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.


Methotrexate Gives Protection Against the New Onset of Uveitis in Combination with Etanercept. Data from the German Etanercept Registry.

Foeldvari1,  Ivan, Thome2,  Nina, Horneff2,  Gerd

Hamburger Zentrum Fuer Kinder- und Jugendrheumatologie, Hamburg, Germany
Kinder- und Jugendrheumatologie Asklepios Clinics, Sankt Augustin, Sant Augustin, Germany

Introduction:

Uveitis occurs in 10 % of patients with juvenile idiopathic Arthritis (JIA). Methotrexate (MTX) and corticosteroids (ST) appear to be an effective treatment for uveitis, We evaluated the occurrence of uveitis under different treatment combinations in the German Etanercept Registry.

Methods:

We evaluated the prevalence of uveitis flares or new onset of uveitis in patients in the different treatment arms of the German Etanercept Registry.

Results:

We reviewed the data of 868 patients. We grouped the patients in 8 therapy arms, these were Etanercept(ETA) monotherapy (n=74); ETA + glucocorticoids (ST) (n=34); ETA + Methotrexate (MTX)(n=246); ETA+ MTX+ST(n=290); ETA + other DMADs (n=45); ETA + other DMARDs + ST(n=45); ETA+MTX+ other DMARDs(n=32); ETA+MTX+ other DMARDs +ST(n=102).

We evaluated the rate of uveitis per patient in the different groups. The lowest rate was found in the combination with MTX with ETA with 0.02. We evaluated the mean number of uveitis per 100 patient years and MTX +ETA group showed 0.9 compared to 3.5 for ETA monotherapy. ST in combination with ETA showed a protective effect too. Interestingly the other DMARDs did not had this protective effective of uveitis, the other DMARDs were mostly leflunomide or sulfasalazine.

Discussion:

MTX and ST seems to be protective in this group of patients against the new onset of uveitis. Based on this data patients with a history of uveitis should receive a combination therapy of ETA and MTX to prevent flares of uveitis.

Treatment groupNumber of patientsAE- UveitisUveitis/ PatientPatient - Treatment yearsUveitis/100 year of treatment Mean value
Etanercept (Eta)7440.05113.753.5
Eta + Steroids3410.0354.101.8
Eta + MTX24640.02431.490.9
Eta + MTX + Steroids29070.02703.650.9
Eta + other DMARD4520.0479.832.5
Eta + other DMARD + Steroids4530.0692.663.2
Eta + MTX + other DMARD3220.0682.802.4
Eta + MTX + other DMARD + Steroids10260.06267.422.2
All patients treated with Steroids471170.041118.001.5
All patients treated with MTX670190.031485.001.3
All patients treated with other DMARDs224130.06523.002.5
All Patients868290.031826.001.6

To cite this abstract, please use the following information:
Foeldvari, Ivan, Thome, Nina, Horneff, Gerd; Methotrexate Gives Protection Against the New Onset of Uveitis in Combination with Etanercept. Data from the German Etanercept Registry. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :230
DOI: 10.1002/art.27999

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