Abstract | OBJECTIVE: METHODS: Patients with systemic JIA who were treated with anti-TNF agents for > 6 months were studied. Demographic and nosologic variables recorded at the start of anti-TNF therapy were analyzed. Association between early variables and occurrence of remission was evaluated through Cox proportional hazard regression analysis. RESULTS: Forty-five patients were included (30 girls), median age 9 years (range 2-17 yrs), age at disease onset 5 years (range 0.5-15), disease duration 3 years (range 0.5-13). Twenty-one (47%) children showed systemic symptoms at the start of anti-TNF therapy. Patients received therapy for 24 months (range 6-88): 45 (100%) were given etanercept, 17 (38%) infliximab, and 5 (11%) adalimumab, in combination with methotrexate. Anti-TNF switching was performed in 22 (49%) children. Eleven (24%) met definition criteria for remission while taking etanercept (n = 8), infliximab (2), or adalimumab (1). Remission occurred following 26 (range 9-65) months of therapy. Flares occurred in 5 (45%) patients 2 to 14 months after remission was first recorded. Absence of systemic symptoms at the start of therapy and fulfillment of improvement criteria at Month 3 were associated with remission in univariate analysis; no variable showed any association in multivariate analysis. CONCLUSION: Twenty-four percent of patients with systemic JIA experienced remission with anti-TNF therapy, but only 13% experienced sustained benefit.
|
Authors | Ricardo A G Russo, María M Katsicas |
Journal | The Journal of rheumatology
(J Rheumatol)
Vol. 36
Issue 5
Pg. 1078-82
(May 2009)
ISSN: 0315-162X [Print] Canada |
PMID | 19435972
(Publication Type: Clinical Trial, Journal Article)
|
Chemical References |
- Antibodies, Monoclonal
- Antibodies, Monoclonal, Humanized
- Antirheumatic Agents
- Immunoglobulin G
- Receptors, Tumor Necrosis Factor
- Tumor Necrosis Factor-alpha
- Infliximab
- Adalimumab
- Etanercept
- Methotrexate
|
Topics |
- Adalimumab
- Antibodies, Monoclonal
(therapeutic use)
- Antibodies, Monoclonal, Humanized
- Antirheumatic Agents
(therapeutic use)
- Arthritis, Juvenile
(drug therapy, physiopathology)
- Child
- Child, Preschool
- Drug Therapy, Combination
- Etanercept
- Female
- Humans
- Immunoglobulin G
(therapeutic use)
- Infant
- Infliximab
- Male
- Methotrexate
(therapeutic use)
- Receptors, Tumor Necrosis Factor
(therapeutic use)
- Remission Induction
- Tumor Necrosis Factor-alpha
(antagonists & inhibitors)
|