Featured Research

from universities, journals, and other organizations

Effectiveness Of Medication For Juvenile Rheumatoid Arthritis Affirmed

Date:
May 8, 2008
Source:
Wiley-Blackwell
Summary:
Juvenile rheumatoid arthritis is a chronic autoimmune disease that strikes children between the ages of newborn to 16 years. All children with JRA have joint pain, stiffness, and swelling and some also have fever and skin rashes. JRA can impede growth, damage joints, and lead to disability in adulthood.

Juvenile rheumatoid arthritis (JRA) is a chronic autoimmune disease that strikes children between the ages of newborn to 16 years. All children with JRA have joint pain, stiffness, and swelling and some also have fever and skin rashes. JRA can impede growth, damage joints, and lead to disability in adulthood. Traditionally, children with JRA have been treated with the same drugs prescribed to adults with inflammatory diseases: corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and disease-modifying antirheumatic drugs (DMARDs) such as methotrexate (MTX). Unfortunately, these medications fail to improve disease activity for many children with JRA.

Related Articles


Tumor necrosis factor (TNF) plays a key role in the inflammatory process. In the past decade, TNF-blockers have brought dramatic gains in treatment for rheumatoid arthritis patients. Etanercept, the only FDA-approved biologic for JRA patients until very recently, has also been proven highly effective and safe for children in short-term trials. Yet, since many children with JRA have active disease that lasts for many years, past adolescence and into adult life for many, assurance of the effectiveness and safety of long-term anti-TNF treatment is essential.

Toward that goal, the Pediatric Rheumatology Collaborative Study Group—comprised of over 70 pediatric rheumatology centers in the US and Canada has been conducting a trial of etanercept in JRA patients for more than 8 years. The group shares reassuring news for pediatricians, parents, and, above all, children afflicted with JRA.

To evaluate the long-term therapeutic value of etanercept, the study group began with a randomized controlled trial, focusing on 69 JRA patients between the ages of 4 and 17 years. Treatment with MTX and other DMARDs was discontinued a minimum of 2 weeks before enrollment, while maintaining a low-dose regimen of corticosteroids or NSAIDs was allowed. Patients received injections of etanercept based on the patient’s body weight with a maximum weekly dosage of 50 milligrams. As the trial was extended beyond 1 year, participants were permitted to add low-dose MTX if recommended by their physician.

At every 3 months during the first year of the extension phase, and then every 4 to 6 months during the following years, participants were assessed for improvement in overall disease status using the American College of Rheumatology Pediatric (ACR Pedi) criteria, as well as evaluated for changes in joint inflammation, mobility, pain, ability to perform routine daily tasks and C-reactive protein level. Patients were also monitored for frequency of serious adverse events (SAEs) such as those that required hospitalization, resulted in prolonged incapacity or death. Also medically important infections (MIIs) defined as those that required treatment with intravenous antibiotics were monitored.

58 JRA patients, 84 percent of the participants in the randomized controlled trial, enrolled in the long-term extension trial and received weekly treatment for a total of 318 patient years of etanercept exposure. Most patients were female (67 percent) and white (74 percent), and all had taken MTX prior to the study. At baseline, the mean age of the patients was 10 years and the mean duration of disease was 5.9 years. 42 of these patients (72 percent) entered the fourth year of continuous etanercept treatment, and 26 patients (45 percent) entered the eighth year. Here’s an overview of the results:

  • 16 of the original 69 study participants reported 39 serious adverse events, for an overall exposure-adjusted rate of 0.12 SAEs per patient year. This rate did not increase with long-term exposure to etanercept.
  • 8 patients reported 9 medically important infections over the course of the long-term trial, for an overall exposure-adjusted rate of 0.03 MIIs per patient year. This rate did not increase with long-term exposure to etanercept.
  • The most common adverse event was a flare of JRA. There were no reported cases of tuberculosis, which has been linked to anti-TNF therapy, or lupus; no malignancies or lymphomas; no nervous system disorders; and no deaths.
  • Among patients who received 8 years worth of weekly etanercept treatment, 100 percent achieved an ACR Pedi 70 response, indicating 70 percent improvement in joint symptoms from baseline. Over the course of the study, only 7 patients withdrew due to the therapy’s lack of effectiveness on disease activity.

“Continuous treatment with etanercept resulted in truly important, often profound, sustained improvement in all aspects of this disease including clinically important signs and symptoms of JRA, improvements in functional ability and decreased pain for up to 8 years,” notes study group spokesperson Dr. Daniel J. Lovell. Demonstrating long-term safety comparable to studies of patients across a variety of rheumatic disorders, this study supports the potential of etanercept therapy to give children with JRA the promise of a better quality of life as adults.


Story Source:

The above story is based on materials provided by Wiley-Blackwell. Note: Materials may be edited for content and length.


Journal Reference:

  1. Safety and Efficacy of up to Eight Years of Continuous Etanercept Therapy in Patients with Juvenile Rheumatoid Arthritis. Daniel J. Lovell, Andreas Reiff, Norman T. Ilowite, Carol A. Wallace, Yun Chon, Shao-Lee Lin, Scott W. Baumgartner, and Edward H. Giannini, for the Pediatric Rheumatology Collaborative Study Group, Arthritis & Rheumatism, May 2008; 58:5 pp. 1496-1504.

Cite This Page:

Wiley-Blackwell. "Effectiveness Of Medication For Juvenile Rheumatoid Arthritis Affirmed." ScienceDaily. ScienceDaily, 8 May 2008. <www.sciencedaily.com/releases/2008/05/080508143257.htm>.
Wiley-Blackwell. (2008, May 8). Effectiveness Of Medication For Juvenile Rheumatoid Arthritis Affirmed. ScienceDaily. Retrieved October 25, 2014 from www.sciencedaily.com/releases/2008/05/080508143257.htm
Wiley-Blackwell. "Effectiveness Of Medication For Juvenile Rheumatoid Arthritis Affirmed." ScienceDaily. www.sciencedaily.com/releases/2008/05/080508143257.htm (accessed October 25, 2014).

Share This



More Health & Medicine News

Saturday, October 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Texas Nurse Nina Pham Cured of Ebola

Texas Nurse Nina Pham Cured of Ebola

AFP (Oct. 25, 2014) — An American nurse who contracted Ebola while caring for a Liberian patient in Texas has been declared free of the virus and will leave the hospital. Duration: 01:01 Video provided by AFP
Powered by NewsLook.com
IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) — IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) — A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com
WHO: Millions of Ebola Vaccine Doses by 2015

WHO: Millions of Ebola Vaccine Doses by 2015

AP (Oct. 24, 2014) — The World Health Organization said on Friday that millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines would start being tested in March. (Oct. 24) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins