Skip to main content

Advertisement

Log in

Safety and efficacy of etanercept in children with juvenile idiopathic arthritis below the age of 4 years

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Little is known about the safety and efficacy of etanercept in children below the age of 4 years. Twenty-five patients with juvenile idiopathic arthritis (JIA) below the age of 4 years, who received etanercept, were documented in the German JIA Etanercept Registry. Patients with the nonsystemic JIA disease-subtype responded more frequently to treatment with etanercept than systemic onset patients. At last observation, two (20%) of the nonsystemic patients did not reach a PedACR 30 response, while six (40%) of the systemic onset patients did not respond to the therapy. Complete resolution of symptoms was observed in two (20%) nonsystemic and in five (33%) systemic onset patients with JIA. Tolerability was good with only two infections occurring in the total patients group. Patients with JIA below the age of 4 years, with a methotrexate-resistant disease course, would also benefit from treatment with etanercept, showing a good tolerability. The restriction to children older than 4 years appears to be artificial without any good rationale.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Petty R, Malleson P (1987) Epidemiology of juvenile rheumatoid arthritis. World Pediatr Child Care 3:205–210

    Google Scholar 

  2. Cassidy JT, Petty RE. Textbook of pediatric rheumatology. Elsevier, Oxford. ISBN-10: 1416002464

  3. Wallace CA, Sherry DD (1992) Preliminary report of higher dose methotrexate treatment in juvenile rheumatoid arthritis. J Rheum 19:1604–1607

    PubMed  CAS  Google Scholar 

  4. Reiff A, Shaham B, Wood BP, Berstein BH, Stanley P, Szer IS (1995) High dose methotrexate in the treatment of refractory juvenile rheumatoid arthritis. Clin Exp Rheumatol 13:113–118

    PubMed  CAS  Google Scholar 

  5. Moreland LW, Schiff MH, Baumgarnter SW, Tindall EA, Fleischmann RM, Bulpitt KJ et al (1999) Etanercept therapy in rheumatoid arthritis: a randomized, controlled trial. Ann Intern Med 130:478–486

    PubMed  CAS  Google Scholar 

  6. Weinblatt ME, Kremer JM, Bankhurst AD, Bulpitt KJ, Fleischmann RM, Fox RI et al (1999) A trial of etanercept, a recombinant tumor necrosis factor receptor:Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate. N Engl J Med 340:253–259

    Article  PubMed  CAS  Google Scholar 

  7. Bathon JM, Martin RW, Fleischmann RM, Tesser JR, Schiff MH, Keystone EC et al (2000) A comparison of etanercept and methotrexate in patients with early rheumatoid arthritis. N Engl J Med 343:1586–1593

    Article  PubMed  CAS  Google Scholar 

  8. Mease PJ, Goffe BS, Metz J, Vandersoep A, Finck B, Burge DJ (2000) Etanercept in the treatment of psoriatic arthritis and psoriasis: a randomised trial. Lancet 356:385–390

    Article  PubMed  CAS  Google Scholar 

  9. Lovell DJ, Giannini EH, Reiff A, Cawkwell GD, Silverman ED, Nocton JJ et al; for Pediatric Rheumatology Collaborative Study Group (2000) Etanercept in children with polyarticular juvenile rheumatoid arthritis. N Engl J Med 342:763–769

    Article  PubMed  CAS  Google Scholar 

  10. Lovell DJ, Giannini EH, Reiff A, Jones OY, Schneider R, Olson JC et al; for Pediatric Rheumatology Collaborative Study Group (2003) Long-term efficacy and safety of etanercept in children with polyarticular-course juvenile rheumatoid arthritis: interim results from an ongoing multicenter, open-label, extended-treatment trial. Arthritis Rheum 48:218–226

    Article  PubMed  CAS  Google Scholar 

  11. Lovell DJ, Reiff A, Jones OY, Schneider R, Nocton J, Stein LD, Gedalia A, Illowite NT, Wallace CA, Whitmore JB, White B, Giannini EH; for Pediatric Rheumatology Collaborative Study Group (2006) Long-term safety and efficacy of etanercept in children with polyarticular-course juvenile rheumatoid arthritis. Arthritis Rheum 54:1987–1994

    Article  PubMed  Google Scholar 

  12. Horneff G, Schmeling H, Biedermann T, Foeldvari I, Ganser G, Girschick HJ, Hospach T, Huppertz HI, Keitzer R, Kuester RM, Michels H, Moebius D, Rogalski B, Thon A; for Pediatric Rheumatology Collaborative Group (2004) The German etanercept registry for treatment of juvenile idiopathic arthritis. Ann Rheum Dis 63:1638–1644

    Article  PubMed  CAS  Google Scholar 

  13. Quartier P, Taupin P, Bourdeaut F, Lemelle I, Pillet P, Bost M, Sibilia J, Kone-Paut I, Gandon-Laloum S, LeBideau M, Bader-Meunier B, Mouy R, Debre M, Landais P, Prieur AM (2003) Efficacy of etanercept for the treatment of juvenile idiopathic arthritis according to the onset type. Arthritis Rheum 48:1093–1101

    Article  PubMed  CAS  Google Scholar 

  14. Giannini EH, Ruperto N, Ravelli A, Lovell DJ, Felson DT, Martini A (1997) Preliminary definition of improvement in juvenile arthritis. Arthritis Rheum 40:1202–1209

    PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors would like to thank the following investigators who participated in the trial: A. Urban, Fürth, R.Keitzer, and J. Roth, Berlin; T. Hospach, Stuttgart, H. Girschick, Würzburg, M. Borte, Leipzig; H. Michels, Garmisch-Partenkirchen, I. Földvari, Hamburg, H.I. Huppertz, and N. Onken, Bremen; B. Rogalski, Neckargmuend, G. Ganser, Sendenhorst; all from Germany.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to N. Tzaribachev.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tzaribachev, N., Kuemmerle-Deschner, J., Eichner, M. et al. Safety and efficacy of etanercept in children with juvenile idiopathic arthritis below the age of 4 years. Rheumatol Int 28, 1031–1034 (2008). https://doi.org/10.1007/s00296-008-0563-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-008-0563-2

Keywords

Navigation