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Etanercept therapy resulted in disease remission in 50% of patients with JIA
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About half of children with juvenile idiopathic arthritis who were treated with etanercept achieved an inactive disease state, according to study results.
“The [research] objective is in line with our effort to promote the introduction of treat-to-target strategy in pediatric rheumatology practice,” researcher Angelo Ravelli, MD, associate professor of pediatrics at University of Genoa in Italy, told Healio.com.
Angelo Ravelli
Researchers reviewed clinical charts of 173 patients with juvenile idiopathic arthritis (median age at disease onset, 3.6 years; 71.1% female) who were treated with etanercept for a median of 2.2 years between January 2002 and January 2011. To determine progress toward inactive disease state, visits were examined between therapy initiation and the last follow-up evaluation, in which patients still were receiving etanercept. Methotrexate was administered to 67.1% of patients receiving etanercept, 22% received intra-articular corticosteroids and 13.9% received systemic corticosteroids as concomitant medications. Univariate analysis and Cox regression procedures determined clinical characteristics associated with inactive disease achievement.
After a median of 0.6 years of etanercept therapy, 87 patients (50.3%; 62 females) achieved inactive disease. Eighty-five patients (49.1%) continued to have inactive disease at a median of 2.2 years at last follow-up, while 70 patients (40.5%) achieved clinical remission on medication. Inactive disease after 6, 12 and 24 months of therapy had an achievement probability of 24%, 46% and 57%, respectively. Lack of wrist involvement and patients aged younger than 3.6 years at disease onset were associated with attaining inactive disease, according to Cox regression analysis.
“These findings suggest that the presence of wrist disease and an older age at disease presentation may constitute an indication for the earlier introduction of etanercept or its administration in combination with methotrexate,” Ravelli said. “An important point of innovation of the study is that the efficacy of treatment was assessed by evaluating the achievement of complete remission, rather than the simple percentage improvement in outcome measures.”
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