Three new studies have individually shown the anti-TNF (tumour necrosis factor) therapy etanercept to be effective, with a good safety profile, in children under four years of age with juvenile idiopathic arthritis (JIA), and associated with improved Health-Related Quality of Life in a substantial proportion of children with JIA. The data are being presented at the Paediatric Rheumatology European Society Congress 2009, a joint congress with the 2009 Congress of the European League Against Rheumatism in Copenhagen, Denmark.

The first study, conducted in Italy, showed entanercept to be effective, with a good safety profile, in children under 4 years of age (an as yet unlicensed patient population for the treatment). Thirty-three patients under 4 years of age with unresponsive JIA (24 female, 9 male) were treated with etanercept for an average of 23 months. After the first 6 months of treatment, 82 percent achieved the ACR Pedi 30 response and 48 percent achieved the ACR Pedi 70 response. There was a low rate of mild adverse events, whilst one patient temporarily suspended treatment following hospitalization for an infection.

The second study, conducted in The Netherlands, from the Arthritis and Biological in Children project, observed impressive improvements in the Health-Related Quality of Life of 53 patients with previously refractory (unresponsive) JIA in seven Dutch centers during entanercept use of at least 27 months. These comprised both disease-specific improvements (inflamed joints, functional impairment, erythrocyte sedimentation rate (ESR), a laboratory marker of inflammation) (p<0.001) and all generic HRQoL outcomes impaired by JIA (including pain, movement, and dexterity) (p<0.05).

The third study, also from The Netherlands ABC-project, showed that a substantial 57 percent of non-responders to etanercept at three months (12 patients from 21 non-responders of a total of 179 JIA patients; average age of 5.8 years) who continued with the treatment eventually responded. The researchers in this study thereby suggest extending the use of etanercept in non-responding patients beyond the commonly recommended three-month therapy window to achieve higher response rates in JIA patients.

Source: European League Against Rheumatism