Experience with etanercept, tocilizumab and interleukin-1 inhibitors in systemic onset juvenile idiopathic arthritis patients from the BIKER registry

Horneff, Gerd; Schulz, Anna Carina; Klotsche, Jens; Hospach, Anton; Foeldvari, Ivan; Trauzeddel, Ralf; Ganser, Gerd; Weller‐Heinemann, Frank; Haas, J.-P.

doi:10.1186/s13075-017-1462-2

Cited by 87 publications

(96 citation statements)

References 26 publications

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“…Anti‐TNF drugs are preferred in sJIA patients with chronic arthritis. In the BIKER registry, 143 out of 245 (58%) sJIA patients were successfully treated with etanercept . In our cohort, etanercept was also the most commonly used anti‐TNF agent.…”

Section: Discussionmentioning

confidence: 84%

“…One patient had herpes zoster infection and the other one had pneumonia during tocilizumab treatment. Among those treated with anti‐IL‐1, 2 patients had bronchiolitis, one had severe upper respiratory tract infection, one tonsillitis, one enteritis and one pneumonia . In a study from Brazil, a country with high frequency of tuberculosis infection, 3 out of 69 patients treated with TNF inhibitors had latent tuberculosis .…”

Section: Discussionmentioning

confidence: 99%

“…11 In our cohort, 72 (42.8%) patients were The adverse effects of biological treatment have been reported as rare. 9 We retrospectively collected data on adverse effects.…”

Section: Discussionmentioning

confidence: 99%

“…Proinflammatory cytokines including interleukin (IL)‐1, IL‐6 and IL‐18 play an important role in the pathogenesis of the disease. Blockade of the aforementioned cytokines represents the main mechanism of sJIA treatment and prevention of potential disease complications . The number of studies evaluating long‐term follow‐up, disease complications and treatment response in sJIA patients is limited …”

Section: Introductionmentioning

confidence: 99%

“…Blockade of the aforementioned cytokines represents the main mechanism of sJIA treatment and prevention of potential disease complications. 8,9 The number of studies evaluating long-term follow-up, disease complications and treatment response in sJIA patients is limited. [10][11][12] A significant number of patients develop severe disease and treatment-related complications such as joint damage and deformity, growth retardation or osteoporosis.…”

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confidence: 99%

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Prognosis, complications and treatment response in systemic juvenile idiopathic arthritis patients: A single‐center experience

et al. 2019

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Aim Systemic juvenile idiopathic arthritis (sJIA) is a distinctive subtype of JIA characterized by systemic features and poor outcome. We aimed to investigate demographic and clinical features, long‐term treatment response and disease complications in a large sJIA cohort. Methods Patients diagnosed with sJIA followed up at a pediatric rheumatology outpatient department from January 2003 to December 2017 were included. Demographic and clinical features, long‐term treatment response and disease complications were retrospectively collected. Results A total of 168 sJIA patients (51.8% female, 48.2% male) were included: 31.5% with monocyclic, 13.7% polycyclic and 54.8% with persistent clinical course. Corticosteroids were initially used in all patients. Methotrexate was used in 75% and cyclosporine A was used in 17.3% patients. Biological drugs were used in 42.8% patients; etanercept in 29.7%, anakinra in 16%, canakinumab in 16%, tocilizumab in 10% patients. Remission off medication was achieved in 82 (48.8%). Macrophage activation syndrome (MAS) was present in 11.9%, growth retardation in 11.3% patients. Eight percent (4/50) of patients had low bone mineral density. Three patients (1.78%) died due to MAS secondary multiorgan insufficiency and infection. Conclusion The disease is characterized with diverse clinical presentation and possibly severe complications. MAS complicated with multiorgan insufficiency is the major mortality factor. Corticosteroids represent the mainstay of the initial treatment. In patients resistant to classic treatment, biological drugs should be timely introduced.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

“…11 In our cohort, 72 (42.8%) patients were The adverse effects of biological treatment have been reported as rare. 9 We retrospectively collected data on adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Prognosis, complications and treatment response in systemic juvenile idiopathic arthritis patients: A single‐center experience

et al. 2019

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Efficacy and Safety of Etanercept Biosimilars Compared With the Originator for Treatment of Juvenile Arthritis: A Prospective Observational Study

