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Etanercept treatment for children with refractory juvenile idiopathic arthritis

Ho-Chang Kuo1, Hong-Ren Yu2, Chih-Chiang Wu1

  • 1Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan.

Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi
|May 3, 2011
PubMed

Insights

Etanercept effectively treated refractory juvenile idiopathic arthritis (JIA) in most patients, improving joint symptoms and reducing inflammation. Conventional therapies were discontinued in responders, though systemic JIA showed less benefit.

Area of Science:

  • Rheumatology
  • Pediatric Rheumatology
  • Immunology

Background:

  • Juvenile idiopathic arthritis (JIA) is a chronic autoimmune disease affecting children.
  • Refractory JIA cases often require advanced therapeutic strategies.
  • Etanercept is a biologic agent targeting tumor necrosis factor-alpha.

Purpose of the Study:

  • To evaluate the effectiveness of etanercept in treating juvenile idiopathic arthritis (JIA) refractory to conventional therapies.
  • To assess clinical and laboratory outcomes in patients with refractory JIA treated with etanercept.

Main Methods:

  • Retrospective analysis of 11 patients with refractory JIA (polyarticular, pauciarticular, systemic types).
  • Patients received etanercept (0.4 mg/kg, max 25mg subcutaneously twice weekly) for 12 months.
  • Indications included persistent fever, arthritis/arthralgia, or elevated inflammatory markers despite prior treatment.

Main Results:

  • 10 out of 11 patients showed significant improvement in arthritis/arthralgia and reduced inflammatory markers (CRP, ESR) at follow-up.
  • Mean hemoglobin levels increased, and platelet counts decreased post-treatment.
  • Conventional immunosuppressive drugs were discontinued in 10 responders within 2.5 months of etanercept initiation.

Conclusions:

  • Etanercept demonstrates significant benefit for polyarticular and pauciarticular JIA refractory to standard treatments.
  • Etanercept appears less beneficial for the systemic type of JIA.
  • Successful treatment allowed for discontinuation of other immunosuppressive medications in most JIA patients.
Abstract

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