Dimitri Poddighe, Kazakhstan

Nazarbayev University School of Medicine Medicine
Dr. Dimitri Poddighe graduated cum laude in 2003 from the medical school of the University of Pavia (Italy) cum laude; here, he also completed his residency/clinical fellowship program and became Medical Specialist in Pediatrics (PhD-equivalent, EQF level 8) cum laude in 2008. He was also alumnus at the Collegio Ghislieri in Pavia. From 2007 to 2009, Dr. Dimitri Poddighe worked as Research Fellow in Immunology at the Children’s Hospital Boston Harvard University (MA, USA). After his return to Italy, he served as a consultant pediatrician in several hospitals in Lombardy (Italy), including the Fondazione IRCCS Policlinico San Matteo (Pavia), affiliated to the University of Pavia, where he has been lecturer/instructor at the Department of Pediatrics since 2015. During his professional career, Dr. Dimitri Poddighe completed three 2nd level Master academic programs (EQF level 8): I) Pediatric Hematology at the Univesity “La Sapienza” in Rome (2010-2011); II) Pediatric Immunology at the University of Pavia (2011-2012); III) Pediatric Gastroenterology, Hepatology and Nutrition at the University “La Sapienza” in Rome (2016-2017). In 2015-2016 he also completed a clinical training in the Department of Pediatric Rheumatology at the Istituto G. Pini (Milano, Italy). Dr. Dimitri Poddighe joined the School of Medicine at Nazarbayev University (NUSOM) in 2018. Currently, he is Associate Professor at NUSOM and Director of the Clinical Academic Department of the University Medical Center (UMC) in Nur-Sultan. Moreover, he is the Director of the Pediatric Residency Program started in September 2019. His research activity is focused on allergic, immune-mediated and autoimmune/rheumatic pediatric diseases.

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THERAPEUTIC MANAGEMENT OF JUVENILE IDIOPATHIC ARTHRITIS WITH TOCILIZUMAB IN CENTRAL ASIA: PRELIMINARY DATA FROM A SINGLE TERTIARY CENTER EXPERIENCE IN KAZAKHSTAN.

Session Name
PS59 - JUVENILE AUTOIMMUNE DISEASES
Session Type
PARALLEL SESSIONS
Date
01.06.2021, Tuesday
Session Time
08:00 - 10:00
Room
HALL F
Lecture Time
08:40 - 08:50
Presenter
Session Icon
Pre Recorded

Abstract

Background and Aims

In Kazakhstan, tocilizumab(TCZ) therapy was first authorized to treat systemic JIA(sJIA) patients in 2011 and, starting from 2014, it has been registered for poly-articular(pJIA) forms as well. TCZ was the only biologic registered in Kazakhstan for JIA therapy until 2015.

Methods

Data from children with JIA (n=81), who received TCZ in the 2011-2016 period, were retrospectively analyzed.

Results

TCZ was administered to 69 patients with sJIA and 12 patients with pJIA. Before TCZ, 53 patients received NSAIDs, DMARDs and glucocorticoids, whereas 28 patients immediately received it in monotherapy, due to the early onset of systemic manifestations.

In 96% of patients with sJIA, fever stopped after the first infusion and the skin manifestations completely resolved within 12 weeks in 85% of them; importantly, the articular involvement improved in all patients by 6 months. At this time point, TCZ was stopped in 23 patients and, eventually, only 3 of them relapsed and needed TCZ again.

As for pJIA, 11 patients reached the stage of inactive disease at 12 weeks of therapy. The ACRpedi 30/50/70/90 criteria at 6 months were fulfilled by 100%,75%,65% and 50% of these patients, respectively. The main factors of unfavorable prognosis resulted to be the disease duration before TCZ (>3 years) and the early onset of poly-articular involvement.

Seven patients had to stop TCZ for allergic reaction or leukopenia; 4 patients developed hepatitis, but needed only temporary suspension. One patient died, because of MAS.

Conclusions

TCZ has changed the JIA management in Kazakhstan/Central Asia and will improve its prognosis in these developing countries.

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