Adalimumab (brand name Humira): Injection battles childhood arthritis

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Injection battles childhood arthritis

Adult medication is also effective in kids, according to a recent study

December 13, 2006

http://www.macleans.ca/topstories/health/article.jsp?content=20061212_143542_546\

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An injectable medication already approved for treating adults with

rheumatoid arthritis now appears to be safe and effective for children with

the juvenile form of the joint-destroying disease.

A recent study indicates the drug, called adalimumab (brand name Humira), is

more effective than inactive placebo injections at improving the symptoms of

juvenile rheumatoid arthritis, with or without the addition of another

arthritis drug called methotrexate.

" Based on these data, adalimumab taken with or without methotrexate provided

rapid, substantial and sustainable improvement for children with very active

juvenile rheumatoid arthritis, " says study investigator Dr. Lovell,

chairman of the Pediatric Rheumatology Collaborative Study Group in

Cincinnati. " Given that the medication was generally well tolerated,

adalimumab has emerged as an excellent treatment option for children with

juvenile rheumatoid arthritis. "

In juvenile rheumatoid arthritis, the immune system mistakenly attacks

healthy joint tissue. What triggers this process is unknown. The disease

affects one in 1,000 Canadian children under the age of 16, according to the

Arthritis Society.

The study involved 171 children between four and 17 years of age with

rheumatoid arthritis, some of whom were already being treated with

methotrexate. The children had at least five swollen joints and three or

more joints with limited motion at the beginning of the 48-week study.

Adalimumab doses were based on a child's size, with participants receiving

injections every two weeks for 16 weeks. At the end of the 16 weeks, the 142

children who responded to the medication were randomly assigned to continue

on adalimumab or placebo for the next 32 weeks or until their arthritis

flared up.

Among children not on methotrexate, 71 per cent of those assigned to placebo

flared, compared with only 43 per cent of those who continued on adalimumab.

For children on methotrexate, 65 per cent of the placebo patients flared

compared with only 37 per cent of children on adalimumab. The most common

problems associated with adalimumab were mild upper respiratory infections.

Dr. Stanley Cohen, clinical professor of internal medicine at the University

of Texas Southwestern Medical School in Dallas, says these findings are

exciting and very good news. However, he says the medication is expensive

and he wonders how many children with juvenile rheumatoid arthritis would

ultimately benefit from this approach.

" We are now in a new era. No doubt about it. ... But cost plays into

everybody's care. "