Efficacy and safety of tumor necrosis factor inhibitors for systemic juvenile idiopathic arthritis: a systematic review.

Autor:	Ishikawa T; Division of Immunology, National Center for Child Health and Development, Tokyo, Japan.; Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan., Nishimura K; Department of Pediatrics, Yokohama City University Graduate School of Medicine, Kanagawa, Japan., Okamoto N; Department of Pediatrics, Osaka Medical and Pharmaceutical University, Osaka, Japan., Akamine K; Department of Nephrology and Rheumatology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan., Inoue N; Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Ishikawa, Japan., Irabu H; Department of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan., Kato K; Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan., Keino H; Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan., Kojima M; Nagoya City University, Aichi, Japan., Kubo H; Department of Pediatrics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan., Maruyama K; Department of Vision Informatics, Graduate School of Medicine, Osaka University, Osaka, Japan., Mizuta M; Department of Pediatric Rheumatology, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan., Shabana K; Department of Pediatrics, Osaka Medical and Pharmaceutical University, Osaka, Japan., Shimizu M; Department of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan., Sugita Y; Department of Pediatrics, Osaka Medical and Pharmaceutical University, Osaka, Japan., Takakuwa Y; Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan., Takanashi S; Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan., Takase H; Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan., Umebayashi H; Department of Rheumatism, Infectious Disease, Miyagi Children's Hospital, Miyagi, Japan., Umezawa N; Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan., Yamanishi S; Department of Pediatrics, Tokyo Yamate Medical Center, Tokyo, Japan., Yamazaki K; Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan., Yashiro M; Department of Pediatrics, Okayama University Hospital, Okayama, Japan., Yasumi T; Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan., Mori M; Lifetime Clinical Immunology, Tokyo Medical and Dental University, Tokyo, Japan.
Jazyk:	angličtina
Zdroj:	Modern rheumatology [Mod Rheumatol] 2024 May 25. Date of Electronic Publication: 2024 May 25.
DOI:	10.1093/mr/roae050
Abstrakt:	Objectives: This systematic review assessed the efficacy and safety of tumor necrosis factor (TNF) inhibitors in patients with systemic juvenile idiopathic arthritis (JIA). Methods: Studies were searched using PubMed, Embase, Cochrane, Ichushi-Web, and clinical trial registries (from 2000 to 2021). The risk of bias was assessed using the Cochrane Risk of Bias version 2 for randomized controlled trials (RCTs) and the manual for development clinical practice guidelines by Minds, a project promoting evidence-based medicine in Japan, for observational studies. Results: One RCT and 22 observational studies were included. In the RCT on infliximab, the American College of Rheumatology pediatric (ACR Pedi) 30/50/70 responses at 14 weeks were 63.8%/50.0%/22.4%, with relative risks of 1.30 (95% confidence interval [CI]: 0.94-1.79)/1.48 (95% CI: 0.95-2.29)/1.89 (95% CI: 0.81-4.40), respectively. In the observational studies, ACR Pedi 30/50/70 responses for etanercept at 12 months were 76.7%/64.7%/46.4%, respectively. Infliximab treatment caused anaphylaxis in 17% and an infusion reaction in 23% of patients. The incidence of macrophage activation syndrome, serious infection and malignancy caused by TNF inhibitors was 0%-4%. Conclusions: Thus, although TNF inhibitors were relatively safe, they were unlikely to be preferentially administered in patients with systemic JIA because of their inadequate efficacy. Further studies, particularly well-designed RCTs, are necessary to confirm the efficacy and safety of TNF inhibitors for systemic JIA. (© Japan College of Rheumatology 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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