Neutropenia During Tocilizumab Treatment Is Not Associated with Infection Risk in Systemic or Polyarticular-course Juvenile Idiopathic Arthritis

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Arquivos
art_PARDEO_Neutropenia_During_Tocilizumab_Treatment_Is_Not_Associated_with_2019.PDF (2.86 MB)
Citações na Scopus
10
Tipo de produção
article
Data de publicação
2019
Editora
J RHEUMATOL PUBL CO
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
PARDEO, Manuela
WANG, Jianmei
RUPERTO, Nicolino
ALEXEEVA, Ekaterina
CHASNYK, Vyacheslav
SCHNEIDER, Rayfel
HORNEFF, Gerd
HUPPERTZ, Hans-Iko
MINDEN, Kirsten
ONEL, Karen
Autor de Grupo de pesquisa
Paediat Rheumatology Int Trials Or
Rheumatology Collaborative Study G
Editores
Coordenadores
Organizadores
Citação
JOURNAL OF RHEUMATOLOGY, v.46, n.9, p.1117-1126, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective. To determine whether neutropenia is associated with increased risk for infection in patients with systemic juvenile idiopathic arthritis (sJIA) and polyarticular-course juvenile idiopathic arthritis (pcJIA) treated with tocilizumab (TCZ). Methods. Data up to Week 104 from 2 phase III trials of intravenous TCZ in sJIA (n = 112; ClinicalTrials.gov, NCT00642460) and pcJIA (n = 188; ClinicalTrials.gov, NCT00988221) were pooled. Worst common toxicity criteria grade and lowest observed absolute neutrophil count (ANC) were identified for each patient. Associations between patient characteristics and lowest observed ANC were tested using univariate regression analysis. Infection and serious infection rates per 100 patient-years (PY) in periods associated with grades 1/2 and 3/4 neutrophil counts were compared with rates associated with normal neutrophil counts. Results. ANC decreased to grade >= 3 in 25.0% and 5.9% of sJIA and pcJIA patients, respectively, and decreases were transient. Young age (p = 0.047) and methotrexate use (p = 0.012) were positively associated with neutropenia in patients with sJIA but not in patients with pcJIA. The rate of serious infections in patients with sJIA (10.9/100 PY; 95% CI 6.8-165) tended to be higher than in patients with pcJIA (5.2/100 PY; 95% CI 3-8.5). No increase in rates of serious or nonserious infections was observed during periods of neutropenia in either trial. Conclusion. Patients with JIA treated with TCZ experienced transient neutropenia that was not associated with an increased number of infections.
Palavras-chave
BIOLOGICAL THERAPY, INFECTION, JUVENILE IDIOPATHIC ARTHRITIS, NEUTROPHILS
URI
https://observatorio.fm.usp.br/handle/OPI/34070
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MPE
Artigos e Materiais de Revistas Científicas - HC/ICr
Artigos e Materiais de Revistas Científicas - LIM/36