | Article |
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Once destroyed, however, the affected bones and cartilage are not fully repaired. We describe the case of an 8‐year‐old girl with anti‐citrullinated peptide antibody (ACPA)‐positive polyarticular juvenile idiopathic arthritis (p‐JIA). Destructive arthritis progressed during combination therapy with infliximab, methotrexate, mizoribine and prednisolone. Clinical remission was achieved, however, after switching the biologic agent to tocilizumab, a humanized monoclonal antibody to interleukin‐6 receptor. Both bone erosion and bone marrow edema on magnetic resonance imaging were repaired in association with restoration of joint spaces. Furthermore, there was no relapse of arthritis on weekly methotrexate alone for 2 years after discontinuation of the tocilizumab. Tocilizumab led to radiological repair of both bone and cartilage destruction and long‐term biologics‐free remission in a patient with ACPA‐positive p‐JIA, and should be considered for tumor necrosis factor inhibitor‐resistant cases.</description><identifier>ISSN: 1328-8067</identifier><identifier>EISSN: 1442-200X</identifier><identifier>DOI: 10.1111/ped.12454</identifier><identifier>PMID: 25868948</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Antibodies, Monoclonal, Humanized - therapeutic use ; anti‐citrullinated peptide antibody ; Arthritis ; Arthritis, Juvenile - drug therapy ; bone repair ; Child ; Disease Progression ; Drug therapy ; Female ; Hand - diagnostic imaging ; Hand - pathology ; Humans ; juvenile idiopathic arthritis ; Magnetic Resonance Imaging ; Pediatrics ; Remission Induction ; rheumatoid factor ; tocilizumab ; Treatment Outcome</subject><ispartof>Pediatrics international, 2015-04, Vol.57 (2), p.307-310</ispartof><rights>2015 Japan Pediatric Society</rights><rights>2015 Japan Pediatric Society.</rights><rights>Pediatrics International © 2015 Japan Pediatric Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3774-6861bd42054cff194fbd50537855c4e80d6544b6e8b497cc9aedfadc315fac0c3</citedby><cites>FETCH-LOGICAL-c3774-6861bd42054cff194fbd50537855c4e80d6544b6e8b497cc9aedfadc315fac0c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fped.12454$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fped.12454$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25868948$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tozawa, Yusuke</creatorcontrib><creatorcontrib>Fujita, Shouji</creatorcontrib><creatorcontrib>Abe, Shuji</creatorcontrib><creatorcontrib>Kitamura, Koichi</creatorcontrib><creatorcontrib>Kobayashi, Ichiro</creatorcontrib><title>Radiological improvement by tocilizumab in polyarticular juvenile idiopathic arthritis</title><title>Pediatrics international</title><addtitle>Pediatr Int</addtitle><description>Recent advances in biologic therapy have enabled reduction of the progression of destructive arthritis in rheumatoid arthritis. Once destroyed, however, the affected bones and cartilage are not fully repaired. We describe the case of an 8‐year‐old girl with anti‐citrullinated peptide antibody (ACPA)‐positive polyarticular juvenile idiopathic arthritis (p‐JIA). Destructive arthritis progressed during combination therapy with infliximab, methotrexate, mizoribine and prednisolone. Clinical remission was achieved, however, after switching the biologic agent to tocilizumab, a humanized monoclonal antibody to interleukin‐6 receptor. Both bone erosion and bone marrow edema on magnetic resonance imaging were repaired in association with restoration of joint spaces. Furthermore, there was no relapse of arthritis on weekly methotrexate alone for 2 years after discontinuation of the tocilizumab. Tocilizumab led to radiological repair of both bone and cartilage destruction and long‐term biologics‐free remission in a patient with ACPA‐positive p‐JIA, and should be considered for tumor necrosis factor inhibitor‐resistant cases.