Patients with JIA treated with Enbrel may be at higher risk for infections

Patients with juvenile idiopathic arthritis who were treated with Enbrel may be at a higher risk for medically significant infections compared to patients only treated with methotrexate, according to the results of a recently published study.

Researchers studied 1,112 patients with juvenile idiopathic arthritis (JIA) enrolled in the British Society for Pediatric and Adolescent Rheumatology Etanercept Cohort Study (BSPAR-ETN). Enbrel, (etanercept, Amgen) was prescribed to 852 patients with JIA and 260 patients received methotrexate. Medically significant infections (MSIs) were defined as “serious” by the consultant for at least one infection that was life-threatening, caused significant disability, caused death, led to hospitalization, required IV antibiotics or IV antivirals, or was otherwise defined as “medically significant” by the consultant.

Researchers identified 184 MSIs, with 158 in the patients who received etanercept and 26 in the patients who received methotrexate, 133 of which were first events (n = 109 in the etanercept group). Varicella and respiratory infections were the most common infections, and the overall incidence rate for MSI per 100 person-years was 4.8. Univariate analysis revealed patients who were younger, had systemic JIA, had oral steroid use at baseline, had concurrent methotrexate use at baseline or had two or more comorbidities were more likely to develop an infection.

Sensitivity analysis showed that 46 of 64 first serious infections occurred during therapy with etanercept, including 22 patients who received etanercept as monotherapy. Varicella and pneumonia were the most commonly reported infections. – by Shirley Pulawski

Disclosure: Davies reports no relevant financial disclosures. Please see the full study for a complete list of all other authors’ financial disclosures.

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Source:

Davies R, et al. Arth Rheum. 2015; doi:10.1002/art.39197.