Thiele

Klein

Hospach

et al. 2021

ACR Open Rheumatology

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Objective. Analysis of etanercept biosimilars in pediatric patients with juvenile idiopathic arthritis (JIA) in comparison with the etanercept originator in terms of efficacy and safety.Methods. Patients diagnosed with JIA who started treatment with either the etanercept originator or a biosimilar after January 1, 2017, were selected from the German BIKER registry (Biologics in Paediatric Rheumatology Registry). Furthermore, patients who started therapy with the originator and switched to a biosimilar during the course of therapy were identified. For both patient groups, disease activity and safety were examined and compared separately.Results. After January 1, 2017, 348 patients started treatment with the etanercept originator (n = 293) or a biosimilar (n = 55). Another 57 patients switched to a biosimilar during the course of therapy. A significant decrease or a stable remission of disease activity was observed in both patient groups. The safety profiles were comparable, and frequencies and types of adverse events (AEs) and serious AEs were similar in patients starting therapy with the originator or a biosimilar. Only injection site reactions occurred slightly more frequently under biosimilar therapy, without having an impact on therapy adherence. In patients who switched therapy, the AE rate per 100 patient-years was comparable before (26.4) and after (32.1) the switch.Conclusion. In patients with JIA who require treatment with etanercept, the originator is still used much more frequently. However, our study highlights the equivalence of etanercept biosimilars for therapy for JIA. Increased use of these biosimilars in pediatric patients can therefore be recommended without hesitation.

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Treatment to Target Using Recombinant Interleukin‐1 Receptor Antagonist as First‐Line Monotherapy in New‐Onset Systemic Juvenile Idiopathic Arthritis: Results From a Five‐Year Follow‐Up Study

Haar

Dijkhuizen

Swart

et al. 2019

Arthritis & Rheumatology

140

110

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Objective Systemic juvenile idiopathic arthritis (JIA) is a multifactorial autoinflammatory disease with a historically poor prognosis. With current treatment regimens, approximately half of patients still experience active disease after 1 year of therapy. This study was undertaken to evaluate a treat‐to‐target approach using recombinant interleukin‐1 receptor antagonist (rIL‐1Ra; anakinra) as first‐line monotherapy to achieve early inactive disease and prevent damage. Methods In this single‐center, prospective study, patients with new‐onset systemic JIA with an unsatisfactory response to nonsteroidal antiinflammatory drugs received rIL‐1Ra monotherapy according to a treat‐to‐target strategy. Patients with an incomplete response to 2 mg/kg rIL‐1Ra subsequently received 4 mg/kg rIL‐1Ra or additional prednisolone, or switched to alternative therapy. For patients in whom inactive disease was achieved, rIL‐1Ra was tapered after 3 months and subsequently stopped. Results Forty‐two patients, including 12 who had no arthritis at disease onset, were followed up for a median of 5.8 years. The median time to achieve inactive disease was 33 days. At 1 year, 76% had inactive disease, and 52% had inactive disease while not receiving medication. High neutrophil counts at baseline and a complete response after 1 month of rIL‐1Ra were highly associated with inactive disease at 1 year. After 5 years of follow‐up, 96% of the patients included had inactive disease, and 75% had inactive disease while not receiving medication. Articular or extraarticular damage was reported in <5%, and only 33% of the patients received glucocorticoids. Treatment with rIL‐1Ra was equally effective in systemic JIA patients without arthritis at disease onset. Conclusion Treatment to target, starting with first‐line, short‐course monotherapy with rIL‐1Ra, is a highly efficacious strategy to induce and sustain inactive disease and to prevent disease‐ and glucocorticoid‐related damage in systemic JIA.

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Experience with etanercept, tocilizumab and interleukin-1 inhibitors in systemic onset juvenile idiopathic arthritis patients from the BIKER registry

Cited by 87 publications

References 26 publications

Prognosis, complications and treatment response in systemic juvenile idiopathic arthritis patients: A single‐center experience

Prognosis, complications and treatment response in systemic juvenile idiopathic arthritis patients: A single‐center experience

Efficacy and Safety of Etanercept Biosimilars Compared With the Originator for Treatment of Juvenile Arthritis: A Prospective Observational Study

Treatment to Target Using Recombinant Interleukin‐1 Receptor Antagonist as First‐Line Monotherapy in New‐Onset Systemic Juvenile Idiopathic Arthritis: Results From a Five‐Year Follow‐Up Study

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