Good disease control , with therapeutic escalation to achieve low disease activity , was recommended .
OBJECTIVE To develop treatment recommendations for children with juvenile idiopathic arthritis manifesting as non-systemic polyarthritis , sacroiliitis , or enthesitis .
Long-term efficacy and safety of etanercept in children with polyarticular-course juvenile rheumatoid arthritis: interim results from an ongoing multicenter, open-label, extended-treatment trial.
OBJECTIVE To evaluate the long-term efficacy and safety of etanercept in children with juvenile rheumatoid arthritis ( JRA ) participating in an ongoing multicenter , open-label , extended-treatment trial . All patients had been participants in an initial r and omized efficacy and safety trial of etanercept . METHODS Etanercept was administered at a dosage of 0.4 mg/kg ( maximum 25 mg ) subcutaneously twice each week . Safety and efficacy evaluations were performed every 3 - 4 months . The JRA 30 % definition of improvement ( DOI ) was defined as improvement of > or = 30 % in at least 3 of 6 response variables used to assess disease activity , with no more than 1 variable worsening by more than 30 % . RESULTS At the time of analysis , 48 of the 58 patients ( 83 % ) were still enrolled in the study ; 43 of them ( 74 % ) had completed 2 years of treatment . Of these 43 patients , 81 % met the JRA 30 % DOI , 79 % met the JRA 50 % DOI , and 67 % met the JRA 70 % DOI . Ten children started low-dose methotrexate after year 1 . Of the 32 children taking prednisone , the dosage was decreased to < 5 mg/day in 26 ( 81 % ) . Two children had serious infections ( varicella with aseptic meningitis in one and complicated sepsis in the other ) . In general , adverse events were of the types seen in a general pediatric patient population . CONCLUSION Children with severe , longst and ing , methotrexate-resistant polyarticular JRA demonstrated sustained clinical improvement with > 2 years of continuous etanercept treatment . Etanercept was generally well-tolerated . There were no increases in the rates of adverse events over time . However , children taking etanercept should be monitored closely for infections
Good disease control , with therapeutic escalation to achieve low disease activity , was recommended .
OBJECTIVE To develop treatment recommendations for children with juvenile idiopathic arthritis manifesting as non-systemic polyarthritis , sacroiliitis , or enthesitis .