A recent study issued in the Arthritis Research & Therapy journal proved the efficacy of etanercept (ETA) when used as a re-treatment in juvenile idiopathic arthritis (JIA) patients.

Jens Klotsche and researchers aimed to assess the correlates for discontinuation of ETA following an inactive disease and for the consequent risk of flare. The efficacy of ETA in the re-treatment after a flare-up has also been assessed based on data from 2 ongoing prospective registries. These registries provided the overall clinical results from childhood to adulthood in JIA patients who used conventional synthetic (cs-) and biologic disease-modifying anti-rheumatic drugs (bDMARDs) therapy.

Firstly, 1724 patients were treated with ETA course followed by 33 8 with second, and 54 with third course. All the three courses had similar withdrawal rates due to ineffectiveness and adverse events, as shown below:

After achieving remission with the first ETA course, overall 332 patients (19.3%) withdrew the use of ETA. Continued oligoarthritis, younger age, and shorter period between JIA beginning and ETA initiation, along with good response to therapy within first 6 months was significantly associated with withdrawal with inactive disease. Active disease relpase was described for 77% patients (mean time to flareup- 12.1 months). Many patients were re-treated with ETA (117 out of 161 patients; 72.7%) following the flare.

One patients out of five discontinued ETA again after attaining an inactive disease. An year after resuming with ETA, about 70% patients achieved an inactive disease.

A possible link between timely bDMARDs treatment and higher rate of inactive disease may suggest a window of opportunity, the study researchers concluded.