Etanercept in juvenile idiopathic arthritis: Who will benefit?

Results 262 previously biologic-naive JIA-patients initiated etanercept; 71% female, 18% systemic-onset subtype. Median age at onset 6.9 (IQR 3.6-11.1) years, median followup 35.6 (IQR 17.4-53.6) months. In the long-term, the overall majority responded to etanercept and up to 40% reached inactive disease. Excellent response after 15 months (85 patients, 32%) was associated with low baseline disability (OR 0.49/point increase, 95%CI 0.33-0.74), fewer DMARDs used before etanercept (OR 0.64/ DMARD used, 95%CI 0.43-0.95) and younger age at onset (OR 0.92/year, 95%CI 0.84-0.99); poor response (88 patients, 34%) was associated with female gender (OR 2.12, 95%CI 1.11-4.08) and systemic-onset subtype (OR 3.24, 95%CI 1.39-7.56). However, 24% of systemiconset patients reached excellent response. Reasons for discontinuation: ineffectiveness in 78, adverse events (AEs) in 25, remission in 39 patients. Etanercept was well tolerated. Patients who developed AEs could not be identified at baseline.