Extension Study of Participants from the Trial of Early Aggressive Therapy in Juvenile Idiopathic Arthritis

Abstract

Early aggressive therapy in this cohort of patients with polyarticular JIA who had high initial disease activity was associated with prolonged periods of CID in the majority of patients during followup. Those not in CID had low levels of disease activity.

Risk of Serious Infection in Juvenile Idiopathic Arthritis Patients Associated With Tumor Necrosis Factor Inhibitors and Disease Activity in the German Biologics in Pediatric Rheumatology Registry

“…In the TREAT (Trial of Early Aggressive Therapy) study, 2 serious infections occurred in 85 patients, 1 pneumonia and 1 septic hip arthritis, both resolved (17). Patients of the TREAT study have been followed for an additional 2 years (18). Four patients had 6 infections requiring systemic antibiotics, and no pneumonia occurred.…”

“…Within the ETN cohort, patients using monotherapy had an incidence rate of 43 per 1,000 patient-years (95% CI 32-57) compared to 72 per 1,000 patient-years (95% CI 54-93) in combination therapy with MTX. In addition, 64 first serious infections were reported, with 46 occurring with ETN (22 monotherapy, 24 combination therapy, with a rate of 22 per 1,000 patient-years [95% CI [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]). The adjusted HR of serious infections for the ETN-treated patients versus those taking MTX was only 1.36 (95% CI 0.6-3.07) and not significantly different.…”

Risk, Timing, and Predictors of Disease Flare After Discontinuation of Anti–Tumor Necrosis Factor Therapy in Children With Polyarticular Forms of Juvenile Idiopathic Arthritis With Clinically Inactive Disease

“…Current treatment approaches for children with polyarticular forms of juvenile idiopathic arthritis (JIA) have resulted in up to 50% of patients demonstrating clinically inactive disease while receiving treatment . Much of the success in inducing clinically inactive disease is due to the introduction of anti–tumor necrosis factor (anti‐TNF) biologic therapies used early in the treatment of a large proportion of children with JIA . Anti‐TNF therapy has shown short‐ and medium‐term toxicities in children with JIA; the long‐term toxicities (>15 years) are unknown, and the medication cost is substantial .…”

Proceedings of the 2018 Childhood Arthritis and Rheumatology Research Alliance (CARRA) Scientific Meeting

“…ankles and wrists) early in the disease course increases the likelihood that a patient will progress to polyarticular disease (6). Determining if these patients are at risk for disease progression would be valuable in terms of initiating more aggressive therapy earlier, as the likelihood of achieving inactive disease is higher the earlier treatment is initiated (7). Indications for biologic medications, such as TNFinhibitors, are currently restricted to patients with "Polyarticular" JIA.…”