Evaluation of Efficacy and Safety of Etanercept and Etanercept + Methotrexate Therapy in Patients with Juvenile Idiopathic Arthritis without Systemic Manifestations

• Main Authors: T. M. Bzarova (Author), Ye. I. Alekseeva (Author), S. I. Valieva (Author), R. V. Denisova (Author), K. B. Isaeva (Author), Ye. G. Chistyakova (Author), A. M. Chomakhidze (Author), T. V. Sleptsova (Author), A. N. Fetisova (Author), O. L. Lomakina (Author), M. A. Soloshenko (Author)
• Format: Book
• Published: "Paediatrician" Publishers LLC, 2016-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Background: At present, it is urgent to find ways to overcome the inefficiency of and intolerance to the methotrexate therapy in patients with juvenile idiopathic arthritis (JIA). A promising method is the use of TNF-alpha inhibitors as monotherapy.Objective: Our aim was to evaluate the efficacy and safety of etanercept monotherapy and treatment with etanercept and methotrexate in patients with JIA without systemic manifestations.Methods: Observational study with retrospective assessment of the treatment of patients who received etanercept - the treatment group (n = 55) and the combination of etanercept and methotrexate - the control group (n = 136). The efficacy was evaluated for 3 years using the pediatric criteria of the American College of Rheumatology (ACR), remission criteria by C. Wallace and index JADAS71.Results: Total amount of patients with JIA without systemic manifestations under study is 191. As early as 1 month after the first etanercept injection, clinical and laboratory parameters of disease activity significantly decreased in 83 and 77% and functional ability of joints improved in 87 and 74% of patients treated with TNF- inhibitor and its combination with methotrexate. After 6 months, the improvement according to the ACR pediatric criteria 30/50/70 was recorded in 98/98/96 and 96/95/86%; inactive stage of the disease/remission was recorded in 44 and 24% of patients who received etanercept and etanercept + methotrexate. After 1 year, the improvement was recorded in 100 and 100/98/93% of patients in the treatment group and the control group and inactive stage of the disease/remission - in 65 and 43% of patients. In the course of etanercept + methotrexate therapy, infectious adverse events were more common. 12.7 and 7.3% of patients treated with etanercept and methotrexate discontinued their participation in the study during the first 6 months and 18 and 10% - during the first year. 8.4% of patients treated with the combination of etanercept and methotrexate discontinued their participation in the study during the second year.Conclusion: Etanercept monotherapy is effective on a par with the combination therapy, but it has a higher safety profile and a lower therapy «survival».

Item Description

1682-5527
1682-5535
10.15690/vsp.v14i6.1473