In a nutshell
This study investigated the long-term safety and effectiveness of etanercept (Enbrel) in juvenile idiopathic arthritis (JIA).
They found that etanercept is well tolerated and effective on the long-term in patients with JIA.
Some background
Juvenile idiopathic arthritis (JIA) is an inflammatory condition affecting children. Children with JIA have a variety of symptoms. These include painful swelling in the joints. Disease-modifying anti-rheumatic drugs (DMARDs) are used to treat JIA. DMARDs target the immune system to reduce inflammation. Biological DMARDs (bDMARDs) specifically target inflammatory chemicals. They bind to these chemicals and neutralize them. Tumor necrosis factor (TNF) is a chemical that causes inflammation.
Etanercept is a bDMARD that blocks TNF. This reduces the release of other inflammatory chemicals. It also reduces the number of immune cells that are activated. This helps to prevent tissue damage and pain. Etanercept has been used to treat JIA for several years. Studies have shown that it is safe and effective. The long-term safety and effectiveness of etanercept in patients with JIA is unclear.
Methods & findings
This study included 109 patients with inflammatory joint conditions. 55 of these patients had JIA. All patients received etanercept treatment for a maximum dose of 50 mg once weekly. Disease activity was measured using the JADAS score. Effectiveness was measured using the American College of Rheumatology (ACR) score. For example, ACR20 equals a 20% improvement in JIA symptoms.
Improvements in JADAS were maintained from 24 months to 48 months. Clinical remission was achieved by 34 patients based on the JADAS score. CR was achieved by 30 patients based on ACR scores. 22 patients stopped etanercept treatment due to low disease activity.
The most common side effects were infections, injection site reactions, and headache. Joint pain, fever, diarrhoea and reduced white blood cell count were also common.
The bottom line
The authors concluded that etanercept was well tolerated and effective in the long-term in patients with JIA.
The fine print
The number of patients in this study was low. Many patients were not available for long-term follow up.
What’s next?
If you have any concerns regarding JIA management please consult with your physician.
Published By :
Arthritis Research & Therapy
Date :
May 23, 2019
