CYCLOSPORIN A IN THERAPY FOR JUVENILE ARTHRITIS
https://doi.org/10.14412/1996-7012-2010-599
Abstract
The paper describes approaches to using cyclosporin A (CsA) in juvenile arthritis (JA). It shows the benefits of combination basic therapy with CsA and methotrexate included into a treatment regimen mainly for systemic JA and JA involving the eye (uveitis) versus monotherapy with the above drugs. Attention is drawn to that the oral dose of glucocorticoids may be decreased when CsA is incorporated into the treatment regimen. CsA is shown to be of value as the drug of choice for the therapy of such a menacing complication of systemic JA as the macrophage activation syndrome
References
1. <div><p>Баранов А.А., Насонов Е.Л., Алексеева Е.И. и др. Состояние специализированной медицинской помощи детям и взрослым в Российской Федерации. Проект Федеральной целевой программы «Ревматические болезни 2008-2012». Вопр. совр. педиатр. 2007; 1: 4-6.</p><p>Ревматология. Национальное руководство. М.: ГЭОТАР-Медиа, 2008; 224-7, 686-711.</p><p>Насонов Е.Л. Метотрексат. Перспективы применения в ревматологии. М.: Филоматис, 2005; 129-53.</p><p>Hashkes P.J., Laxer R.L. Medical treatment of juvenile idiopathic arthritis. JAMA 2005; 294: 1671-84.</p><p>Haines K.A. Juvenile Idiopathic Arthritis. Therapies in the 21st Century. Bulletin for the NYU Hospital for Joint Diseases 2007; 65: 205-11.</p><p>Speckmaier M., Findeien J., Woo P. Low- dose methotrexate in systemic onset juvenile chronic arthritis. Clin Exp Rheumol 1989; 7: 647-50.</p><p>Reiff A., Shaham B., Wood B.P. et al. High dose methotrexate in the treatment of refractory juvenile rheumatoid arthritis. Clin Exp Rheumatol 1995; 13: 113-8.</p><p>Woo P., Southwood T.R., Prieur A.-M. et al. Randomized, placebo controlled, crossover trial of low-dose oral methotrexate in children with extended oligoarthicular or systemic arthritis. Arthr Rheum 2000; 43: 1849-57.</p><p>Борель Дж.Ф. Циклоспорин. Руководство по иммунофармакологии. Под ред. Дж.К. Формена. М.: Медицина, 1998: 269-79.</p><p>Алексеева Е.И., Шахбазян И.Е. Принципы патогенетической терапии тяжелых системных вариантов ювенильного ревматоидного артрита. М.: Novartis pharma services Inc., 2002.</p><p>Лучихина Е.Л. Циклоспорин А при ревматоидном артрите: современные данные. Совр. ревматол. 2009; 3: 39-44.</p><p>Landewe R.B., Goei The H.S., van Rijthoowen A.E. et al. A randomized, double blind, 24-weeek controlled study of low-dose cyclosporine versus chloroquine for early rheumatoid arthritis. Arthr Rheum 1994; 37: 637-43.</p><p>Van der Borne B.E., Landewe R.B., Goei The H.S. Combination therapy in recent onset rheumatoid arthritis: a randomized, double blind trial of the addition of low-dose cyclosporine to patients treated with low-dose chloroqiune. Rheumatol 1998; 25: 1993-8.</p><p>Miranda J.M., Alvarez-Nemegeyei J., Saavadera M. et al. A randomized, double blind, multisenter, controlled clinical trial of cyclosporine plus chloroquine vs. cyclosporine plus placebo in early-onset rheumatoid arthritis. Arch Med Res 2004; 35: 36-42.</p><p>Gerards A., Landewe R.B., Prins A.P. et al. Cyclosporine A monotherapy versus cyclosporine A and methotrexate combination therapy in patients with early rheumatoid arthritis: a double blind, randomized, placebo controlled trial. Ann Rheum Dis 2003; 62: 291-6.