Pediatric Rheumatology Online Journal → August 2003 → Newer Treatments → Anti-Tumor Necrosis Factor Therapy → Abstract #159

TREATMENT WITH INFLIXIMAB FOR INDICATIONS OTHER THAN POLY ARTICULAR COURSE JUVENILE RHEUMATOID ARTHRITIS (POLY JRA): THE ROLE OF THE RHEUMATOLOGY CLINIC NURSE

S. J. Parker, R. M. Laxer, R. Schneider, B. M. Feldman, E. D. Silverman

¹Rheumatology, The Hospital for Sick Children (HSC), Toronto, ON, Canada

Background: At HSC we have used Infliximab to treat children with indications other than Poly JRA, including uveitis (2 patients), spondylarthropathy (3), psoriatic arthritis (1), systemic onset JRA (1), sarcoidosis (1), and polyarteritis nodosa (1). These patients have moderate to severe disease and failed or did not tolerate conventional therapy.
Objective: a) To report our experience with Infliximab therapy for diseases other than Poly JRA and b) To characterize the role of the Rheumatology clinic nurse in the treatment protocol.
Methods: Patients (5M: 4F), age range 9 to 18 years, were treated with Infliximab on our Medical Short Stay Unit (MSSU) between 02/2001 and 09/2002. An Infliximab treatment protocol was developed in consultation with the Rheumatologist and pharmacist. A retrospective analysis was performed to assess the role of the Rheumatology clinic nurse in the protocol development and implementation.
Results: An average of 8 Infliximab infusions/patient (range 3-12) was given on MSSU. 8/9 patients have continued treatment. No patient discontinued treatment because of side-effects, inaccessibility, or scheduling difficulties. Two patients have been successfully transfered to adult care and 1 to a facility closer to home for ongoing infusions. The Rheumatology clinic nurse provided all patient education, support, follow-up, and coordinated all administrative functions including assistance in obtaining access to treatment, ensuring the pre-treatment screening procedures are completed, scheduling and documentation.
Conclusion: Infliximab therapy is well tolerated in these patients . The protocol provided clear guidelines for infliximab administration and monitoring parameters for paediatric patients. The role of the clinic nurse is vital in ensuring consistent and timely delivery of therapy. The nurse functioned as the liaison between patient, family, pharmaceutical company, government and insurance agency, and the health care team.