Re-treatment with Etanercept is Effective as the initial fir
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A Study was conducted to determine:
(i) Correlates for etanercept (ETA) discontinuation after achieving an inactive disease and for the subsequent risk of flare and
(ii) To analyze the effectiveness of ETA in the re-treatment after a disease flare.

The study used data from two ongoing prospective registries, BiKeR and JuMBO. Both registries monitor clinical data and outcomes in juvenile idiopathic arthritis (JIA) patients treated with biologic disease-modifying anti-rheumatic drugs (bDMARDs) and traditional synthetic DMARDs from childhood to adulthood (csDMARDs).

Results:
--A total of 1724 patients were treated first with ETA treatment course (338 with second, 54 with third ETA course).

--Similar rates of discontinuation due to ineffectiveness and adverse events could be observed for the first (19.4%/6.2%), second (18.6%/5.9%), and third (14.8%/5.6%) ETA course.

--A total of 332 patients (+/-methotrexate, 19.3%) discontinued ETA after achieving remission with the first ETA course.

--Younger age (hazard ratio (HR) 1.08), persistent oligoarthritis (HR 1.89), and shorter duration between JIA onset and ETA start (HR 1.10), as well as good response to therapy within the first 6 months of treatment (HR 1.11) significantly correlated to discontinuation with inactive disease.

--Reoccurrence of active disease was reported for 77% of patients with mean time to flare of 12.1 months. The majority of patients were re-treated with ETA (n=117 of 161) after the flare.

--1 in 5 patients (n=23) discontinued ETA again after achieving an inactive disease and about 70% of the patients achieved an inactive disease 12 months after restarting ETA.

In conclusion, the report confirms the efficacy of ETA in the re-treatment of JIA patients. This study shows a connection between early bDMARD treatment and a higher incidence of inactive disease, suggesting a potential window of opportunity.

Source: https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-021-02492-0
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