[Biotherapies for juvenile idiopathic arthristis]

BIOTHERAPIES FOR JUVENILE IDIOPATHIC ARTHRITIS. The introduction of biotherapies has dramatically changed the care and evolution of children with juvenile idiopathic arthritis. These biotherapies, directed against tumor necrosis factor (TNF) alpha, interleukine (IL)-1, IL-6, IL-17 or T cell costimulation (abatacept), and more recently small molecules, the Janus kinase (JAK) inhibitors, have significantly improved the outcomes of these patients. In addition, multiple biotherapies are currently evaluated in clinical trials. The overall safety profile of biotherapies in children is similar to adults; the most common adverse events are infections, dysimmune manifestations and allergic reactions. Up-to-date vaccination status is crucial to prevent treatment-associated complications. Children with juvenile idiopathic arthritis under biotherapy should be followed in specialised center, long-term follow-up regarding efficacy and pharmacovigilance is important.