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Efficacy of a second TNF blocker, when the first one failed, in patients with juvenile idiopathic arthritis (JIA)

Objectives

To determine the efficacy of a second treatment with a different TNF blocker in JIA when the first one failed.

Methods

All JIA patients prospectively followed at our Centre, who failed a first TNF blocker and switched to a second one were enrolled. For each patient the DAS, ACR Ped30, ACR20, ACR50 and ACR70 responses were evaluated at baseline and after a period ranging from 3 to 6 months of each treatment.

Results

Out of 60 JIA patients enrolled, 40 (37 f, 3 m) were evaluated: 10 systemic arthritis, 2 persistent oligoarthritis, 11 extended oligoarthritis, 9 RF negative polyarthritis, 4 RF positive polyarthritis, 1 ERA (enthesitis related arthritis), 3 psoriatic arthritis. With a standard Chi square model, we didn't find a significant difference in the ACR and DAS response rates between the first and the second anti TNF treatment (p > 0.1). Stratifying the population for the type of the shift (Etanercept to Infliximab/Adalimumab, Infliximab to Etanercept/Adalimumab) we didn't find a significant difference in the ACR and DAS response rates between the first and the second anti TNF treatment (p > 0.1). Our data show that failure of an anti-TNF therapy in patients with JIA does not preclude a response to a second anti-TNF agent of a different class.

Author information

Correspondence to A Salmaso.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Keywords

  • Arthritis
  • Infliximab
  • Etanercept
  • Juvenile Idiopathic Arthritis
  • Psoriatic Arthritis