Treatment of juvenile idiopatic arthritis and biological agents

Year 2011, , 76 - 85, 01.09.2011

Pelin Oktayoğlu İbrahim Tekeoğlu

https://doi.org/10.5505/sakaryamj.2011.36844

Abstract

Juvenile idiopathic arthritis (JIA) is the general term of a group of diseases including psoriatic arthritis and other spondyloarthropathies which are not in the spectrum of juvenile rheumatoid arthritis. Although up to date most of drugs are used for the treatment of this disease, an exact cure can not be developed. The targets of the therapy are protecting joint functions, improving clinic symptoms and providing achievement of normal growth and physical development. Disease modifiying antirheumatic drugs like methotrexate, sulfasalazine, hydroxychloroquine and corticosteroids, antiinflammatory agents are used for providing these targets. While the trials are going on about biologics related with rheumatic diseases, these agents are also being used for the treatment of JIA. In short and mid term periods promising results are validated from clinic trials. Three of these drugs, etanercept, adalimumab and abatacept are approved by FDA for the treatment of JIA. We are expecting long term results of ongoing trials with a great interest. 'Pediatric core set' related with the American College of Rheumatology (ACR) response levels are used for documentation of clinic results in research arena. New treatment researches are still going on bacause of there is no exact cure for this disease.

Keywords

Juvenile idiopathic arthritis, disease modifiying antirheumatic drugs, anticytokine therapy

Jüvenil idyopatik artrtte tedavi biyolojik ajanlar

Abstract

Juvenil idyopatik artrit (JIA), psöriyatik artrit ve diğer spondiloartritler gibi hastalıkları da içine alan fakat juvenil romatoid artrit (JRA) spektrumu içinde bulunmayan hastalıklar grubunun genel adıdır. Geçmişten günümüze pek çok ajan kullanılmış olmakla beraber hastalığın kesin tedavisi sağlanamamıştır. Medikal tedavinin amaçları, eklem fonksiyonlarını korumak, semptomları iyileştirmek, normal büyüme ve gelişmenin devamını sağlamaktır. Bu amaçla metotreksat, sülfasalazin, hidroksiklorokin gibi temel etkili anti romatizmal ilaçlar, kortikosteroidler, non steroid anti enflamatuvar ilaçlar kullanılmıştır. Romatizmal hastalıkların tedavisinde biyolojik ajanların kullanımıyla birlikte bu ajanlar JIA tedavisinde de denenmiş, kısa ve orta vadede umut verici sonuçlar elde edilmiştir. Bu ajanlardan etanercept, adalimumab ve abatacept JIA tedavisinde Amerika Gıda ve İlaç Dairesi (FDA) tarafından onaylanmış üç ajandır. Bu ajanların JIA'de uzun vadeli sonuçları merakla beklenmektedir. Geliştirilmiş ajanların klinik etkilerinin araştırılmasında Amerikan Romatizma Cemiyeti'nin (ARC) cevap düzeylerinin değerlendirildiği 'core set data' denilen parametreler kullanılmaktadır. Hastalığın kesin tedavisinin olmaması nedeniyle yeni tedavi araştırmaları halen sürdürülmektedir.

Keywords

Juvenil idyopatik artrit, temel etkili ajan, antisitokin tedavi

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