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Remittive agents in pediatric rheumatology
Nora G Singer1, Lisabeth V Scalzi
1Department of Pediatrics and Internal Medicine, CASE School of Medicine and Rainbow Babies and Children's Hospital/University Hospitals, Cleveland, Ohio 44106, USA. ngs@cwru.edu
Current Opinion in Rheumatology
|August 18, 2004
Summary
This review summarizes evidence for disease-modifying antirheumatic drugs and biologic agents in pediatric rheumatic diseases. It covers approved and novel therapies, including tumor necrosis factor-alpha inhibitors and others.
Area of Science:
- Pediatric Rheumatology
- Immunology
- Pharmacology
Background:
- Children with rheumatic diseases often need disease-modifying antirheumatic drugs (DMARDs) and biologic agents.
- Adult therapies are frequently used in children before comprehensive safety and efficacy evaluations.
- Published "off-label" usage data aids decision-making but doesn't replace prospective trials.
Purpose of the Study:
- To review recent evidence on the efficacy and safety of standard and novel agents for pediatric rheumatic diseases.
- To consolidate information on treatments used in children with these conditions.
Main Methods:
- Literature review of published evidence.
- Summary of efficacy and safety data for selected DMARDs and biologic agents.
- Inclusion of both approved and novel "off-label" therapeutic uses.
Main Results:
- Etanercept, a tumor necrosis factor-alpha inhibitor, is indicated for juvenile idiopathic arthritis.
- Novel "off-label" pediatric uses of Anakinra (interleukin-1 receptor agonist), MRA (anti-interleukin-6 receptor antibody), and rituximab (anti-CD20 monoclonal antibody) are discussed.
- Evidence for efficacy and safety of these agents in pediatric rheumatic diseases is summarized.
Conclusions:
- The review synthesizes published data supporting the use of specific DMARDs and novel biologic agents in pediatric rheumatic diseases.
- It highlights the importance of evidence-based treatment selection for children with these conditions.