Treatment of Pediatric Takayasu Arteritis With Infliximab and Cyclophosphamide Experience From an American-Brazilian Cohort Study

Show simple item record

dc.contributor.author Stern, Sara
dc.contributor.author Clemente, Gleice [UNIFESP]
dc.contributor.author Reiff, Andreas
dc.contributor.author Romao Ramos, Margarida Paula [UNIFESP]
dc.contributor.author Marzan, Katherine Anne
dc.contributor.author Terreri, Maria Teresa [UNIFESP]
dc.date.accessioned 2016-01-24T14:37:23Z
dc.date.available 2016-01-24T14:37:23Z
dc.date.issued 2014-06-01
dc.identifier http://dx.doi.org/10.1097/RHU.0000000000000106
dc.identifier.citation Jcr-Journal of Clinical Rheumatology. Philadelphia: Lippincott Williams & Wilkins, v. 20, n. 4, p. 183-188, 2014.
dc.identifier.issn 1076-1608
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/37843
dc.description.abstract Background: Pediatric Takayasu arteritis (pTA) is difficult to treat and can lead to significant morbidity and mortality.Objectives: the objective of this study was to describe clinical characteristics for pTA and determine the safety and efficacy of cyclophosphamide (CYC) and infliximab (IFX) in pTA.Methods: This was a retrospective analysis of 23 pTA patients seen at Children's Hospital Los Angeles and Universidade Federal de São Paulo-Brazil from 1990 to 2011. All patients fulfilled the 1990 American College of Rheumatology criteria for Takayasu arteritis. Disease activity was assessed using a modified National Institutes of Health score.Results: Twenty-three patients (14 female and 9 male patients), mean age of 15.7 +/- 6.0 years, were included. Cyclophosphamide was used before IFX treatment in 17 of 23 and IFX before CYC in 2 of 23 patients. the average time from disease onset to treatment initiation was 2.6 +/- 2.4 years for CYC and 4.1 +/- 2.4 years for IFX. Nine (60%) of 15 patients failed CYC, and of these 6 were changed to IFX with subsequent clinical stabilization in 5 (83%) of 6. Two patients initially treated with IFX were switched to CYC because of lack of appropriate response: 1 patient later worsened, and the other was lost to follow-up. Five opportunistic infections requiring hospitalization occurred in the CYC group, whereas none were observed in the IFX group. Patients in the IFX group were more likely to decrease or stop their corticosteroids when compared with the CYC patients.Conclusions: Cyclophosphamide is often used as initial treatment but has many adverse effects. in this retrospective case series, IFX was equivalent to CYC with fewer adverse effects, making IFX an alternative therapeutic option for pTA. en
dc.format.extent 183-188
dc.language.iso eng
dc.publisher Lippincott Williams & Wilkins
dc.relation.ispartof Jcr-Journal of Clinical Rheumatology
dc.rights Acesso restrito
dc.subject Takayasu arteritis en
dc.subject pediatric vasculitis en
dc.subject cyclophosphamide en
dc.subject and infliximab en
dc.title Treatment of Pediatric Takayasu Arteritis With Infliximab and Cyclophosphamide Experience From an American-Brazilian Cohort Study en
dc.type Artigo
dc.contributor.institution Univ Utah
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Univ So Calif
dc.description.affiliation Univ Utah, Div Immunol, Salt Lake City, UT 84158 USA
dc.description.affiliation Universidade Federal de São Paulo UNIFESP, Dept Pediat, Pediat Rheumatol Unit, São Paulo, Brazil
dc.description.affiliation Univ So Calif, Childrens Hosp Los Angeles, Div Rheumatol, Los Angeles, CA USA
dc.description.affiliationUnifesp Universidade Federal de São Paulo UNIFESP, Dept Pediat, Pediat Rheumatol Unit, São Paulo, Brazil
dc.identifier.doi 10.1097/RHU.0000000000000106
dc.description.source Web of Science
dc.identifier.wos WOS:000337159800002



File

File Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record

Search


Browse

Statistics

My Account