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TNF inhibitor improves outcomes in children with enthesitis-related arthritis

04 Jan 2018

Use of antitumour necrosis factor (anti-TNF) therapy provides benefits for several clinically meaningful outcomes in children with enthesitis-related arthritis (ERA) during the first year after diagnosis, a study has shown.

A total of 965 clinic visits the first year after disease diagnosis were reported in 217 patients with ERA during the study period. Children (median age 11.6 years; interquartile range, 10‒14) received anti-TNF monotherapy (n=33; 15.2 percent), conventional synthetic disease-modifying antirheumatic drugs (csDMARD) monotherapy (n=73; 33.6 percent), or both (n=52; 23.9 percent) in the first year after ERA diagnosis.

Over time, children administered anti-TNF drug vs those who did not had a statistically significant improvement in active joint count (p=0.03). Anti-TNF therapy exposure vs no anti-TNF therapy also correlated with less patient-reported pain (p<0.01) and improved disease activity over time based on the clinical Juvenile Arthritis Disease Activity Score (p<0.01).

Furthermore, there was consistently greater magnitude of estimated effect on clinical outcomes in children treated with an anti-TNF drug vs csDMARD, except with tender entheses count.

The investigators conducted a multicentre retrospective comparative effectiveness study to describe the effect of ant-TNF therapy vs csDMARD in children diagnosed with ERA. They used state-of-the-art comparative effectiveness analytic methods to assess the effect of anti-TNF therapy on clinical variables (active joint count and tender entheses count) and patient-reported pain and global assessment of disease activity over the first year after diagnosis.

In a study that analysed and compared the effectiveness and drug survival in patients with rheumatoid arthritis of anti-TNF monotherapy, anti-TNF plus leflunomide, anti-TNF plus sulfasalazine, anti-TNF plus other csDMARD, and anti-TNF plus methotrexate (MTX) therapy in daily practice, researchers suggested that anti-TNF therapy should be prescribed together with MTX and if not possible, with other csDMARD. [J Rheumatol 2016;43:1787-1794]

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Most Read Articles
4 days ago
Prenatal and postpartum vitamin D supplementation does not appear to improve foetal or infant growth, a study reports.
6 days ago
Excessive daytime sleepiness appears to increase the long-term risk of amyloid β (Aβ) deposition, a recent study has shown.
6 days ago
Substituting diets high in carbohydrates with those high in monounsaturated fatty acids in the context of low saturated fatty acids do not appear to yield favourable effects on blood pressure, according to a meta-analysis.
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