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

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


Evaluate clinical response to current biological agent in JIA patients.


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.


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


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.

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  • Methotrexate
  • Visual Analogue Scale
  • Infliximab
  • Etanercept
  • Juvenile Idiopathic Arthritis