This article is part of the supplement: 15th Paediatric Rheumatology European Society (PreS) Congress
Poster presentation
When and how to stop etanercept after successful treatment of patients with juvenile idiopathic arthritis
1 Erasmus MC Sophia Children's Hospital, Rotterdam, Netherlands
2 Leiden University Medical Centre, Leiden, Netherlands
3 AMC Emma Children's Hospital, Amsterdam, Netherlands
4 UMCG Beatrix Children's Hospital, Groningen, Netherlands
5 Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
6 Academic Hospital Maastricht, Maastricht, Netherlands
7 Hagaziekenhuis Juliana Children's Hospital, Den Haag, Netherlands
8 Utrecht MC Wilhelmina Children's Hospital, Utrecht, Netherlands
Pediatric Rheumatology 2008, 6(Suppl 1):P40 doi:10.1186/1546-0096-6-S1-P40
The electronic version of this article is the complete one and can be found online at: http://www.ped-rheum.com/content/6/S1/P40
| Published: | 15 September 2008 |
© 2008 Prince et al; licensee BioMed Central Ltd.
Objective
The aim of etanercept therapy in juvenile idiopathic arthritis (JIA) is to achieve disease remission. However, little is known about when or how to stop etanercept when this aim is reached. Our objective was to describe characteristics and disease course of JIA patients who discontinued etanercept because of a sustained good clinical response.
Methods
The "Arthritis and Biologicals in Children" (ABC)-project is the Dutch national register on biologicals in JIA, in which data are collected prospectively. All patients from this register who discontinued etanercept because of a good clinical response were selected. For evaluation of the disease course we used the criteria for clinical remission on medication and off medication by Wallace et al.
Results
Of the 210 patients in the ABC-register, 17 patients discontinued etanercept because of a good clinical response. After discontinuation nine patients (53%), with a mean follow-up of 1.4 years, did not develop a disease flare. They showed a longer mean period of clinical remission on medication (1.9 vs. 0.3 years, p < 0.01) and used etanercept longer (3.7 vs. 2.4 years, p = 0.16) compared to patients who flared. Three out of the 17 patients discontinued etanercept instantaneously and flared within one year, all other patients tapered the etanercept dose before discontinuation. All seven patients who resumed etanercept use after flaring recovered soon.
Conclusion
Patients who meet the clinical remission criteria on etanercept for a longer period have a better chance of retaining remission after etanercept discontinuation. Tapering of etanercept dose before discontinuation is favourable.