AB1108 The efficacy and safety of treatment of 152 non-systemic juvenile idiopathic arthritispatients with etanercept: factors, associated with achievement remission and risk of flare
Authors: M. Kostik, I. Chikova, E. Isupova, M. Likhacheva, T. Likhacheva, M. Dubko, V. Masalova, L. Snegireva, E. Gaidar, O. Kalashnikova, V. Chasnyk
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Juvenile idiopathic arthritis (JIA) is the most frequent chronic inflammatory joint disease in childhood, required biologics administration if the previous therapy falls. Etanercept is the most worldwide biologic using in JIA patients. <h3>Objectives</h3> The aim of our study was to evaluate the efficacy and safety of etanercept in children with non-systemic categories of JIA and determine predictors of achievement of the remission and risk of flares. <h3>Methods</h3> In the retrospective observational study were included 152 children with non-systemic categories of JIA, treated with etanercept. Standard JIA measures and outcomes were utilised, remission was based on C. Wallace criteria (2004). We used descriptive statistics, χ<sup>2</sup>-test, Fisher's exact test, Mac-Nemar test, Mann-Whitny, Wilcoxon, Friedmann and log-rank tests, AUC-ROC analysis, odds ratio and relative risk calculation with Cox regression models. <h3>Results</h3> The cumulative remission was achieved in 58.8% patients during the trial. The maximum remission rates (80%) were in children with treatment duration near the 5 years and increased from year to year. Patient who achieved remission had less JIA onset age (p=0.015), age of inclusion in the study (p=0.004) and age of etanercept administration (p=0.00007). The main predictors of achievement remission were JIA onset age ≤7.8 years (OR=4,3 (95%CI: 1.9–9.8), p=0.0003), age of inclusion in the study ≤14.0 years (OR=2.85 (95%CI: 1.4–5.9), p=0.00007), age of etanercept administration ≤10.0 years (OR=3.5 (95%CI: 1.7–7.2), p=0.0007), time before etanercept administration ≤2.4 years (OR=2.7 (95%CI: 1.3; 5.5), p=0.0007). In Cox regression model (p=0.007) HLA B27 positivity (RR=2.15 (95%CI: 0.98; 4.75), p=0.06) and time before etanercept administration ≤2.4 years (RR=2.4 (95%CI: 1.4; 4.4), p=0.003) were main predictors of remission achievement. Polyarticular JIA increased the risk of flare compare to oligoarticular (RR=2.7 (95%CI: 0.9; 8.2), p=0.08), then concomitant methotrexate decresed the risk of flare (RR=0.32 (0.1; 1.15), p=0.05) in Cox regression model. During the study etanercept was discontinued due to primarily or secondary inefficacy (9.2%), new onset of uveitis (5.2%) and other reasons (4.0%), including injecting site reaction. No serious adverse events, including severe infections, required hospitalisation were observed during the study. <h3>Conclusions</h3> Etanercept enables of induction of remission in JIA patients less than 10 years, with JIA duration less than 2.4 years, and whome have HLA B27-antigene. More stable effect was observed in oligoarticular JIA patients and who received concomitant methotrexate treatment. <h3>Acknowledgements</h3> Etanercept enables of induction of remission in JIA patients less than 10 years, with JIA duration less than 2.4 years, and whome have HLA B27-antigene. More stable effect was observed in oligoarticular JIA patients and who received concomitant methotrexate treatment. <h3>Disclosure of Interest</h3> None declared