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https://doi.org/10.20471/acc.2020.59.01.20

How to Treat Patients after Serious Adverse Effects Caused by TNF Inhibitors?

Saša Sršen ; Department of Pediatrics, Split University Hospital Centre, University of Split School of Medicine, Split, Croatia
Eugenija Marušić ; Department of Pediatrics, Split University Hospital Centre, University of Split School of Medicine, Split, Croatia
Vitomir Metličić ; Department of Pediatrics, Split University Hospital Centre, University of Split School of Medicine, Split, Croatia
Luka Stričević ; Department of Pediatrics, Split University Hospital Centre, University of Split School of Medicine, Split, Croatia
Marijan Frković ; Department of Pediatrics, Division of Pediatric Rheumatology and Immunology, Zagreb University Hospital Centre, University of Zagreb School of Medicine, Zagreb, Croatia
Marija Jelušić orcid.org/0000-0002-1728-4260 ; Department of Pediatrics, Division of Pediatric Rheumatology and Immunology, Zagreb University Hospital Centre, University of Zagreb School of Medicine, Zagreb, Croatia

Abstract

Biological agents are widely used in the treatment of autoimmune rheumatic disorders. We report on serious adverse events during treatment with anti-tumor necrosis factor antibody in two of our patients with juvenile idiopathic arthritis. One patient was treated with a biological agent due to juvenile idiopathic arthritis complicated by uveitis, developing miliary tuberculosis during treatment. After treatment with antituberculotics, she recovered completely. Her underlying disease is currently in remission. Another patient was treated for juvenile spondyloarthritis and developed an inflammatory process of the central nervous system with serious neurological deficits. He was treated with high-dose corticosteroids, followed by slowly tapering doses of corticosteroids. His neurological deficits improved, but are still present. Similar cases have been described previously, but there are no
recommendations how to treat arthritis afterwards in such patients. We would like to emphasize the need of developing guidelines for further treatment of arthritis after the occurrence of serious adverse effects during treatment with biological agents.

Keywords

Rheumatology; Arthritis, juvenile; Tumor necrosis factor-alpha – adverse effects; Neurologic manifestations; Tuberculosis, miliary

Hrčak ID:

242361

URI

https://hrcak.srce.hr/242361

Publication date:

1.3.2020.

Article data in other languages: croatian

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