Younger patients and those who did not require corticosteroid treatment were more likely to have an excellent response, Dr. Kimme Hyrich of the University of Manchester in the UK and colleagues found. They reported their findings online on Dec. 31, 2015, in Rheumatology.
Clinical factors associated with response to anti-tumor necrosis factor therapy in adults with rheumatoid arthritis include lower disease activity and less disability, but few studies have looked at the issue in children, Dr. Hyrich and colleagues note.
To investigate factors associated with etanercept response in a real-world setting, the researchers looked at 496 children and young adults with JIA who were starting etanercept treatment as part of the British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study.
At one year, 74% had achieved American College of Rheumatology Pediatric (ACR Pedi) 30; 69% achieved ACR Pedi 50; and 38% ACR Pedi 90, while 48% of patients had minimal disease activity.
Shorter disease duration (odds ratio 0.91), no concurrent corticosteroid use (OR 0.48), and history of uveitis (OR 2.26) were each independently associated with achieving an excellent response (ACR Pedi 90), while younger age and no concurrent corticosteroid also were independently associated with achieving minimal disease activity (OR 0.60 and OR 0.57, respectively).
“The finding of a greater response in younger children and those with a history of CAU warrants further investigation and may relate to differences in disease phenotype, drug pharmacokinetics or adherence,” Dr. Hyrich and colleagues write. “Despite these positive outcomes, only one child in the study stopped etanercept therapy within one year due to remission.”
Dr. Hyrich did not respond to an interview request by press time. The researchers reported no funding. Two coauthors reported disclosures.