Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Long-Term Outcome of Patients with Juvenile Idiopathic Arthritis Treated with Etanercept Results of the Biologic Register JuMBO.
Horneff1, Gerd, Girschick7, Hermann, Foeldvari5, Ivan, Seipelt6, Eva, Zink2, Angela E., Niewerth4, Martina, Minden3, Kirsten
Asklepios Kinderklinik St. Augustin GmbH
German Arthritis Res Centre, Berlin, Germany
German Rheumatism Research Center Berlin, a Leibnitz Institute, Berlin, Germany
German Rheumatism Research Center Berlin, a Leibnitz Institute
Hamburger Zentrum für Kinder- und Jugendrheumatologie am Klinikum Eilbek, Hamburg, Germany
Immanuel Krankenhaus Berlin-Buch, Germany
Scientific Advisory Board
To assess the outcome of patients with juvenile idiopathic arthritis (JIA) who received Etanercept in childhood.
JIA patients >= 18 years who were formerly included in the nation-wide child Etanercept/Methotrexate register were contacted and asked to participate in the prospective cohort study JuMBO (Juvenile arthritis Methotrexate/Biologics long-term Observation). For those included in JuMBO, clinical status, therapy, and patient-derived data, e.g. functional capacity, quality of life and socioeconomic status, were documented every 6 months. Here, data of the last available visit of patients included and treated with Etanercept at any time were analyzed.
Until April 2010, 486 out of 645 (75%) patients could be relocated and contacted, 398 of them agreed to participate in JuMBO. Baseline or follow-up data were available for 285 patients ever treated with Etanercept. These patients had a mean age of 20 years (SD 2.8) and a mean disease duration of 11 years (SD 5.3). At last documentation more than 80% of the patients still received DMARDs, 58% Etanercept. Twenty four percent of the patients had an inactive disease, 45% reported no functional limitations (HAQ-score = 0). The patients rated their quality of life lower than age-matched controls, but only regarding physical functioning, vitality, bodily pain, general health, and physical role.
Three deaths occurred in this cohort, all patients died of complications connected to their rheumatic disease. Considering the years of observation of all patients contacted (2,320 patient-years), the calculated standardized mortality ratio was 6.2 (95% CI 1.0420.48) for women and 1.4 (95% CI 0.1211.6) for men.
Co-morbidities or serious adverse events reported over the observation period of 1,097 patient years included the following: three new-onset inflammatory bowel diseases of which two occurred under Etanercept, seven newly diagnosed uveitis cases (four in patients receiving Etanercept), and 16 medically important infections (1.5/100 patient-years). Only six of the serious infections occurred under Etanercept, one was an infection of an endoprosthesis. No malignancy was recorded.
First data of the JuMBO register point to a better functional long-term outcome of patients with severe JIA treated in the biological era as compared to those treated before the year 2000. There seems to be an acceptable safety profile of Etanercept long-term use, however, more data are needed to confirm this.
To cite this abstract, please use the following information:
Horneff, Gerd, Girschick, Hermann, Foeldvari, Ivan, Seipelt, Eva, Zink, Angela E., Niewerth, Martina, et al; Long-Term Outcome of Patients with Juvenile Idiopathic Arthritis Treated with Etanercept Results of the Biologic Register JuMBO. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :227