The frequency of infections in patients with juvenile idiopathic arthritis on biologic agents: 1-year prospective study
- PMID: 30448935
- DOI: 10.1007/s10067-018-4367-9
The frequency of infections in patients with juvenile idiopathic arthritis on biologic agents: 1-year prospective study
Abstract
Introduction: The most effective and concurrently the safest treatment regimen selection is important to provide early control of juvenile idiopathic arthritis (JIA) and to have an acceptable quality of life. The effectivity of biologic agents as well as standard disease-modifying drugs is well documented in treatment of JIA. In spite of their high benefit, these drugs have the risk of serious infections. Herein, we conducted a prospective study to investigate the infectious complications of biologic agents in patients diagnosed with JIA.
Methods: Patients on biologic treatment regimen were examined by the pediatric infectious disease specialist in every 2 months during 1-year long.
Results: Throughout the study period, 57% (n:175) of the patients developed infection and 43% (n:132) of them completed this period without any infection. Upper respiratory tract infections which were treated in outpatient clinic were the most common infection. Only three serious infections (two pneumonia, one pleural effusion), which required hospitalization, developed. The infection rate was highest in systemic JIA and lowest in enthesitis-related arthritis (p < 0.001). The total rate of infection development after 1-year period was lowest for etanercept; it was highest for the patients on infliximab treatment (p < 0.001).
Conclusion: We comment that the altered immune system of JIA can be responsible from the serious infections irrespective of immunosuppressive therapy. Biologic agents can be safely used in JIA evaluating the loss and benefit statement.
Keywords: Biologic agents; Etanercept; Infection; Juvenile idiopathic arthritis.
Similar articles
-
Pharmacovigilance in juvenile idiopathic arthritis patients treated with biologic or synthetic drugs: combined data of more than 15,000 patients from Pharmachild and national registries.Arthritis Res Ther. 2018 Dec 27;20(1):285. doi: 10.1186/s13075-018-1780-z. Arthritis Res Ther. 2018. PMID: 30587248 Free PMC article. Clinical Trial.
-
Effectiveness and long-term retention of anti-tumour necrosis factor treatment in juvenile and adult patients with juvenile idiopathic arthritis: data from Reuma.pt.Rheumatology (Oxford). 2016 Apr;55(4):697-703. doi: 10.1093/rheumatology/kev398. Epub 2015 Dec 15. Rheumatology (Oxford). 2016. PMID: 26672905
-
Decreasing trend in the incidence of serious pneumonias in Finnish children with juvenile idiopathic arthritis.Clin Rheumatol. 2020 Mar;39(3):853-860. doi: 10.1007/s10067-019-04804-x. Epub 2019 Nov 16. Clin Rheumatol. 2020. PMID: 31732822
-
Risk of Serious Infections Associated with Biologic Agents in Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analyses.J Pediatr. 2019 Jan;204:162-171.e3. doi: 10.1016/j.jpeds.2018.08.065. Epub 2018 Oct 11. J Pediatr. 2019. PMID: 30318371
-
An update on the safety of biologic therapies for the treatment of polyarticular juvenile idiopathic arthritis.Expert Opin Drug Saf. 2025 Jun;24(6):627-642. doi: 10.1080/14740338.2025.2467179. Epub 2025 Feb 16. Expert Opin Drug Saf. 2025. PMID: 39946290 Review.
Cited by
-
Unveiling the differences: infection disorders associated with tumor necrosis factor α inhibitors in pediatric patients-a pharmacovigilance study (2004-2023).Eur J Pediatr. 2025 May 3;184(5):324. doi: 10.1007/s00431-025-06152-2. Eur J Pediatr. 2025. PMID: 40317305
-
Tuberculosis in children and adolescents with rheumatic diseases using biologic agents: an integrative review.Rev Paul Pediatr. 2023 Jul 10;42:e2022084. doi: 10.1590/1984-0462/2024/42/2022084. eCollection 2023. Rev Paul Pediatr. 2023. PMID: 37436237 Free PMC article. Review.
-
Vaccination in children with immune-mediated disorders.J Pediatr (Rio J). 2023 Mar-Apr;99 Suppl 1(Suppl 1):S62-S69. doi: 10.1016/j.jped.2022.11.008. Epub 2022 Dec 21. J Pediatr (Rio J). 2023. PMID: 36566017 Free PMC article. Review.
-
Vaccination in Children With Autoimmune Disorders and Treated With Various Immunosuppressive Regimens: A Comprehensive Review and Practical Guide.Front Immunol. 2021 Aug 2;12:711637. doi: 10.3389/fimmu.2021.711637. eCollection 2021. Front Immunol. 2021. PMID: 34408752 Free PMC article. Review.
-
Tuberculosis in Children with Rheumatic Diseases Treated with Biologic Disease-Modifying Anti-Rheumatic Drugs.Mediterr J Rheumatol. 2021 Dec 27;32(4):290-315. doi: 10.31138/mjr.32.4.290. eCollection 2021 Dec. Mediterr J Rheumatol. 2021. PMID: 35128322 Free PMC article.
References
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical