DUGOTRAJNA EFIKASNOST I BEZBEDNOST PRIMENE ADALIMUMABA U LEČENJU JUVENILNOG IDIOPATSKOG ARTRITISA (JIA) SA UVEITISOM
Sažetak
Poslednjih godina primena inhibitora tumor nekrozis faktor-α (TNF-α) pokazala je odličnu kontrolu inflamacije prednjeg očnog segmenta kod pacijenata sa juvenilnim idiopatskim artritisom (JIA) sa uveitisom. Retrospektivnom analizom smo želeli proceniti dugoročnu terapijsku efikasnost i bezbednost primene adalimumaba kod 19 JIA pacijenata sa uveitisom iz našeg biološkog registra, koji prethodno nisu lečeni biološkim lekom. Prikupljani su demografski podaci i uzorkovana je krv u odredjenim vremenskim intervalima. Procena aktivnosti upale prednjeg očnog segmenta vršena je biomikroskopskim pregledom. Praćena je pojava ozbiljnih neželjenih efekata.
Naš biološki registar je obuhvatio desetogodišnju analizu podataka 11 (57.90%) pacijenata ženskog pola sa dijagnozom oligo i proširenog oligoartikularnog JIA sa uveitisom, dok je 8 (42.10%) pacijenta bilo muškog pola sa dijagnozom artritisa sa entezitisom (ERA) i uveitisom. Adalimumab je bio prvi biološki lek kojim je započeto lečenje JIA pacijenata sa aktivnim uveitisom koji nisu odgovorili na standardni terapijski algoritam. Tokom desetogodišnjeg perioda praćenja, dok su pacijenti lečeni adalimumabom i metotreksatom, nije bilo novih relapsa uveitisa. Svi naši pacijenti su nakon uvođenja adalimumaba bili u mogućnosti da postepeno redukuju i obustave primenu topičnih kortikosteroida. 36.84% pacijenata je bilo u mogućnosti da prekine primenu biološke terapije 36 meseci nakon počeka primene adalimumaba. Samo kod dva pacijenta je zabeležan relaps uveitisa 3 meseca nakon prestanka primene adalimumaba. 31,58% pacijenata je ispoljilo blage neželjene reakcije, dok ozbiljne neželjene reakcije nisu zabeležene.
Tokom desetogodišnjeg perioda praćenja adalimumab je pokazao dobru terapijsku efikasnost i bezbednost u lečenju JIA pacijenata sa uveitisom.
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