Review of Biologics in Children With Rheumatic Diseases

Shabina Habibi; Athimalaipet V Ramanan

Disclosures

Int J Clin Rheumatol. 2012;7(1):81-93. 

In This Article

Abstract and Introduction

Abstract

The advent of biological drugs has revolutionized the management of various pediatric rheumatologic diseases, primarily juvenile idiopathic arthritis. These drugs enable better disease control and prevent or retard damage due to active disease in a substantial number of children. Their use in the periodic fever syndromes has enabled the control of active inflammation leading to symptom control and prevention of long-term consequences such as amyloidosis and renal failure. In this review, we discuss the efficacy and safety of the various biologics used to treat a number of childhood rheumatic diseases, with particular emphasis on juvenile idiopathic arthritis.

Introduction

In recent years, the advent of new drugs has led to a dramatic change in the management of rheumatic diseases in children. Central to this, is the development of a new class of agents termed biologics, which has virtually revolutionized management of juvenile idiopathic arthritis (JIA), such that 'complete disease remission' is a frequent reality today. Prolonged treatment of JIA with traditional disease modifying antirheumatic drugs such as methotrexate and sulfasalazine leads to persistence of active disease in approximately 50% of children.[1] Thus there is a need for more aggressive therapy, especially early in the course of the disease, which could lead to better outcomes.

Currently available biologics include TNF-α blockers, agents that target IL-1 and IL-6, T-cell costimulation inhibitors and antibodies against the CD20 molecule present on B cells.

In this review, we present data relating to the efficacy and safety of the different biologics used to treat various childhood rheumatic diseases, with particular focus on JIA.

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