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Etanercept, adalimumab linked with increased infection risk vs methotrexate for JIA
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Investigators found a slightly increased risk for serious infection among patients with juvenile idiopathic arthritis who took first-line etanercept or adalimumab compared with patients who took methotrexate alone, according to recently published data.
Gerd Horneff, MD, and Ingrid Becker, MSc, both at the Asklepios Clinic Sankt Augustin in Germany, used the German Biologic Registry for Pediatric Rheumatology registry to assess serious infection rates in 3,350 patients — for a total of 5,919 observation-years — who took first-line etanercept (n = 1,720), adalimumab (n= 177) or methotrexate (n =1,453). They calculated infection rates per 1,000 observation-years.
Researchers found 21 serious infections in the etanercept group, five serious infections in the methotrexate group and two cases in the adalimumab group. Risk factors for infection included therapy with biologics, disease duration before initiation of therapy, corticosteroid use and nonbiologic premedication. Other factors included higher clinical Juvenile arthritis disease activity score including maximal 10 joints (cJADAS10) at therapy initiation and higher mean cJADAS10 scores while patients received therapy. After multivariate regression, investigators found only biologic therapy and cJADAS10 were significant. There was an increased risk for infection in patients who took etanercept (ratio = 6) and patients who took adalimumab (ratio = 7.3) compared with methotrexate, and an elevated cJADAS10 at therapy initiation (ratio = 1.1 per unit increase). – by Will Offit
Disclosure: Horneff reports he received research grants from AbbVie, Pfizer and Roche/Chugai and received consulting fees from Abbott, Chugai, Genzyme, Pfizer, Novartis, Roche, Sandoz and Swedish Orphan.
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