THU0323 Achievement of clinical remission in patients with juvenile idiopathic arthritis after a long-term (2–5 years) etanercept exposure: A national referral center’s experience. (preliminary report)

• Published in: Annals of the rheumatic diseases Vol. 71; no. Suppl 3; p. 265
• Main Authors: Trachana, M., Pratsidou-Gertsi, P., Pardalos, G.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.06.2013; BMJ Publishing Group LTD
• DOI: 10.1136/annrheumdis-2012-eular.2288
• ISSN: 0003-4967

Background Published data on the achievement of clinical remission (CR) - which is the ultimate goal of drug efficacy- over a long period of Etanercept (ETN) therapy in JIA patients, are worldwide sparse and completely lacking from Greece. Objectives To record the achievement of CR in JIA patients under ETN over a period of 2-5yrs and investigate predictors of CR. Methods Data from the 10-year Registry of our Pediatric Referral Center were retrieved. Patients previously resistant to conventional regimen and with a ≥2-year drug exposure were enrolled in the study. The annual impact of ETN on the disease course was assessed by the application of: a) American College of Rheumatology pediatric criteria (ACRpedi), b) the pre- and post-treatment disease activity score (Juvenile Arthritis Disease Activity Score [JADAS71]) and c) Wallace’s criteria for CR. Results 41pts (F: M 32:9) were enrolled in the study. Their median age at the time of the ETN dose was 10.6 yrs and their disease course was mainly polyarthritis (32/41). The median disease duration prior to study entry was 4.17 years. One of the pts received ETN for 2 different periods, 24 and 48 mo respectively, thus the annual number of ETN receivers were 42/42/29/20 and 13 from Year 1 to 5, respectively. The annual scores of ACRpedi 30/50/70/90/100 and the number of CR achievers are shown in Table 1. JADAS0 (baseline) did not correlate well with the subsequent achievement of CR. However, JADAS1 (1st year post-treatment) had a significant correlation with CR2 (2nd year post-treatment, p=0.002, ROC/AUC 0.81) and a similar trend was observed for the following treatment years. Table 1. Efficacy of Etanercept over the 5-year study period No of ETN receiversACRpediClinical Remission <3030507090100No of pts (%) Year 142048671721 (50.00) Year 242124971924 (54.14) Year 329133561115 (51.72) Year 41812312910 (55.76) Year 5132110458 (61.54) Conclusions These preliminary findings emphasize the impact of ETN in the achievement of CR overtime, as ≥50% of pts had achieved CR and sustained it over the 5-year period. There was a strong probability that a low JADAS score 1 year post-treatment, can predict the maintenance of CR over the next year(s) of treatment. References Consolaro A, Ruperto N, Bazso A et al. Development and Validation of a Composite Disease Activity Score for Juvenile Idiopathic Arthritis. Arthritis Rheum 2009; 61: 658–66. Ringold S, Wallace CA. Measuring clinical response and remission in juvenile idiopathic arthritis. Curr Opin Rheumatol 2007; 19:471–6. Disclosure of Interest M. Trachana Grant/Research support from: Abbott, Novartis and Pfizer, P. Pratsidou-Gertsi Grant/Research support from: Abbott, Novartis and Pfizer, G. Pardalos Grant/Research support from: Novartis. This study was funded by Pfizer