Remittive agents in pediatric rheumatology.
OBJECTIVE
Children with rheumatic diseases frequently require therapy with disease-modifying antirheumatic drugs and/or biologic agents. Therapies that have been prospectively tested in adults are often used in children before full evaluation of their safety and efficacy. Published experience that may report "off-label" usage can be helpful in decision making, although such reports do not reduce the need for prospective clinical trials in children. The purpose of this review is to summarize the recent published evidence regarding efficacy (and safety, when available) of standard and novel agents used in pediatric rheumatic disease.


RESULTS
Etanercept, one of three currently available tumor necrosis factor-alpha inhibitors has a juvenile idiopathic arthritis indication. Novel "off-label" uses in children for interleukin-1 receptor agonist (Anakinra), antiinterleukin-6 receptor antibody (MRA), and rituximab (anti-CD20 monoclonal antibody) are discussed.


CONCLUSIONS
This review summarizes the published evidence that supports the use of selected disease-modifying antirheumatic drugs and novel biologic agents in children with rheumatic diseases.
Department 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
Nora G
NG
Singer
Lisabeth V
LV
Scalzi
D000293:Adolescent; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001688:Biological Products / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D012074:Remission Induction; D012216:Rheumatic Diseases / Q000628:therapy*; D012219:Rheumatology / Q000639:trends*
D018501:Antirheumatic Agents; D001688:Biological Products