</description><subject>Antibodies, Monoclonal, Humanized - therapeutic use</subject><subject>anti‐citrullinated peptide antibody</subject><subject>Arthritis</subject><subject>Arthritis, Juvenile - drug therapy</subject><subject>bone repair</subject><subject>Child</subject><subject>Disease Progression</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Hand - diagnostic imaging</subject><subject>Hand - pathology</subject><subject>Humans</subject><subject>juvenile idiopathic arthritis</subject><subject>Magnetic Resonance Imaging</subject><subject>Pediatrics</subject><subject>Remission Induction</subject><subject>rheumatoid factor</subject><subject>tocilizumab</subject><subject>Treatment Outcome</subject><issn>1328-8067</issn><issn>1442-200X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1LwzAYgIMobk4P_gEpeNFDtyRNmvQoc37AQBEVbyVNU5eRfpi0k_rrzay7COaS8Obh4eUB4BTBKfJn1qh8ijChZA-MESE4xBC-7ft3hHnIYcxG4Mi5NYSQM04OwQhTHvOE8DF4fRK5rk39rqUwgS4bW29Uqao2yPqgraU2-qsrRRboKmhq0wvbatkZYYN1t1GVNirQXtCIdqVl4H9XVrfaHYODQhinTn7vCXi5WTzP78Llw-39_GoZyogxEsY8RllOMKREFgVKSJHlFNKIcUolURzmMSUkixXPSMKkTITKC5HLCNFCSCijCbgYvH7vj065Ni21k8oYUam6cymKWRQxxCD26PkfdF13tvLbbSnMGIYk8dTlQElbO2dVkTZWl8L2KYLpNnbqY6c_sT179mvsstJPd-SurgdmA_DpO_X_m9LHxfWg_AYPnIoM</recordid><startdate>201504</startdate><enddate>201504</enddate><creator>Tozawa, Yusuke</creator><creator>Fujita, Shouji</creator><creator>Abe, Shuji</creator><creator>Kitamura, Koichi</creator><creator>Kobayashi, Ichiro</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201504</creationdate><title>Radiological improvement by tocilizumab in polyarticular juvenile idiopathic arthritis</title><author>Tozawa, Yusuke ; Fujita, Shouji ; Abe, Shuji ; Kitamura, Koichi ; Kobayashi, Ichiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3774-6861bd42054cff194fbd50537855c4e80d6544b6e8b497cc9aedfadc315fac0c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Antibodies, Monoclonal, Humanized - therapeutic use</topic><topic>anti‐citrullinated peptide antibody</topic><topic>Arthritis</topic><topic>Arthritis, Juvenile - drug therapy</topic><topic>bone repair</topic><topic>Child</topic><topic>Disease Progression</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Hand - diagnostic imaging</topic><topic>Hand - pathology</topic><topic>Humans</topic><topic>juvenile idiopathic arthritis</topic><topic>Magnetic Resonance Imaging</topic><topic>Pediatrics</topic><topic>Remission Induction</topic><topic>rheumatoid factor</topic><topic>tocilizumab</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tozawa, Yusuke</creatorcontrib><creatorcontrib>Fujita, Shouji</creatorcontrib><creatorcontrib>Abe, Shuji</creatorcontrib><creatorcontrib>Kitamura, Koichi</creatorcontrib><creatorcontrib>Kobayashi, Ichiro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tozawa, Yusuke</au><au>Fujita, Shouji</au><au>Abe, Shuji</au><au>Kitamura, Koichi</au><au>Kobayashi, Ichiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Radiological improvement by tocilizumab in polyarticular juvenile idiopathic arthritis</atitle><jtitle>Pediatrics international</jtitle><addtitle>Pediatr Int</addtitle><date>2015-04</date><risdate>2015</risdate><volume>57</volume><issue>2</issue><spage>307</spage><epage>310</epage><pages>307-310</pages><issn>1328-8067</issn><eissn>1442-200X</eissn><abstract>Recent advances in biologic therapy have enabled reduction of the progression of destructive arthritis in rheumatoid arthritis. Once destroyed, however, the affected bones and cartilage are not fully repaired. We describe the case of an 8‐year‐old girl with anti‐citrullinated peptide antibody (ACPA)‐positive polyarticular juvenile idiopathic arthritis (p‐JIA). Destructive arthritis progressed during combination therapy with infliximab, methotrexate, mizoribine and prednisolone. Clinical remission was achieved, however, after switching the biologic agent to tocilizumab, a humanized monoclonal antibody to interleukin‐6 receptor. Both bone erosion and bone marrow edema on magnetic resonance imaging were repaired in association with restoration of joint spaces. Furthermore, there was no relapse of arthritis on weekly methotrexate alone for 2 years after discontinuation of the tocilizumab. Tocilizumab led to radiological repair of both bone and cartilage destruction and long‐term biologics‐free remission in a patient with ACPA‐positive p‐JIA, and should be considered for tumor necrosis factor inhibitor‐resistant cases.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>25868948</pmid><doi>10.1111/ped.12454</doi><tpages>3</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Antibodies, Monoclonal, Humanized - therapeutic use anti‐citrullinated peptide antibody Arthritis Arthritis, Juvenile - drug therapy bone repair Child Disease Progression Drug therapy Female Hand - diagnostic imaging Hand - pathology Humans juvenile idiopathic arthritis Magnetic Resonance Imaging Pediatrics Remission Induction rheumatoid factor tocilizumab Treatment Outcome |
| title | Radiological improvement by tocilizumab in polyarticular juvenile idiopathic arthritis |
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