A comparison of biological treatments for juvenile arthritis

This study compared effectiveness and safety of the biological drugs etanercept (Enbrel), adalimumab (Humira), and tocilizumab (Actemra) in patients with juvenile idiopathic arthritis (JIA). The authors concluded that there were no significant differences in effectiveness.

Juvenile idiopathic arthritis (JIA) is a common form of arthritis in children under the age of 16. It can cause limited mobility, stiffness, and swelling in the joints. Patients often suffer from persistent pain and discomfort.

Non-steroidal anti-rheumatic drugs or disease modifying anti-rheumatic drugs, such as methotrexate (Rheumatrex), are often a first-line therapy for JIA. In more recent years, biological drugs such as etanercept, adalimumab, and tocilizumab have been approved for JIA. Whether there are differences in safety or effectiveness is still being studied.

236 JIA patients taking adalimumab, 419 patients taking etanercept, and 74 patients taking tocilizumab were included in this study. Improvements in the condition, changes in disease activity, remission rates (where no symptoms are present), and safety were compared.

Patients’ conditions improved by up to 68% in the etanercept group. This was 67% in the adalimumab group and 61% in the tocilizumab group.

A significant decrease in disease activity was seen in all 3 groups. There was no significant difference between patients who were taking a second-line biologic and those who had never taken a biologic before.

Remission was seen in 34.8% of patients in the etanercept group. This was similar in the adalimumab group (27.9%) and in the tocilizumab group (23.5%).

Patients taking adalimumab showed the highest rate of side effects overall. The number of serious infections was higher in the etanercept group. 

The authors concluded that all 3 biological drugs were effective treatments for JIA. This did not depend on whether the drug was being taken as a first-line or second-line therapy. 

Some of the authors received funding from the companies that make the drugs used in this study. Further studies that randomly assign patients to treatment groups are needed to confirm these results.