Volume 9 Supplement 1

Proceedings of 18th Pediatric Rheumatology European Society (PReS) Congress

Open Access

Switching to an alternative biological agent in juvenile idiopathic arthritis (II)

  • S Murias,
  • A Remesal,
  • L Latorre,
  • M Gomez and
  • R Merino
Pediatric Rheumatology20119(Suppl 1):P163

https://doi.org/10.1186/1546-0096-9-S1-P163

Published: 14 September 2011

Background

Juvenile idiopathic arthritis (JIA) is a heterogeneous disease, and it’s associated with an increased use of various biological agents in recent years.

Aim

Evaluate clinical response to current biological agent in JIA patients.

Methods

This is a retrospective study of 109 JIA patients from a tertiary centre (see poster 1). Variables included were: current biological treatment (both the first agent used as the second, third or fourth when it had been switched) and duration of treatment (years with a new agent or since reintroduction of an agent used before) plus physician visual analogue scale (ph-VAS), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) at baseline and at the end of the study. Concomitant therapy with methotrexate (MTX) was also recorded.

Results

Duration of treatment with the current biological agent was 1.2 ± 1 (0.1- 4.9) median 0.8 years. This agent was etanercept (ETA) in 58 cases, adalimumab (ADA) in 16, tocilizumab (TCZ) in 11, anakinra (AK) in 9 and infliximab (IFX) in 2. Thirteen patients were off treatment with biological agents, 12 due to inactive disease and one because of inefficacy.

Concomitant treatment with MTX was observed in 8/58 (14%) patients with ETA, 4/16 (25%) with ADA, 5/11 (46%) with TCZ, 1/2 (50%) with IFX and none with AK. Table 1.
Table 1

Analytical and clinical response to current biological agent

 

Ph-VAS

ESR

CRP

 

Initial*

End*

۵

p

Initial*

End*

۵

p

Initial*

End*

۵

p

ETA

3.25

0.5

-6

0.00

28

12

-5

0.00

13.2

2.3

-5

0.00

ADA

2.42

0.4

-3

0.01

17

13

-1

0.26

5.58

1.2

-2

0.06

AK

5.36

0.00

-3

0.01

62

9

-2

0.02

69.5

2.9

-2

0.03

TCZ

6.45

0.86

-3

0.01

46

4

-3

0.01

95.6

0.6

-3

0.01

IFX

4.9

0.00

  

47

6

  

32.8

0.9

  

*Values are expressed as mean.

Conclusion

The results indicate that reintroduction of a previously effective biological agent may be successful; besides, switching to a second, third or even fourth biological agent in those patients whose disease remains active, can be effective as well.

Copyright

© Murias et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://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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