Publications by authors named "Andreas Woerner"

Understanding adalimumab pharmacokinetics (PK) in pediatric inflammatory rheumatic diseases (PIRD) could facilitate individualized treatment strategies. This pharmacometric (PMX) analysis, utilizing prospectively collected data, aimed to develop a PMX model investigating associations between disease-specific factors and adalimumab exposure in PIRD. PK data originating from a prospective two-center study including 36 children with PIRD (weight IQR: 33-55 kg) receiving subcutaneous adalimumab (IQR: 30-40 mg biweekly; n = 28 at steady state, n = 8 after first dose, i.

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Article Synopsis
  • The study examines the pharmacokinetics (PK) of adalimumab in pediatric rheumatic diseases (PRD) and how methotrexate treatment affects its levels, as prior data on this topic is limited.
  • Conducted over 12 weeks with 28 patients, the research compared adalimumab concentrations in two groups: those receiving adalimumab with methotrexate and those receiving adalimumab alone.
  • Results showed variability in adalimumab levels across patients, with those on methotrexate exhibiting slightly higher overall exposure, but the difference in median concentrations was not statistically significant.
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Introduction: Children with pediatric inflammatory rheumatic diseases (PRD) have an increased infection risk. Vaccinations are effective to avoid vaccine-preventable diseases. This study aimed to assess the vaccination completeness in Swiss PRD patients stratified by immunosuppressive treatment (IST).

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We present a 9-year-old girl with persistent pain and swelling of the left wrist. X-ray, magnetic resonance imaging (MRI) and bone biopsy led to the diagnosis of chronic recurrent multifocal osteomyelitis (CRMO), affecting phalangeal and metacarpal bases and distal carpal bones on the ulnar side of the wrist. She was treated with non-steroidal anti-inflammatory drugs and complete remission with no long-term sequelae was achieved.

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Background: Chronic pain is a frequent complaint in children and adolescents, with great international variation in prevalence. Paediatricians are usually the first-line contact for pain problems in children and might refer patients to other specialists or pain clinics where available. Prevalence estimates of paediatric chronic pain and paediatricians' care experiences in Switzerland are currently lacking.

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Article Synopsis
  • Interleukin inhibitors are key treatments for conditions like colchicine-resistant familial Mediterranean fever (crFMF), mevalonate kinase deficiency (MKD), and tumor necrosis factor receptor-associated periodic syndrome (TRAPS), but the reasons for their use remain unclear.
  • An analysis of data from an international registry and literature review revealed that the primary reasons for using IL-1 blockers include treatment failure, persistent disease activity, severe complications, and a decline in patients' quality of life.
  • The study highlights the need for standardized treatment guidelines, suggesting that the findings could help develop a clear strategy for using IL-1 inhibitors in these hereditary recurrent fevers.
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Background: About half of all children with rheumatic diseases need continuous medical care during adolescence and adulthood. A good transition into adult rheumatology is essential. Guidelines for a structured transition process have therefore been recommended by the European League Against Rheumatism (EULAR) and the Paediatric Rheumatology European Society (PReS).

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  • - Most children with SARS-CoV-2 have mild or no symptoms, but a small group develops a serious inflammatory condition known as MIS-C, which resembles other severe immune responses.
  • - A case study describes a boy with MIS-C who showed unusual lab results and ultimately suffered from severe complications, including fatal liver failure linked to EBV-associated HLH, despite receiving multiple treatments.
  • - The diagnosis of X-linked lymphoproliferative disease type 1 (XLP1) post-mortem suggests that doctors should consider HLH in severe MIS-C cases for better treatment strategies and genetic counseling.
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Following the spread of the coronavirus disease 2019 (COVID-19) pandemic a new disease entity emerged, defined as Pediatric Inflammatory Multisystem Syndrome temporally associated with COVID-19 (PIMS-TS), or Multisystem Inflammatory Syndrome in Children (MIS-C). In the absence of trials, evidence for treatment remains scarce. To develop best practice recommendations for the diagnosis and treatment of children with PIMS-TS in Switzerland.

