Background Etanercept (ETN) has significantly improved outcomes for children with severe juvenile idiopathic arthritis (JIA), but there are concerns regarding its long-term safety. Recently, 2 case reports have suggested ETN may be associated with a worsening of atopic dermatitis (AD).
Objectives The purpose of this analysis is to study the risk of new or flare of AD in ETN versus MTX treated children using data from The British Society for Paediatric and Adolescent Rheumatology (BSPAR) ETN Cohort Study.
Methods The BSPAR ETN cohort study, launched in 2004, is prospectively following children with JIA starting either ETN or MTX. Demographic, disease, treatment and adverse events data are collected at regular intervals. Reports of AD both at the time of and after treatment start were identified. Incidence rates of new/worsening AD were calculated for both groups and the risk compared using Cox proportional hazard models adjusted by deciles of propensity score.
Results To 30/11/13, 700 ETN and 200 MTX treated children were recruited, with 7% recording a history of AD at treatment start. Over 2214 person-years (pyrs) of exposure there were 24 (ETN) and 6 (MTX) first reports of new/flare AD, giving an on-treatment incidence of 1.5 (95% CI 1.0, 2.2) and 1.0 (95% CI 0.4, 2.1)/100pyrs respectively. The adjusted hazard ratio for risk of new/flare AD in patients receiving ETN compared to MTX was 2.10 (95% CI 0.67, 6.52).
Conclusions Overall, the use of ETN was not associated with new/worsening AD compared to MTX, although small numbers prevented robust estimates.
Disclosure of Interest None declared
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