Scroll Up
Scroll Down
Play Play Play Play
Unregistered User
Click here if this is not your Personal Edition
 
Contact Us | Free E-Mail Updates | Journals | Register a colleague
 
 
Arthritis Other
 
   
 
SEARCH   
Doctor's Guide Free CME
Medline
Congress Resource Centre
 

 EXPLORE :
   Most Read News
 All News  All News
 All Webcasts / CME  All Webcasts / CME
 All Cases  All Cases
 Congress Resource Centre  Congress Resource Centre
 All Medical Resources  All Medical Resources
 Medical  My Personal Edition



Warning | Privacy

 

 
 Recent news - Arthritis Other
    Efficacy and Safety of Golimumab Treatment Maintained at 52 Weeks in Patients With Psoriatic Arthritis: Reported at ACR-ARHP - (DGDispatch)
    FDA Approves Labeling Changes, Boxed Warning for Efalizumab - (DGNews)
    New ACR Guidelines Update Strategies for Treating RA - (DGNews)
    Abatacept Improves Juvenile Idiopathic Arthritis in Randomised Withdrawal Trial, but Study Design Questioned - (DGNews)
    Zoledronic Acid Better for Bone Remodelling Than Risedronate in Glucocorticoid-Induced Osteoporosis: Presented at EULAR - (DGDispatch)

    News archive

     Recent webcasts/CME - Arthritis Other
      Diagnosis and New Treatments for Gout
      Current Concepts in Pharmacological Management of Juvenile Idiopathic Arthritis
      Current Strategies for the Diagnosis and Management of Spondyloarthropathies
      Inflammatory Arthritis -The Antisynthetase Syndrome
      Inflammatory Arthritis - Gout

      Webcasts/CME archive

       Recent cases - Arthritis Other
        Chronic Tophaceous Gout Presenting as Acute Arthritis During an Acute Illness: A Case Report
        Mycobacterium Tuberculosis Monoarthritis in a Child
        Popliteal Venous Thrombosis in Juvenile Arthritis with Baker Cysts: Report of 3 Cases
        Acute Onset Polyarthritis in Older People: Is it RS3PE Syndrome?
        Symptomatic Hypercalcemia in a Patient with Chronic Tophaceous Gout: A Case Report

        Cases archive
          




        my personal edition > arthritis other > news
        divider

          E-Mail this DGDispatch to a colleague

        DGDispatch


        Etanercept Plus Methotrexate Effective Therapy for Juvenile Idiopathic Arthritis: Presented at ACR

        By Bruce Sylvester

        SAN DIEGO, CA -- November 22, 2005 -- Etanercept as monotherapy or in combination with methotrexate resulted in significant improvements in the signs and symptoms of juvenile idiopathic arthritis (JIA) compared with methotrexate monotherapy, researchers reported here at the American College of Rheumatology Annual Scientific Meeting (ACR).

        Etanercept is approved for treatment of polyarticular juvenile arthritis, but research in patients with rheumatoid arthritis has shown its superiority in combination with methotrexate compared with methotrexate alone.

        Until now, no study has evaluated the efficacy and safety of etanercept plus methotrexate in JIA, said Gerd Horneff, MD, rheumatologist, Asklepions Clinic, Sakt Augustin, Germany, during his presentation on November 17th. His research team therefore compared the combination to single etanercept in a cohort of patients with JIA.

        The study enrolled 354 pediatric patients with JIA who received etanercept in addition to their pre-existing methotrexate therapy. A total of 81 subjects received etanercept monotherapy.

        The 2 treatment arms had similar distribution of JIA subtypes.

        At the start of etanercept treatment, subjects on combination treatment had a higher number of active and tender joints, longer duration of morning stiffness, higher physician's or patient's assessment of disease severity evaluated by Visual Analog Scale, and higher serum levels of C reactive protein compared with the etanercept monotherapy group.

        The investigators found a higher rate of ongoing steroid use among subjects in the combination therapy group than those in the monotherapy group (P < .001).

        Using the American College of Rheumatology - Juvenile Rheumatoid Arthritis criteria to evaluate for therapeutic efficacy, the researchers found that the number of subjects achieving a 30%, 50% or 70% response after 6 and 12 months of treatment was higher in the combination treatment group.

        There were 18 discontinuations (22%) in the etanercept monotherapy group, caused by inefficacy in 10 subjects, adverse events in 6 subjects, and remission in 2 subjects.

        There were 55 discontinuations (18%) in the combination group, caused by inefficacy in 30 subjects, adverse events in 20 subjects and, remission in 15 subjects.

        Methotrexate was discontinued in 7% of patients, largely due to the, "remarkable therapeutic response of etanercept," the authors state in their abstract.

        Corticosteroids were discontinued more often in the combination group.

        During a total of 600 patient-years of treatment, the investigators recorded 18 adverse events in 13 patients in the etanercept group and 100 adverse events in 61 patients of the combination group.

        Elevations in liver enzymes appeared only in the methotrexate-treated patients. "All but 1 patient in whom cytopenia was noted belonged to the combination group," the authors reported.

        Frequency of infections, skin-reactions, or other adverse events did not vary between treatment groups.

        Discontinuation due to treatment failure was lower in the combination group. Tolerability of treatment was excellent in both groups, Dr. Horneff said.

        "Combination therapy appears to be a reasonable course of therapy for this JIA patient population, " he concluded.

        "There were more remissions in the etanercept/methotrexate group," he added. "Combination therapy also produced a significantly higher rate of discontinuation of corticosteroid use."


        [Presentation title: Combination Therapy With Etanercept and Methotrexate Compared to Etanercept Monotherapy in Patients With Juvenile Idiopathic Arthritis. Abstract 1955]



        E-Mail this DGDispatch to a colleague   To print, use this version






        All contents Copyright (c) 1995-2008 Doctor's Guide Publishing Limited. All rights reserved.



        The NTK initiative. Physicians helping physicians identify Need-To-Know science
           Feedback
        Please rate this article: Strongly DISAGREE...Strongly AGREE NTK logo
        Question 1 - Physicians need to become aware of this information as soon as possible. Question 2 - This information is likely to have an impact on the way physicians practice medicine.
        1
        2
        3
        4
        5
        6
        7
        Send