TY - JOUR T1 - Tumour necrosis factor (TNF)-blocking agents in juvenile psoriatic arthritis: are they effective? JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 337 LP - 340 DO - 10.1136/ard.2010.135731 VL - 70 IS - 2 AU - Marieke H Otten AU - Femke H M Prince AU - Rebecca ten Cate AU - Marion A J van Rossum AU - Marinka Twilt AU - Esther P A H Hoppenreijs AU - Yvonne Koopman-Keemink AU - Arnold P Oranje AU - Flora B de Waard-van der Spek AU - Simone L Gorter AU - Wineke Armbrust AU - Koert M Dolman AU - Nico M Wulffraat AU - Lisette W A van Suijlekom-Smit Y1 - 2011/02/01 UR - http://ard.bmj.com/content/70/2/337.abstract N2 - Objectives To evaluate the effectiveness of tumour necrosis factor (TNF) blockers in juvenile psoriatic arthritis (JPsA). Methods The study was a prospective ongoing multicentre, observational study of all Dutch juvenile idiopathic arthritis (JIA) patients using biologicals. The response of arthritis was assessed by American College of Rheumatology (ACR) paediatric response and Wallace inactive disease criteria. The response of psoriatic skin lesions was scored by a 5-point scale. Results Eighteen JPsA patients (72% female, median age onset 11.1 (range 3.3–14.6) years, 50% psoriatic skin lesions, 39% nail pitting, 22% dactylitis) were studied. The median follow-up time since starting anti-TNFα was 26 (range 3–62) months. Seventeen patients started on etanercept and one started on adalimumab. After 3 months of treatment 83% of the patients achieved ACR30 response, increasing to 100% after 15 months. Inactive disease reached in 67% after 39 months. There was no discontinuation because of inefficacy. Six patients discontinued treatment after a good clinical response. However, five patients flared and restarted treatment, all with a good response. During treatment four patients (two JPsA and two JIA patients with other subtypes) developed de novo psoriasis. In four of the nine patients the pre-existing psoriatic skin lesions improved. Conclusion Anti-TNFα therapy in JPsA seems effective in treating arthritis. However, in most patients the arthritis flared up after treatment discontinuation, emphasising the need to investigate optimal therapy duration. The psoriatic skin lesions did not respond well and four patients developed de novo psoriasis. ER -