A study on the efficacy, tolerability and safety of biologics in children with juvenile idiopathic arthritis
Abstract
This study was done to assess the efficacy of biologics in patients with various subtypes of Juvenile Idiopathic Arthritis (JIA). All JIA patients with active chronic polyarthritis, who were non responders to methotrexate, were included in this open-label, prospective, study. Systemic arthritis was treated with Tocilizumab and the other JIA subtypes were treated with Etanercept. JADAS-27, Leeds Enthesitis Index (LEI) and ACR Pedi-30 were used to assess improvement. We also assessed the tolerance to treatment of JIA with biologics. 54 patients were enrolled and followed up for a median of 14 months. In Oligoarticular and Polyarticular arthritis, JADAS-scores improved by > or =30% in 72% of patients after 3 months. There was a statistically significant improvement in JADAS 27 scores. In patients with oligoarthritis the mean JADAS 27 before treatment was 36± 2.5, which improved to 28.6±1.2 (p=0.008). in polyarticular JIA, the mean JADAS 27 before treatment was 40.2± 2.5, which improved to 31.6±1.2(p=0.001). In ERA Leeds Enthesitis index improved in 80% of patients and JADAS-27 score improved by > or =30% in 80% in 3 months. In Systemic Arthritis the primary end point was absence of fever and ACR Pedi-30 response at the end of 12 week of treatment achieved in 84% of patients. Tocilizumab and Etanercept were found efficacious in Systemic arthritis and in other JIA subsets respectively in methotrexate non-responders. Both tolicizumab and etanercept were well tolerated.
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