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Adherence to Therapy in Children with Juvenile Arthritis Treated with Infliximab.

Compagno, Michele LU ; Nordqvist, Ingrid ; Saxne, Tore LU and Månsson, Bengt LU orcid (2007) Medicinska Riksstämman 2007
Abstract
PURPOSE:
Among available tumour necrosis factor inhibitors (TNF-inhibitors) only etanercept is approved for treatment of children with polyarticular course juvenile arthritis. Nevertheless also infliximab and adalimumab are used in selected cases, especially in patients having failed on etanercept.
The objective was to evaluate adherence to therapy (a combined measure of efficacy and side effects as judged by the clinician) in patients with juvenile arthritis treated with infliximab before the age of 20.

METHODS:
In our database we identified all patients with a diagnosis of juvenile arthritis commencing treatment with TNF-inhibitors before the age of 20. Sixty-four patients have been treated with at least one... (More)
PURPOSE:
Among available tumour necrosis factor inhibitors (TNF-inhibitors) only etanercept is approved for treatment of children with polyarticular course juvenile arthritis. Nevertheless also infliximab and adalimumab are used in selected cases, especially in patients having failed on etanercept.
The objective was to evaluate adherence to therapy (a combined measure of efficacy and side effects as judged by the clinician) in patients with juvenile arthritis treated with infliximab before the age of 20.

METHODS:
In our database we identified all patients with a diagnosis of juvenile arthritis commencing treatment with TNF-inhibitors before the age of 20. Sixty-four patients have been treated with at least one TNF-inhibitor (62 etanercept, 23 infliximab, 8 adalimumab). Patients treated with infliximab were retrospectively evaluated regarding adherence to therapy, treatment dosage (after the initial loading phase) as well as time and reasons for stopping therapy. All, but one patient received concomitant immunosuppressive therapy, the majority with methotrexate.

RESULTS:
Of 23 patients starting infliximab, all with polyarticular course of disease, 17 were previously treated with etanercept. Patients were followed for median 2.4 years from initiation of infliximab therapy. Fourteen patients terminated infliximab therapy after median 0.6 years, 6 due to infusion reactions (5 previously treated with etanercept) and 8 due to lack of efficacy (5 previously treated with etanercept) as judged by the clinician. Except for the infusion reactions, no serious adverse events were recorded. Of the 9 patients remaining on therapy, 7 had previously been treated with etanercept. The dosage used in patients remaining on therapy (median 0.59 mg/kg/week) was equal to the dose in those stopping therapy (median 0.73 mg/kg/week), both slightly higher than the recommended dose in adults of 0.375 mg/kg/week.

CONCLUSIONS:
Patients that previously have failed on etanercept may respond to infliximab. However, 14/23 patients commencing infliximab therapy stopped treatment due to infusion reactions or treatment failure within median 0.6 years. (Less)
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author
; ; and
organization
publishing date
type
Contribution to conference
publication status
published
subject
conference name
Medicinska Riksstämman 2007
conference location
Stockholm, Sweden
conference dates
2007-11-28 - 2007-11-30
language
English
LU publication?
yes
id
59a1cc41-16f3-4f12-ba2d-f5215f3eb89a
alternative location
https://etidning.svenskreumatologi.se/p/reumabulletinen/2007-11-01/r/9/16-17/1913/475109
date added to LUP
2026-02-22 10:19:07
date last changed
2026-03-02 09:19:53
@misc{59a1cc41-16f3-4f12-ba2d-f5215f3eb89a,
  abstract     = {{PURPOSE:<br/>Among available tumour necrosis factor inhibitors (TNF-inhibitors) only etanercept is approved for treatment of children with polyarticular course juvenile arthritis. Nevertheless also infliximab and adalimumab are used in selected cases, especially in patients having failed on etanercept.<br/>The objective was to evaluate adherence to therapy (a combined measure of efficacy and side effects as judged by the clinician) in patients with juvenile arthritis treated with infliximab before the age of 20.<br/><br/>METHODS:<br/>In our database we identified all patients with a diagnosis of juvenile arthritis commencing treatment with TNF-inhibitors before the age of 20. Sixty-four patients have been treated with at least one TNF-inhibitor (62 etanercept, 23 infliximab, 8 adalimumab). Patients treated with infliximab were retrospectively evaluated regarding adherence to therapy, treatment dosage (after the initial loading phase) as well as time and reasons for stopping therapy. All, but one patient received concomitant immunosuppressive therapy, the majority with methotrexate.<br/><br/>RESULTS:<br/>Of 23 patients starting infliximab, all with polyarticular course of disease, 17 were previously treated with etanercept. Patients were followed for median 2.4 years from initiation of infliximab therapy. Fourteen patients terminated infliximab therapy after median 0.6 years, 6 due to infusion reactions (5 previously treated with etanercept) and 8 due to lack of efficacy (5 previously treated with etanercept) as judged by the clinician. Except for the infusion reactions, no serious adverse events were recorded. Of the 9 patients remaining on therapy, 7 had previously been treated with etanercept. The dosage used in patients remaining on therapy (median 0.59 mg/kg/week) was equal to the dose in those stopping therapy (median 0.73 mg/kg/week), both slightly higher than the recommended dose in adults of 0.375 mg/kg/week.<br/><br/>CONCLUSIONS:<br/>Patients that previously have failed on etanercept may respond to infliximab. However, 14/23 patients commencing infliximab therapy stopped treatment due to infusion reactions or treatment failure within median 0.6 years.}},
  author       = {{Compagno, Michele and Nordqvist, Ingrid and Saxne, Tore and Månsson, Bengt}},
  language     = {{eng}},
  title        = {{Adherence to Therapy in Children with Juvenile Arthritis Treated with Infliximab.}},
  url          = {{https://etidning.svenskreumatologi.se/p/reumabulletinen/2007-11-01/r/9/16-17/1913/475109}},
  year         = {{2007}},
}