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FRI0347 Efficacy and safety of etanercept in patients with polyarticular juvenile idiopatic arthritis under four years old
  1. I. Calvo Penadés,
  2. A. Marco Puche,
  3. B. Lopez Montesinos,
  4. Y. Rodriguez Santana,
  5. S. Henriquez Santana
  1. Reumatologia Pediatrica, Hospital Universitari i Politecni La Fe., Valencia, Spain

Abstract

Background The efficacy and safety of etanercept (ETN) has been demonstrated in patients with juvenile idiopathic arthritis (JIA) from 4 years, although more data are needed regarding the population under 4 years old.

Objectives The aim is to evaluate the efficacy and safety of etanercept in patients under 4 years old diagnosed with polyarticular JIA and to assess the adherence to drug treatment in this population.

Methods We analyzed retrospectively, from medical records of patients, the following variables: epidemiologic data, number of active and limited joints at baseline and at 6 months; we also registered laboratory parameters including CRP, ESR, iron and hemoglobin. Other variables recorded were CHAQ punctuation; physician and parents global assessment at baseline and 6 months of treatment. Continuous variables are presented as means±SD.

Results From a total of 25 patients with JIA younger than 4 years old treated with ETN only 21 were analyzed. There were 14 girls and 7 boys with a mean age at diagnosis of 23±19.4 months. All patients had received methotrexate (MTX), corticosteroids (prednisolone) and ETN (0.8mg/kg/wk) as initial therapy. The mean duration of treatment with etanercept was 36.6±22 months.Iron laboratory values at baseline were low (49.89±25.6μg/dl) but normalized at 6 months of treatment (70.76±31.2μg/dl). Number of active and limited joints at baseline were 12±4.3/3.5±5.1 respectively; at six months of treatment were 1.44±1.77/1±1.33.CHAQ punctuation at baseline was 1.2±0.3 and 0.4±0.2 at six months. Physician and parents’global assessment at baseline were 71.5±11.5/70±14.1 respectively and 11.6±11.2/12.9±12.4 at 6 months of treatment. CRP and ESR parameters at baseline were 40.8±24.1 mg/l/51.9±19.4 mm/h respectively and 3±4.9 mg/l/14.1±8.3mm/h at six months of treatment. All patients achieved clinical remission at 6 months of treatment. Furthermore, in all patients discontinuation of therapy with corticosteroids was performed and 60% achieved discontinuation of MTX after 6 months of treatment. ETN was discontinued in 2 patients (9.5%) due to remission of the disease: one outbreak must be restarted on therapy after 3 months and the other remains in remission without treatment a year later. Four patients (19%) remained at doses below 0.8mg/kg/wk. Any patient had serious adverse effects secondary to treatment.

Conclusions Although important joint involvement and alteration of analytical parameters at baseline a high percentage of patients achieved remission at 6 months of treatment with etanercept. All patients could reduce concomitant medication and dose reduction or withdrawal of etanercept was possible in some patients. Treatment with etanerceptin patients under 4 years old is shown as safe and effective in our patient group after 6 months of treatment.

Disclosure of Interest None Declared

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