Efficacy of golimumab in children with polyarticular juvenile idi-opathic arthritis

Golimumab is a human anti- monoclonal antibody against tumor necrosis factor alpha (TNF-α) TNF-α is one of the main proinflammatory cytokines taking part in JRA’s (juvenile idiopathic arthritis) pathogenesis. To compare with currently used tumor necrosis factor inhibitors golimumab therapy has high compliance because of low pain in the site of injection and long half-life period. The efficacy of golimumab was demonstrated earlier in adults with rheumatoid arthritis, spondyloarthritis and psoriatic arthritis. 10 children with active polyarticular JRA despite previous methotrexate treatment were enrolled in randomized study. All patients received subcutaneous golimumab 30 mg/kg every 4 weeks. At week 16 patients were randomly assigned to one of two treatment arms: 4 of them received placebo, others continued subcutaneous golimumab at the same dose. 3 of 4 children who received placebo later continued golimumab because of confirmed flare. Assessments were performed at week 24 and at the moment of last visit available for assessment (week 96-week 116) Dynamics of main clinical and laboratory disease activity measures were evaluated, including JA-DAS and CDAI dynamics and ACRPedi response criteria. During this study the majority of patients showed significant improvement of disease activity measures and their components with good ACR-Pedi response without serious adverse events and significant changes in blood count (erythrocytes, leukocytes and hemoglobin). According study results, golimumab can be evaluated as effective and quite safe therapy of polyarticular JRA.