Varying Response to Etanercept in Juvenile Arthritis

Excellent response tied to low disability scores, prior DMARD use, younger age at onset

WEDNESDAY, Nov. 9 (HealthDay News) -- For patients with juvenile idiopathic arthritis (JIA), the treatment response to etanercept varies, with excellent response associated with lower baseline disability scores, fewer pretreatment disease-modifying antirheumatic drugs (DMARDs), and younger age of onset, according to a study published online Nov. 6 in the Journal of the American Medical Association.

Marieke H. Otten, M.D., from the Erasmus Medical Center Sophia Children's Hospital in Rotterdam, Netherlands, and colleagues investigated the response to etanercept in patients with JIA, and assessed the association with baseline characteristics in an ongoing study initiated in 1999. A total of 262 biologically naive patients who initiated etanercept before 2009 were included, with follow-up to January 2011. Response was graded at 15 months after etanercept initiation.

The investigators found that treatment response was excellent, intermediate, and poor in 32, 36, and 32 percent of patients, respectively. Low baseline disability score, pretreatment use of fewer DMARDs, and younger age at onset were significantly associated with excellent response, whereas poor response was significantly associated with systemic JIA and female gender. A total of 119 patients experienced at least one infectious, non-infectious, or serious adverse event, including 37 excellent responders, 36 intermediate responders, and 46 poor responders. Etanercept was discontinued within 15 months by four excellent and 57 poor responders.

"Among patients with JIA who initiated treatment with etanercept, one-third achieved an excellent response, one-third an intermediate response, and one-third a poor response to therapy," the authors write.

Several authors disclosed financial relationships with pharmaceutical companies, including Pfizer and Abbott, which partially funded the study.

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