Novel therapies in pediatric rheumatic diseases.
OBJECTIVE
Better understanding of the etiology of autoimmune diseases and their progression has brought about numerous novel therapies used in the treatment of pediatric rheumatic diseases. The introduction of biologic agents such as tumor necrosis factor inhibitors has changed how we approach and manage autoimmune diseases. This has led to a proliferation of other therapies targeting specific inflammatory processes evident in many rheumatic illnesses, with hopes of improving efficacy and decreasing adverse effects from treatment.


RESULTS
Clinical studies demonstrate safety and efficacy of these newer medications in both adults and children. Although most of the novel therapies have been studied primarily in the adult rheumatic population, many are being evaluated in children in randomized controlled and open label trials as well. Long-term results are being collected regarding these newer regimens in both adults and children.


CONCLUSIONS
This review looks at the risks and benefits of the variety of novel therapies including the new biologics, immunosuppressives, and stem cell transplantation currently being used in rheumatic conditions. Using these new therapies along with traditional antirheumatic medications, pediatric rheumatologists intervene to control disease early and more effectively to prevent long-term damage and complications.
Chira
Peter
P
Department of Pediatrics, Stanford University School of Medicine, Stanford, California 94305-5208, USA.
Sandborg
Christy I
CI
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents / Q000627:therapeutic use; D002648:Child; D015316:Genetic Therapy; D006801:Humans; D000069285:Infliximab; D053590:Interleukin 1 Receptor Antagonist Protein; D007555:Isoxazoles / Q000627:therapeutic use; D000077339:Leflunomide; D008727:Methotrexate / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009363:Neoplasm Proteins / Q000627:therapeutic use; D047889:Receptors, Tumor Necrosis Factor, Type II; D012216:Rheumatic Diseases / Q000235:genetics / Q000628:therapy*; D000069283:Rituximab; D012795:Sialoglycoproteins / Q000627:therapeutic use; D033581:Stem Cell Transplantation; D053319:Tumor Necrosis Factor Decoy Receptors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D007555:Isoxazoles; D009363:Neoplasm Proteins; D047889:Receptors, Tumor Necrosis Factor, Type II; D012795:Sialoglycoproteins; D053319:Tumor Necrosis Factor Decoy Receptors; D000069283:Rituximab; D000069285:Infliximab; D000077339:Leflunomide; D009173:Mycophenolic Acid; D008727:Methotrexate