TY - JOUR T1 - Tumor Necrosis Factor-blocking Agents for Children with Enthesitis-related Arthritis — Data from the Dutch Arthritis and Biologicals in Children Register, 1999–2010 JF - The Journal of Rheumatology JO - J Rheumatol SP - 2258 LP - 2263 DO - 10.3899/jrheum.110145 VL - 38 IS - 10 AU - MARIEKE H. OTTEN AU - FEMKE H.M. PRINCE AU - MARINKA TWILT AU - REBECCA ten CATE AU - WINEKE ARMBRUST AU - ESTHER P.A.H. HOPPENREIJS AU - YVONNE KOOPMAN-KEEMINK AU - NICO M. WULFFRAAT AU - SIMONE L. GORTER AU - KOERT M. DOLMAN AU - JOOST F. SWART AU - J. MERLIJN van den BERG AU - MARION A.J. van ROSSUM AU - LISETTE W.A. van SUIJLEKOM-SMIT Y1 - 2011/10/01 UR - http://www.jrheum.org/content/38/10/2258.abstract N2 - Objective. To evaluate the effectiveness and safety of biological agents in children with enthesitis-related arthritis (ERA). Methods. All patients with ERA in whom a biological agent was initiated between 1999 and 2010 were selected from the Dutch Arthritis and Biologicals in Children (ABC) register. In this ongoing multicenter observational register, data on the course of the disease and medication use are retrieved prospectively at the start of the biological agent, after 3 months, and yearly thereafter. Inactive disease was assessed in accordance with the Wallace criteria. Results. Twenty-two patients with ERA started taking 1 or more biological agents: 20 took etanercept, 2 took adalimumab (1 switched from etanercept to adalimumab), and 2 took infliximab (1 switched from etanercept to infliximab). Characteristics: 77% were male, 77% had enthesitis, 68% were HLA-B27-positive. The median age of onset was 10.4 (IQR 9.4–12.0) years; median followup from the start of the biological agent was 1.2 (IQR 0.5–2.4) years. Intention-to-treat analysis shows that inactive disease was achieved in 7 of 22 patients (32%) after 3 months, 5 of 13 patients (38%) after 15 months, and 5 of 8 patients (63%) after 27 months of treatment. Two patients discontinued etanercept because of ineffectiveness, and switched to adalimumab (inactive disease achieved) or infliximab (decline in joints with arthritis after 3 months of treatment). One patient discontinued etanercept because of remission, but had flare and restarted treatment, with good clinical response. No serious adverse events occurred. Conclusion. Tumor necrosis factor (TNF)-blocking agents seem effective and safe for patients with ERA that was previously unresponsive to 1 or more DMARD. However, a sustained disease-free state could not be achieved, and none discontinued TNF-blocking agents successfully. ER -