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  • The study explores the use of biologic disease modifying antirheumatic drugs (bDMARDs) and Janus Kinase (JAK) inhibitors in pediatric patients with inflammatory rheumatic diseases (PiRD), highlighting their differences from adult patients due to age-related factors.
  • A systematic review identified 35 randomized clinical trials (RCTs) involving PiRD, focusing on efficacy, safety outcomes, and pharmacokinetics of various treatments, particularly TNF inhibitors, IL-1 inhibitors, and IL-6 inhibitors.
  • Most trials were conducted for juvenile idiopathic arthritis (JIA), with treatments often compared to placebo, and a variety of ongoing studies are investigating additional bDMARDs
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Introduction/objectives: To determine vaccination coverage among a French cohort of children with recurrent autoinflammatory fever syndromes (RFS).

Method: All RFS children aged 2 to 19 years from the Juvenile Inflammatory Rheumatism cohort and followed at the French Reference Center for Autoinflammatory Diseases, Versailles Hospital, were included in our observational study. Immunisation status at ages 2, 7 and 15 years and at the last outpatient visit was evaluated according to the standard French vaccine schedule and recommended supplementary vaccines for patients with immunosuppressive therapy.

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Article Synopsis
  • - The study aimed to evaluate the incidence of infectious adverse events (IAE) in children with juvenile idiopathic arthritis (JIA) undergoing treatment with biological agents from January 2001 to August 2015.
  • - Analyzing data from 677 patients over 3075.4 person-years, 184 infectious events were identified, with a higher risk associated with IL-6 and IL-1 antagonists compared to TNF inhibitors; most infections were mild and affected the upper respiratory tract.
  • - Overall, while infectious complications are rare in these patients, they generally present as mild to moderate conditions, with no severe outcomes like tuberculosis or death reported during the study period.
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Neurodegenerative diseases are characterized by the accumulation of misfolded proteins in the brain. Insights into protein quality control mechanisms to prevent neuronal dysfunction and cell death are crucial in developing causal therapies. Here, we report that various disease-associated protein aggregates are modified by the linear ubiquitin chain assembly complex (LUBAC).

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Background: Arthritis and arthralgia are reported as adverse events following immunization with various vaccines.

Objective: To better understand current knowledge of arthritis and arthralgia as an adverse event following immunization.

Methods: A systematic literature review of Pubmed, Embase, and Cochrane Library was conducted.

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Objective: To analyse and report the incidence of side effects of biological agents in paediatric patients with inflammatory diseases using of real-life follow-up cohort.

Methods: In this international, observational, retrospective, multicentre study of children treated by biological agents and followed in the Juvenile Inflammatory Rheumatism (JIR) cohort (JIRcohorte) network, a Kaplan-Meier method was used to estimate the occurrence of adverse events. A Cox model was constructed to identify independent predictors of adverse events.

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Objective: To assess performance of the 2016 macrophage activation syndrome (MAS) classification criteria for patients with systemic juvenile idiopathic arthritis (JIA) who develop MAS while treated with biologic medications.

Methods: A systematic literature review was performed to identify patients with MAS while being treated with interleukin (IL)-1 and IL-6 blocking agents. Clinical and laboratory information was compared to a large previously compiled historical cohort.

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  • This study examines how varicella zoster virus (VZV) infection affects children with rheumatic diseases who are on immunosuppressive medications, highlighting the need for careful management of VZV in this vulnerable population.
  • It reviewed 22 children, primarily with juvenile idiopathic arthritis, with a median age of 7.6 years, of which 16 had varicella and 6 had herpes zoster, showing that the timing of immunosuppressive treatment relative to VZV infection varied widely.
  • Complications were noted in 4 patients, with some requiring hospitalization, underscoring the importance of monitoring and appropriate antiviral treatment for children who are immunosuppressed when they
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Amyloid-like protein aggregation is associated with neurodegeneration and other pathologies. The nature of the toxic aggregate species and their mechanism of action remain elusive. Here, we analyzed the compartment specificity of aggregate toxicity using artificial β-sheet proteins, as well as fragments of mutant huntingtin and TAR DNA binding protein-43 (TDP-43).

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Systemic juvenile idiopathic arthritis (SJIA) is an inflammatory condition characterized by fever, lymphadenopathy, arthritis, rash and serositis. Systemic inflammation has been associated with dysregulation of the innate immune system, suggesting that SJIA is an autoinflammatory disorder. IL-1 and IL-6 play a major role in the pathogenesis of SJIA, and treatment with IL-1 and IL-6 inhibitors has shown to be highly effective.

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Purpose: Early-onset sepsis (EOS) is one of the main causes for the admission of newborns to the neonatal intensive care unit. However, traditional infection markers are poor diagnostic markers of EOS. Pancreatic stone protein (PSP) is a promising sepsis marker in adults.

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