Increasing the etanercept dose in a treat-to-target approach in juvenile idiopathic arthritis: does it help to reach the target? A post-hoc analysis of the BeSt for Kids randomised clinical trial
Authors' conclusion
Escalation to high-dose etanercept in JIA-patients who were treated to target was generally followed by meaningful clinical improvement. However, similar improvements were observed in a smaller comparison group who did not escalate to high-dose etanercept. No SAEs were seen after escalation to high-dose etanercept.
Study context
- Population
- Patients with oligoarticular juvenile idiopathic arthritis (JIA), RF-negative polyarticular JIA or juvenile psoriatic arthritis in the BeSt for Kids treat-to-target trialrandomised in trial
- Participants
- 92 patients
- Comparison
- High-dose etanercept vs no dose escalation despite eligibility
- High-dosen = 32
- Comparisonn = 11reference
Methodological detailstreat-to-target, non-randomised comparison group, Median follow-up 24.6 months
- Treat-to-target
- Non-randomised comparison group
- Median follow-up 24.6 months
Primary result
As reported in the abstract
Clinical parameters before vs within 3 months after dose-increase (high-dose)
- Median JADAS10 from 7.2 to 2.8
- p = 0.008
- VAS-physician from 12 to 4
- p = 0.022
- VAS-patient/parent from 38.5 to 13
- p = 0.003
- Number of active joints from 2 to 0.5
- p = 0.12
- VAS-pain from 35.5 to 15
- p = 0.030
Further findings
Inactive disease · 6 months
Safety
Non-severe AEs per subsequent patient year follow-up
| Outcome | High-dose | Comparison |
|---|---|---|
| SAEs (hospital admission) | — not stated in the abstract | 2 events |
— not stated in the abstract
Severe adverse events (SAEs) after etanercept dose-increase
- No SAEs occurred after etanercept dose-increase (high-dose)
Original publication
Increasing the etanercept dose in a treat-to-target approach in juvenile idiopathic arthritis: does it help to reach the target? A post-hoc analysis of the BeSt for Kids randomised clinical trial. Pediatr Rheumatol Online J. Published 10 May 2024. doi:10.
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