Guest guest Posted January 16, 2001 Report Share Posted January 16, 2001 From the ACR: VARIABLE RESPONSE OF SYSTEMIC JUVENILE RHEUMATOID ARTHRITIS TO ETANERCEPT. Gloria C Higgins, Karla , M Rennebohm Columbus, OH Nine patients with active systemic JRA treated with etanercept (starting dose 0.4 mg/kg by subcutaneous injection twice weekly) were followed for 7-14 months (mean 11 months). Patient ages ranged from 3.5 to 22 years, and disease duration ranged from 0.5 to 20 years. All patients had fever and/or rash and laboratory evidence of systemic inflammation (anemia, thrombocytosis, or elevated ESR), in addition to active joint disease, at the time of beginning etanercept. All patients were already taking other " second line " arthritis medications such as corticosteroids, methotrexate, or cyclosporin A. The clinical course of each patient was carefully followed with serial joint examinations and laboratory testing. Four of nine children had an excellent initial response of both systemic and joint inflammation, two within 1 month and two within 2 months. However, all four experienced major exacerbation of systemic and articular disease within 6 months of institution of therapy. Flares were temporally related to reduction of concomitant methotrexate and/or corticosteroid dosages. In two patients who flared, control of disease was re-established by increasing concomitant medication dosage(s). One of nine patients had objective improvement after nine months of continuous etanercept treatment, perhaps unrelated to this medication. Four other patients derived little or no benefit from etanercept, despite an increase in dosage to 0.5 mg/kg in two. Compared to seventeen polyarticular JRA patients receiving etanercept and followed for a similar length of time, those with systemic JRA were much less likely to have a dramatic response, or much more likely to experience exacerbation of disease after initial improvement. Session Info. : Poster Session: TNF Drugs in Pediatrics (12:30 PM-2:00 PM) Board Number: 195 Quote Link to comment Share on other sites More sharing options...
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