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Precision medicine in juvenile idiopathic arthritis—has the time arrived?
- Source :
- The Lancet Rheumatology. 3:e808-e817
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Summary The introduction of disease-modifying anti-rheumatic drug therapies for treating children and adolescents with chronic arthritis (ie, juvenile idiopathic arthritis [JIA]) has revolutionised care and outcomes. The biologic revolution continues to expand, with ever-changing immunological targets coming to market after basic research and clinical trials. The first class of biologics that was beneficial for children with JIA was tumour necrosis factor (TNF) inhibitors. If used early and aggressively, TNF inhibitors are capable of inducing disease remission for most of the seven subtypes of JIA, with the exception of systemic JIA (which more frequently responds to interleukin [IL]-1 or IL-6 inhibition). Nevertheless, there are still subsets of patients with JIA with disease that is difficult to treat or who develop extra-articular features that require a different therapeutic approach. Although finding an effective biological therapy for individual children with JIA can be trial and error, ongoing research and clinical trials are providing insight into a more personalised approach to care. In addition, redefining the JIA classification, in part based on shared similarities with various adult arthritides, could allow for extrapolation of knowledge from studies in adults with chronic arthritis.
- Subjects :
- musculoskeletal diseases
medicine.medical_specialty
business.industry
Immunology
Arthritis
Chronic arthritis
Disease
Precision medicine
medicine.disease
Clinical trial
Therapeutic approach
Rheumatology
Basic research
Internal medicine
medicine
Immunology and Allergy
Juvenile
skin and connective tissue diseases
business
Subjects
Details
- ISSN :
- 26659913
- Volume :
- 3
- Database :
- OpenAIRE
- Journal :
- The Lancet Rheumatology
- Accession number :
- edsair.doi...........a54afbfb0c52efd1dbd59afeac075f83