Juvenile Rheumatoid Arthritis Patients Can Tolerate Certain Drugs
Posted Jan 17 2011 5:44pm
Treatments prescribed for treatment of rheumatoid arthritis in adults may not be well tolerated in children. Studies presented last month at the American College of Rheumatology (ACR) suggest that some of these drugs are appropriate for treating juvenile rheumatoid arthritis (JRA). Three studies were included in the report which included data on adalimumab (Humira), abatacept, and etanercept ().
The study of adalimumab was led by Dr. Daniel J. Lovell, professor of pediatrics at Cincinnati Children’s Hospital Medical Center. Treatment with adalimumab was found to reduce disease flare-ups and resulted in improvements in patients with juvenile rheumatoid arthritis. Three quarters of the patients had at least a 50 percent decrease in disease symptoms after 16 weeks. In addition, 58 percent of the patients had at least a 70 percent decrease in American College of Rheumatology Pediatric response criteria (measurement criteria that assess disease activity in JRA patients).
After 32 weeks, patients who received adalimumab had significantly fewer disease flare-ups and better ACR Pedi Responses than those who took a placebo. Patients who continued taking the drug for two years showed substantial and sustained improvement, according to the researchers.
Another study led by Dr. Lovell investigated the tolerance of abatacept on children with severe polyarticular juvenile idiopathic arthritis. The researchers conducted a randomized double blind study of abatacept and reported that the results were encouraging for both safety and efficacy for these patients.
The third study was conducted on etanercept, in injectable drug which blocks TNF-alpha. TNF-alpha is a protein that causes the pain and tenderness associated with rheumatic disease.
This research was conducted on 42 JRA patients who took etanercept for 4 years of which 26 continued to take it for 8 years. Those that discontinued use cited parental desire to remove the patient from the study, poor treatment response, adverse effects or a doctor’s decision.
Results from this study found that etanercept is safe for long term treatment of patients with JRA. The rate of serious events didn’t increase with long term use and only one serious infection, a kidney infection, was observed in the last 4 years of the study.