RT Journal Article
SR Electronic
T1 High Doses of Infliximab in the Management of Juvenile Idiopathic Arthritis
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1749
OP 1755
DO 10.3899/jrheum.130133
VO 40
IS 10
A1 Ajay Tambralli
A1 Timothy Beukelman
A1 Peter Weiser
A1 Thomas Prescott Atkinson
A1 Randy Quentin Cron
A1 Matthew Laurence Stoll
YR 2013
UL http://www.jrheum.org/content/40/10/1749.abstract
AB Objective. To review our experiences with high-dose infliximab (IFX) to treat juvenile idiopathic arthritis (JIA). We routinely use high doses of IFX (10–20 mg/kg) in children with recalcitrant or highly active JIA. Although biologics have revolutionized treatment of JIA, many patients have active disease despite therapy. Studies have shown benefits of high-dose IFX in several conditions, including inflammatory bowel disease, psoriasis, and idiopathic uveitis. The safety and effectiveness of high-dose IFX have not been evaluated in JIA. Methods. We performed a retrospective review of children with JIA who received IFX ≥ 10 mg/kg. We recorded all serious adverse events (SAE), medically important infections, and infusion reactions. We also recorded the physician global assessment of disease activity (MD global) and active joint count (AJC) at initiation of high-dose IFX and 3, 6, and 12 months thereafter. Results. Fifty-eight subjects received a total of 1064 infusions over 95 person-years. There were a total of 9 SAE (9.5/100 person-yrs), 7 of which were potentially related to therapy, and 6 infusion reactions (0.5%), none constituting anaphylaxis. Statistically significant improvements were observed in the AJC (median 0, range 0–31, vs 2, 0–39) and MD global (12, 2–31, vs 22, 5–80) over the first year. Conclusion. High-dose IFX appears safe in the management of JIA. Future prospective controlled studies are necessary to evaluate its safety and efficacy.