Rituximab therapy produced rapid and sustained clinical improvement in a patient with systemic onset juvenile idiopathic arthritis refractory to TNF alpha antagonists.
We describe a patient with systemic onset juvenile idiopathic arthritis refractory to disease-modifying antirheumatic drugs, intravenous gamma globulin, and TNF inhibitors (etanercept and infliximab), in whom treatment with rituximab resulted in remission of systemic symptoms (rash and fever), a fall in erythrocyte sedimentation rate, C-reactive protein, and ferritin serum levels, with recovery in disability index and improvement of arthritis. A total of 4 cycles of rituximab were given over 18 months because of relapses. Since her last course, she remains stable and asymptomatic. To our knowledge, this is the first case reported on a long-lasting beneficial effect of rituximab in a patient with soJIA.
Feito
Julio García
JG
Rheumatology Section, Children Outpatient's Clinic, Hospital Torrecárdenas, Almería-Spain.
Pereda
C A
CA
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000097:blood / Q000188:drug therapy*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D000069285:Infliximab; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D000069283:Rituximab; D017211:Treatment Failure; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069283:Rituximab; D002097:C-Reactive Protein; D000069285:Infliximab; D000068800:Etanercept