Our aim was to assess long-term efficacy and tolerability of etanercept and infliximab in patients with JIA.
This was an observational, retrospective study of 41 patients treated with anti-TNF therapy. We assessed clinical remission, flare, ACR improvement, improvement of DAS28, and JADAS. Some patients with polyarticular JIA were scored according to the modified SHARP criteria.
Twenty-four weeks after beginning of therapy 35 patients (92.1%) achieved ACR 20, 33 patients (86.8%) ACR 30, 31 patients (81.6%) ACR 50, 28 patients (73.7%) ACR 70 and 20 patients (52.6%) ACR 90. In the same period 19 patients (50%) had good DAS28 response, 12 patients (31.6%) had moderate response, and 5 patients (13.2%) did not respond to therapy. Statistically significant difference was shown in the average value of JADAS-71 before the beginning and 24 weeks after introduction of anti-TNF therapy. Eleven patients had a flare in the study period (28.9%); five on etanercept (13.1%), three on infliximab (7.9%), and three flared on both of the medications (7.9%). After 12 months, fifteen patients fulfilled criteria for clinical remission on medications. Seven of them were on infliximab and eight on etanercept. Eleven patients have fulfilled criteria for clinical remission off of medications: three were taking etanercept, seven infliximab, and one was switched from etanercept to infliximab.
In our patient cohort, both etanercept and infliximab performed well, since we found no significant difference in the duration, response, flare, resistance or adverse effects between both drugs, however long term remissions are rare.