This article is more than 5 years old. Information may no longer be current.
Etanercept/methotrexate best of three treatments in juvenile idiopathic arthritis
Compared with sulfasalazine monotherapy or methotrexate with initial prednisone bridging, etanercept and methotrexate combination therapy was associated with more clinical improvement in patients with juvenile idiopathic arthritis, according to data published in Pediatric Rheumatology.
“Initial treatment with etanercept and methotrexate is superior to monotherapy in new onset juvenile idiopathic arthritis without previous treatment,”
Petra Hissink Muller, MD, pediatrician at Leiden University Medical Center, told Healio Rheumatology.
Researchers from the Netherlands compared three therapies — initial disease-modifying antirheumatic drug monotherapy with sulfasalazine or methotrexate, initial methotrexate with prednisone bridging, and initial combination therapy with methotrexate and etanercept — in 94 patients with juvenile idiopathic arthritis (67% girls; median age, 9.1 years).
Thirty-eight percent of the patients were anti-nuclear antibody-positive. Ten patients had oligo-articular disease, 69 had polyarticular juvenile idiopathic arthritis and 16 had psoriatic arthritis.
Baseline median ACR Pedi scores were 59 mm for VAS physician, 54 mm for VAS patient, 6.5 mm/hr for ESR, 8 for active joint count, 3 for limited joint count and 0.88 for the Childhood Health Assessment questionnaire.
The researchers recorded side effects and percentage of inactive disease after 6 and 12 weeks of treatment.
The researchers found 31% of the sulfasalazine group, 38% of the methotrexate group and 53% of the etanercept group reached adjusted ACR Pedi 50. In addition, 25%, 19% and 47% reached adjusted ACR Pedi 70. Toxicity was similar and there were few serious adverse events, the researchers wrote.
“Follow up data on the extension of initial treatments aiming at inactive disease are needed to relate to these initial positive results,” Muller said. – by Will Offit
Disclosure: The researchers report no relevant financial disclosures.