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TNF-alpha antagonists: efficacy and safety of Etanercept and Adalimumab in children with juvenile idiopathic arthritis who started treatment under 4 years of age


The aim of the study was to assess efficacy and safety of TNF-alpha antagonists ( anti-TNF ) in a cohort of patients with juvenile idiopathic arthritis ( JIA ) who began treatment under 4 years old and to assess relapse rate after Methotrexate and/or anti-TNF withdrawal.

Researchers did a retrospective charts review of the non-systemic JIA patients treated with anti-TNF under 4 years of age during the period 2006-2013.

Efficacy and safety end points included side effects and time to achieve clinical remission.

27 patients were included: 23 received Etanercept ( Enbrel ) and 4 Adalimumab ( Humira ) with a median age of 3.01 ( range 0.88-3.97 ) years at anti-TNF beginning and 1.94 ( range 0.18-5.44 ) and 2.39 ( range 0.18-7.24 ) years of treatment and follow-up, respectively.

All patients had previously received disease-modifying antirheumatic drugs at optimal dose.

Nineteen patients reached clinical remission on treatment in a median time of 9.1 ( range 6.23-21.17 ) months. Four of those relapsed during treatment.

Six developed mild adverse effects, mostly mild infections. No serious side effect was observed.

Eleven patients who reached clinical remission relapsed after treatment withdrawal. None achieved clinical remission off treatment. Most patients reached clinical remission on anti-TNF.

The study has shown that Etanercept and Adalimumab were safe, with mostly mild infections and no serious side effect. It has been observed a high relapse rate during treatment withdrawal. ( Xagena )

Giménez-Roca C et al, Rheumatol Int 2014; Epub ahead of print

XagenaMedicine_2014



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