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See Latest ArticlesClinical remission in patients with systemic juvenile idiopathic arthritis treated with anti-tumor necrosis factor agents
Journal of Rheumatology, 05/18/09
Russo RAG et al. – Study reports that twenty-four percent of patients with systemic juvenile idiopathic arthritis (JIA) experienced remission with anti-TNF therapy, but only 13% experienced sustained benefit.
Methods- Objective of this study:
- an assessment of the frequency of clinical remission in pts with systemic JIA who received continuous anti-TNF therapy and
- to identify potential predictors of remission
- Pts with systemic JIA treated with anti-TNF agents for >6 mo
- Demographic and nosologic variables recorded at the start of anti-TNF therapy were analyzed
- Association between early variables and occurrence of remission evaluated through Cox proportional hazard regression analysis
- 45 pts (30 girls); median age: 9 yrs; age at disease onset: 5 yrs; disease duration: 3 yrs
- 47% children showed systemic symptoms at the start of anti-TNF therapy
- Pts received therapy for 24 mo: 100% were given etanercept, 38% infliximab, and 11% adalimumab, in combination with methotrexate
- Anti-TNF switching was performed in 49% children
- 24% met definition criteria for remission while taking etanercept (n=8), infliximab (2), or adalimumab (1)
- Remission occurred following 26 mo of therapy
- Flares occurred in 45% pts 2-14 mo after remission was first recorded
- Univariate analysis: absence of systemic symptoms at the start of therapy and fulfilment of improvement criteria at mo 3 were associated with remission
- Multivariate analysis: no variable showed any association
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