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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
Stephen Padilla, 3 days ago
Treatment with oral thrombopoietin receptor agonist eltrombopag leads to similar platelet counts in patients with chronic immune thrombocytopaenia (cITP) and persistent (per)ITP, according to the results of phase III (EXTEND) and IV studies presented at the 23rd Congress of the European Hematology Association (EHA 2018) held in Stockholm, Sweden.
4 days ago
Socioeconomic status, along with other social determinants, appears to influence the long-term outcomes in Asian acute heart failure patients, according to a recent Japan study.
Pearl Toh, 6 days ago
Lonely people were twice as likely to die from any cause than people who did not feel lonely, according to a study based on a national survey presented at the recent EuroHeartCare 2018 in Dublin, Ireland. Also, loneliness is associated with poorer patient-reported outcomes in terms of mental and physical health in patients with heart disease.
Jairia Dela Cruz, 3 days ago
A treatment regimen combining daratumumab plus bortezomib, melphalan and prednisone markedly extends progression-free survival in patients with multiple myeloma, inducing deep responses and demonstrating acceptable tolerability regardless of baseline renal function, according to the results of the phase III ALCYONE study.