Etanercept, adalimumab improve wellbeing in non-systemic juvenile idiopathic arthritis
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Etanercept and adalimumab are both impactful at improving the health of patients with non-systemic juvenile idiopathic arthritis, according to data published in Pediatric Rheumatology.
“We decided to initiate this study given the importance of patient-reported wellbeing in children with JIA and the fact that this is not always 100% related to disease activity,” Joeri W. van Straalen, MSc, of the department of pediatric immunology and rheumatology at Wilhelmina Children’s Hospital, in the Netherlands, told Healio. “However, no study had ever compared the effects of the frequently used biologics adalimumab and etanercept on patient-reported wellbeing in JIA.”
To evaluate the impact of etanercept (Enbrel, Amgen) and adalimumab (Humira, AbbVie) in patients with non-systemic JIA, van Straalen and colleagues analyzed data from the “Pharmacovigilance in JIA patients treated with biologic agents and/or MTX,” or Pharmachild, registry. Patients are eligible to be enrolled in the registry if they have confirmed JIA and are receiving NSAIDs, glucocorticoids, conventional synthetic disease-modifying antirheumatic drugs or biologic DMARDs.
To be included in this analysis, patients were required to have completed a baseline survey when they began taking etanercept or adalimumab. Patients were excluded if they received a biologic DMARD prior to enrollment or if they had systemic JIA or a history of uveitis.
Van Straalen and colleagues compared data of patients who started etanercept compared with data from patients who started adalimumab. The primary outcome of the study was the improvement in the Juvenile Arthritis Multidimensional Assessment Report (JAMAR) visual analogue scale wellbeing score, compared with baseline, at follow-up. The scale is a 21-point visual analogue measure used to determine how a patient feels in the moment. Secondary outcomes included decrease in active joint counts from baseline to follow-up and the number of patient-reported adverse events.
The analysis included 45 patients who started etanercept and 45 patients who received adalimumab. At follow-up, patients who began adalimumab demonstrated “significantly better” scores than patients who started etanercept (P = .001), the researchers wrote. The average estimated difference in well-being improvement in patients receiving etanercept compared with adalimumab was 0.89 (95% CI, –0.01 to 1.78). The estimated difference in active joint count decrease was –0.36 (95% CI, –1.02 to 0.3). According to the researchers, there was one instance of uveitis in the group starting etanercept.
“Both adalimumab and etanercept improve wellbeing in JIA,” van Straalen said. “Our data might indicate that there is a slightly stronger effect for etanercept, possibly due to the citrate buffer which used to be in adalimumab injections, but larger studies are needed to confirm this given the lack of statistical significance we observed.”
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