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Highly Accessed Open Badges Review

What are the immunological consequences of long-term use of biological therapies for juvenile idiopathic arthritis?

Joost F Swart*, Sytze de Roock and Nico M Wulffraat

Author affiliations

Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital/UMC Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands

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Citation and License

Arthritis Research & Therapy 2013, 15:213  doi:10.1186/ar4213

Published: 24 May 2013


This review summarizes the immunological consequences of biological therapies used in juvenile idiopathic arthritis (JIA). For every frequently used biological agent the characteristics are clearly specified (molecular target, isotype, registered indication for JIA, route of administration, half-life, contraindication, very common side effects, expected time of response and average cost in the first year). The emphasis of this review is on the immunological side effects that have been encountered for every separate agent in JIA populations. For each agent these adverse events have been calculated as incidence per 100 patient-years for the following categories: serious infections, tuberculosis, malignancies, response to vaccination, new-onset autoimmune diseases and development of anti-drug antibodies. There are large differences in side effects between various agents and there is a clear need for an international and standardized collection of post-marketing surveillance data of biologicals in the vulnerable group of JIA patients. Such an international pharmacovigilance database, called Pharmachild, has now been started.