</p><p>Ferraciolli G., Gremese E., Tomiento P. et al. Analysis of improvments, full responses, remission and toxicity in rheumatoid patients treated with step-up combination patients (methotrexate, cyclosporine A, sulphasalaxine) or monotherapy for three years. Rheumatology (Oxford) 2002; 41: 892-8.</p><p>Hetland M.L., Stengaard-Pedersen K., Junker P. et al. Combination treatment with methotrexate, cyclosporine A, and intraarthicular bethamethasone compared with methotrexate and intraarthicular bethamethasone in active rheumatoid arthritis: an investigator-initiated, multisenter, randomized, double blind, parallel-group placebo controlled strudy. Arthr Rheum 2006; 54: 1401-9.</p><p>Hetland M.L., Stengaard-Pedersen K., Junker P. et al. Aggressive combination therapy with intra-arthicular glucocorticoid injection and convential disease-modyfying anthirheumatic drugs in early rheumatoid arthritis: second-year clinical and radiographic results from CIMESTRA study. Ann Rheum Dis 2008; 67: 815-22.</p><p>Pascual V., Allantaz F., Arce E. et al. Role of interleukin-1 (IL-1) in the patogenesis of systemic onset juvenile idiopathic arthritis and clinical response to IL-1 blockade. J Exp Med 2005; 201: 1479-86</p><p>De Benedetti F., Ravelli A., Martini A. Cytokines in juvenile rheumatiod artritis. Curr Opin Rheumatol 1997; 9: 428-33.</p><p>Федоров Е.С., Кузьмина Н.Н., Салугина С.О. Роль цитокиновой сети в регуляции воспаления при различных вариантах ювенильного артрита. Науч.-практич. ревматол. 2009; 3: 74-89.</p><p>Ostensen M., Hoyeraal H.M., Kass E. Tolerance of cyclosporine A in children with refractory juvenile rheumatoid arthritis. J Rheumatol 1988; 15: 1536-8.</p><p>Padeh S., Laxer R.M., Silver M.M. et al. Primary pulmonary hypertension in a patient with systemic-onset juvenile arthritis. Arthr Rheum 1991; 34: 1575-9.</p><p>Gerloni V., Cimaz R., Gattinara M. et al. Efficacy and safety profile of cyclosporine A in the treatment of onset juvenile chronic (idiopathic) arthritis. Results of 10-yeaer prospective study. Rheumatology (Oxford) 2001; 40: 907-13.</p><p>Ruperto N., Ravelli A., Castell E. et al. Cyclosporine A in juvenile idiopathic arthritis. Results of the PRCSG/PRINTO phase IV post marketing surveillance study. Clin Exp Rheumatol 2006; 24: 599-605.</p><p>Алексеева Е.И., Шахбазян И.Е., Валиева Т.М. и др. Опыт пятнадцатилетнего применения циклоспорина А в детской ревматологии. Вопр совр педиатр 2008; 6: 104-17.</p><p>Салугина С.О., Кузьмина Н.Н. Ретроспективный анализ эффективности и непереносимости циклоспорина А (сандиммун неорал) у больных с ювенильным идиопатическим артритом. Науч.-практич. ревматол. 2004; 4: 89-91.</p><p>Алексеева Е.И., Шахбазян И.Е. Ювенильный ревматоидный артрит. Практическое руководство по детским болезням. Под ред. В.Ф. Коколиной и А.Г. Румянцева. Т. III. Кардиология и ревматология детского возраста. М.: Медпрактика-М, 2004: 499-600.</p><p>Sawhney S., Woo P., Murray J. Macrophage activation syndrome: a potentially fatal complication pf rheumatic disorders. Arch Dis Child 2001; 85: 421-6.</p><p>Kounami S., Yoshiyama M., Nakayama K. et al. Macrophage activation syndrome in children with systemic-onset juvenile chronic arthritis. Acta Haematol 2005; 113: 124-9.</p><p>Li C.F., He X.H., Kuang W.Y. et al. Macrophage activation syndrome in Chinese children with systemic onset juvenile idiopathic arthritis. Zhonghua Er Ke Za Zhi 2006; 44: 806-11.</p><p>Li C.F., He X.H., Kuang W.Y. et al Macrophage activation syndrome in Chinese children with systemic onset juvenile idiopathic arthritis. Zhonghua Er Ke Za Zhi 2006; 44: 806-11.</p><p>Penadеs I.C., Pascual P.M., Caballero C.M. et al. Macrophage activation syndrome and juvenile idiopathic arthritis. A multicenter study. An Pediatr (Barc) 2008; 68: 110-6.</p><p>Tristano A.G. Macrophage activation syndrome: a frequent but under-diagnosed complication associated with rheumatic diseases. Med Sci Monit 2008; 14:RA27-36.</p><p>Nakakura H., Ashida A., Matsumura H. et al. A case report of successful treatment with plasma exchange for hemophagocytic syndrome associated with severe systemic juvenile idiopathic arthritis in an infant girl. Ther Apher Dial 2009; 13: 71-6.</p><p>Mouy R., Stephan J.L., Pillet P. et al. Efficacy of cyclosporine A in the treatment of macrophage activation syndrome in juvenile arthritis: report of five cases. J Pediatr 1996; 129: 750-4.</p><p>Stеphan J.L., Konе-Paut I., Galambrun C. et al. Reactive haemophagocytic syndrome in children with inflammatory disorders. A retrospective study of 24 patients. Rheumatology (Oxford) 2001; 40: 1285-92.</p><p>Zhang Z., Yang P.Z., Zhou H.Y. The clinical feature, diagnosis and treatment of uveitis associated with juvenile chronic arthritis. Zhonghua Yan Ke Za Zhi 2005 Apr; 41(4): 346-9.</p><p>Nussenblatt R.B., Palestine A.G., Chan C.C. et al. Randomized, double-masked study of cyclosporine compared to prednisolone in the treatment of endogenous uveitis. Am J Ophthalmol 1991 Aug 15; 112(2): 138-46.</p><p>Schlote T., Dannecker G., Thiel H.J. et al. Cyclosporin A in therapy of chronic uveitis in childhood. Ophthalmologe 1996; 93: 745-8.</p><p>Zhang Z., Yang P.Z., Zhou H.Y. et al. The clinical feature, diagnosis and treatment of uveitis associated with juvenile chronic arthritis. Zhonghua Yan Ke Za Zhi 2005; 41: 346-9.</p><p>Heiligenhaus A., Mingels A., Heinz C. et al. Methotrexate for uveitis associated with juvenile idiopathic arthritis: value and requirement for additional anti-inflammatory medication. Eur J Ophthalmol 2007; 17: 743-8.</p><p>Tappeiner C., Roesel M., Heinz C. Limited value of cyclosporine A for the treatment of patients with uveitis associated with juvenile idiopathic arthritis. Eye (Lond) 2009; 23: 1192-8.</p><p>Ravelli A., Moretti C., Temporini F. et al. Combination therapy with methotrexate and cyclosporine A in juvenile idiopathic arthritis. Clin Exp Rheumatol 2002; 20: 569-72.</p><p>Алексеева Е.И., Литвицкий П.Ф. Ювенильный ревматоидный артрит. М.: ВЕДИ, 2007.</p><p>Murphy E.A., Morris A.J., Walker E. Cyclosporine A induced colitis and acquired selective IgA deficiency in a patient with juvenile chronic arthritis. J Rheumatol 1993; 20: 1397-8.</p></div><br />
Review
For citations:
Fedorov ES, Salugina SO. CYCLOSPORIN A IN THERAPY FOR JUVENILE ARTHRITIS. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2010;4(2):29-37. (In Russ.) https://doi.org/10.14412/1996-7012-2010-599
Views:
1272
Email this article 