Achievement of clinical remission in patients with juvenile idiopathic arthritis under a 2–10-year Etanercept exposure

Abstract

The objective of this retrospective study was to record the achievement of clinical remission (CR) in juvenile idiopathic arthritis patients under a 2-10 years' administration of Etanercept (ETN) and to detect any variables associated with CR. Patients previously resistant to conventional regimens were enrolled. The annual impact of ETN was assessed by: (a) the American College of Rheumatology pediatric criteria (ACRpedi), (b) the pre- and posttreatment disease activity score (juvenile arthritis disease activity score [JADAS71]), and (c) Wallace's criteria for CR. A total of 41 patients (F: 31) were registered. The median age and disease duration at baseline were 10.6 and 4.17 years, respectively, and their disease course was mainly polyarthritis (32/41). In respect to baseline, there was an impressive JADAS71 reduction posttreatment, most prominent after the first year. From year 1 to 5, more than 50 % of the patients achieved and retained CR and 66 % reached an ACRpedi 70, whereas after the 5th year, no patient was withdrawn due to an ACRpedi <30. JADAS71 at baseline was not associated with the subsequent CR achievement. However, JADAS71 1-year posttreatment had a significant association with the CR of the second posttreatment year, (p = 0.028, OR 0.79; 95 % CI 0.63-0.98) and a similar trend was observed for the following years. These findings emphasize the sustained impact of ETN in the achievement of CR. A low JADAS71 score 1-year posttreatment, may be associated with the maintenance of CR over the next treatment year.

Etanercept treatment for extended oligoarticular juvenile idiopathic arthritis, enthesitis-related arthritis, or psoriatic arthritis: 6-year efficacy and safety data from an open-label trial

“…With these differences in mind, we point out that 61% of patients in our study achieved ACR70 response at 48 months, compared to approximately 75% of patients at 4 years in an open-label extension study of ETN in polyarticular-course JIA [16], and 75% of patients from the Dutch Arthritis and Biologicals in Children Register at 51 months [17]. Similarly, 27% and 24% of patients in our study achieved sustained clinical remission by ACR or JADAS criteria, respectively, compared with 24% (10/42) of patients who had achieved sustained CR ACR (according to the same definition we used in our trial [21]) in a small, 4-year study of children with JIA (predominantly polyarthritis 78%) [34].…”

Efficacy of Etanercept in Treatment of Various Types of Juvenile Idiopathic Arthritis

“…Лечение этанерцептом не сопровождалось выра-женными нежелательными явлениями, что позволяет подтвердить рекомендации по использованию этого препарата в случае ЮИА без внесуставных проявле-ний, торпидного к стандартной противоревматической терапии [3][4][5]7].…”

“…При использовании этого препарата не развивается вто-ричная резистентность, что позволяет после перерыва возобновлять терапию этанерцептом без повышения риска развития побочных эффектов. Высокая эффектив-ность препарата у детей и практически полное отсутствие серьезных нежелательных явлений доказаны в ходе ран-домизированных клинических исследований и длитель-ной реальной практики [3][4][5][6][7].…”

“…Эти данные согласуются с результатами, полученными в различных исследованиях, и по данным регистров ряда стран [2][3][4][5][6][7].…”

Management of a Patient With Severe Course of Psoriatic Arthritis

“…Но поскольку целью было достижение полной клини-ческой ремиссии и артрита, и псориаза, мы назначили ингибитор ФНО ␣ с другим механизмом действия -этанерцепт. Эффективность и безопасность примене-ния этанерцепта у детей с псориазом была описана в крупных рандомизированных плацебоконтролируе-мых исследованиях [8,9,11,[22][23][24].…”