Is long-term etanercept therapy safe and effective in patients with juvenile RA?

Abstract

Traditional treatment for juvenile rheumatoid arthritis (JRA) includes the use of NSAIDs, corticosteroids, and DMARDs such as methotrexate; however, these drugs are not effective in all patients. Although the use of tumor necrosis factor inhibitors has dramatically improved outcomes in patients with JRA, the long-term safety of these agents in children remains a concern. Lovell et al. recently reported the long-term follow-up of a randomized controlled trial that had shown in 69 patients that etanercept was effective in the treatment of JRA. In the 8-year, open-label extension study (n = 58), the drug remained well tolerated and few adverse events were reported. These results indicate that a substantial number of patients with JRA will have a sustained response to etanercept and that the drug can be given safely for at least 8 years. Although the patients in this study were diagnosed with polyarticular JRA according to American College of Rheumatology criteria, it is reasonable to generalize the findings to patients with polyarticular juvenile idiopathic arthritis as defined by the International League of Associations for Rheumatology guidelines.