Study: Patterns of Etanercept use in Juvenile Idiopathic art
Researchers aimed to characterize etanercept (ETN) use in juvenile idiopathic arthritis (JIA) patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry.

The CARRA Registry is a convenience cohort of patients with paediatric onset rheumatic diseases, including JIA. JIA patients treated with ETN for whom the month and year of ETN initiation were available were included. Patterns of ETN and methotrexate (MTX) use were categorized as follows: combination therapy, step-up therapy (MTX started first and ETN added later), switchers (MTX started and then stopped when or before ETN started), MTX add-on (ETN started first and MTX added later), and ETN only (no MTX use).

-2032 of the 5641 patients with JIA met inclusion criteria.

--Most patients (66.9%) were treated with a non-biologic disease modifying anti-rheumatic drug (DMARD), primarily MTX, prior to ETN.

--There was significant variability in patterns of MTX use prior to starting ETN. Step-up therapy was the most common approach.

--Only 34.0% of persistent oligoarticular JIA patients continued treatment with a non-biologic DMARD 3 months or more after ETN initiation. ETN persistence overall was 66.3, 49.4, and 37.3% at 24, 36 and 48 months respectively.

--ETN persistence among spondyloarthritis patients varied by MTX initiation pattern, with higher ETN persistence rates in those who initiated combination therapy and switchers/ETN only patients compared to step-up and MTX add-on therapy.

Conclusively, this study characterizes contemporary patterns of ETN use.