       Document 0606
 DOCN  M9630606
 TI    Treatment of refractory juvenile chronic arthritis by monoclonal CD4
       antibodies: a pilot study in two children.
 DT    9603
 AU    Horneff G; Dirksen U; Schulze-Koops H; Emmrich F; Wahn V; Department of
       Paediatrics, University of Dusseldorf, Germany.
 SO    Ann Rheum Dis. 1995 Oct;54(10):846-9. Unique Identifier : AIDSLINE
       MED/96097728
 AB    OBJECTIVE--To study the effect of anti-CD4 treatment in patients
       suffering from refractory systemic onset juvenile chronic arthritis
       (JCA). METHODS--Two children were treated with the mouse CD4 antibody
       MAX.16H5. The effects on numbers of circulating CD4 T cells, clinical
       symptoms and C reactive protein (CRP) level were studied and the
       appearance of human antimouse immunoglobulin antibodies investigated.
       RESULTS--In patient one, disappearance of fever and malaise and a
       reduction of arthritic activity were observed together with a reduction
       in CRP. When disease activity returned eight weeks later, a second
       successful course of treatment was administered. It was possible to
       reduce the corticosteroid dosage permanently. In the other child, a
       first treatment cycle did not alter disease activity. A marked reduction
       in clinical and laboratory disease activity markers was observed after
       the second course. Only transient and mild side effects were observed.
       One patient exhibited a short lasting febrile reaction with chills, the
       other an urticarial rash. In both patients, human antibodies to mouse
       immunoglobulin became detectable. The decrease in the number of CD4 T
       cells in the peripheral blood was only short lasting and numbers
       returned to normal values within one to eight weeks, even after the
       second course of antibody treatment and under concomitant
       immunosuppressive treatment. No sustained clinical remissions could be
       achieved. CONCLUSIONS--These preliminary observations support the
       evidence of positive effects of CD4 antibody treatment in refractory
       systemic onset JCA. Long term efficacy, however, remains to be
       established.
 DE    Adolescence  Antibodies, Monoclonal/ADVERSE EFFECTS/*THERAPEUTIC USE
       Antigens, CD4/*IMMUNOLOGY  Arthritis, Juvenile
       Rheumatoid/IMMUNOLOGY/*THERAPY  Child  CD4 Lymphocyte Count  Female
       Human  Male  Pilot Projects  Severity of Illness Index  Support,
       Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

