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Eight years of experience with biological treatment in juvenile idiopathic arthritis
Journal of Translational Medicine volume 8, Article number: P64 (2010)
The introduction of biological agents has provided a new therapeutic approach to the treatment of juvenile idiopathic arthritis (JIA).
To analyze the data from a eight year follow-up of JIA patients treated with biological agents.
Patients with JIA who started a biological treatment were enrolled in a prospective observational study. Clinical and laboratory data were recorded at baseline and every 3 months.
24 patients, 54% female, mean age at disease onset 7±4 years, mean disease duration 11±8 years. 25% had systemic arthritis, 25% rheumatoid factor (RF) positive polyarthritis, 17% RF negative polyarthritis, 12% enthesitis-related arthritis, and the remaining 21% were equally distributed across the other groups. All patients had been previously treated with at least one DMARD. The indication for biological treatment was DMARD failure in 86% of the cases and MTX toxicity in the remaining 14%.
Biological treatment was started at a mean age of 15±7 years and maintained for a mean of three years (2 months- 7 years). 20 patients received etanercept, 3 infliximab and 1 anakinra as first-line biological. All patients experienced a significant reduction in all disease activity parameters at 3 months with maximum improvement at six months (reduction in active joint count of 92%, joints with limited range of motion 81%, VAS 35%, ESR of 61%, CRP 88% (p<0.05)). This response was sustained up to 7 years of treatment in 75% of the patients. The remaining 25% switched to a second biological due to loss of efficacy.
Biological treatment was an effective and safe therapeutic option in this cohort of patients with severe JIA refractory or intolerant to classic DMARDs.
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Mourão, A.F., Rodrigues, A., Vinagre, F. et al. Eight years of experience with biological treatment in juvenile idiopathic arthritis. J Transl Med 8, P64 (2010). https://doi.org/10.1186/1479-5876-8-S1-P64
- Juvenile Idiopathic Arthritis
- Rheumatoid Factor
- Biological Agent