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Use of etanercept again
after its discontinuation in inactive disease
may be effective in juvenile idiopathic arthritis.
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.
Arthritis Research & Therapy
Re-treatment with etanercept is as effective as the initial firstline treatment in patients with juvenile idiopathic arthritis
Jens Klotsche et al.
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