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Use of adalimumab in patients with juvenile idiopathic arthritis refractory to etanercept and/or infliximab
Clinical Rheumatology, 04/01/09

Katsicas MM et al. – Adalimumab appears to be effective and safe in patients with juvenile idiopathic arthritis (JIA) refractory to other anti-TNF agents. Further controlled studies are needed to assess efficacy of adalimumab in children with refractory JIA.

• Aim was to analyse the effectiveness and safety of adalimumab in a group of pts with JIA who had failed treatment with etanercept and/or infliximab
• Pts with JIA with active polyarthritis refractory to MTX (≥20 mg/m2/wk) for at least 3 mo and to etanercept (up to 1 mg/kg x2/wk) and/or infliximab (up to 10 mg/kg/4 wks) for at least 6 mo were included
• All pts received adalimumab 24 mg/m2/wk concomitantly with MTX 7.5–10 mg/wk
• Evaluation of efficacy included improvement as defined by the ACR paediatric 30 criteria, 50% and 70% improvement and remission

• 6 pts were included; 3 met improvement criteria; 50% and 70% improvement occurred in 2 children
• Improvement was sustained for 12, 24 and 36 mo respectively
• Remission occurred in 1 patient
• Adalimumab was discontinued due to lack of efficacy in 3 pts
• No side effects were observed

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