ab222018

Safety of anti-TNFa therapy in children with juvenile idiopathic arthritis

L. Dekker^1,3, W. Armbrust^1,4, C.M.A. Rademaker², B. Prakken¹, W. Kuis¹, N.M. Wulffraat¹

Department of Pediatric Rheumatology and Immunology and ²Department of Pharmacy, University Medical Center Utrecht, "Het Wilhelmina Kinder Ziekenhuis", Utrecht; ³Faculty of Pharmaceutical Sciences, Utrecht University, Utrecht; ⁴Beatrix Children's Hospital, Academic Center Groningen, Groningen, The Netherlands.

ABSTRACT
Anti-TNFa agents are frequently used in the treatment of severe JIA. Etanercept, a fully human soluble recombinant tumour necrosis factor p75 receptor Fc fusion protein, has been registered for the treatment of polyarticular course JIA patients who fail to respond to or do not tolerate methotrexate (MTX). Infliximab, a chimeric human-mouse monoclonal antibody to TNFa, is expected to be registered soon for JIA and Crohn's disease (CD) in children. As in adults, both agents are effective in controlling inflammation and inhibiting the progression of joint destruction. Despite this good clinical efficacy, the physician must remain alert for potential side effects, especially after prolonged use. This review gives an overview of the reported adverse events.

Key words
TNFa, juvenile idiopathic arthritis, adverse effects, infections, tuberculosis.

Please address correspondence to: Nico M. Wulffraat, MD, Department of Immunology, University Medical Center Utrecht, "Het Wilhelmina Kinder Ziekenhuis", PO Box 85090, 3508 AB Utrecht, The Netherlands.
E-mail n.wulffraat@wkz.azu.nl