Preliminary evidence that etanercept may reduce radiographic progression in juvenile idiopathic arthritis.
OBJECTIVE
To investigate the rate of radiographic progression, as measured with the carpo-metacarpal ratio (Poznanski score), during etanercept (ETN) therapy in children with polyarticular juvenile idiopathic arthritis (JIA).


METHODS
Patients included in the Italian ETN registry who had a standard radiograph of both hands and wrists in the posteroanterior view made at start of treatment and after 1 year were included in the study. The clinical response was assessed by means of the ACR Pediatric definition of improvement. Radiographic progression was determined by calculating the change in the Poznanski score between the baseline and the 1-year radiographs.


RESULTS
A total of 40 patients were studied. The frequency of ACR pediatric 30, 50, and 70 response at 1 year was 77%, 72%, and 50%, respectively. The median change in the Poznanski score between baseline and 1 year was + 0.3 units, meaning that, on average, patients experienced improvement in radiographic progression.


CONCLUSIONS
Our pilot study provides evidence that ETN is potentially capable of reducing the progression of radiographic joint damage in JIA. This finding deserves confirmation in a controlled trial.
Nielsen
S
S
Istituto di Ricovero e Cura a Carattere Scientifico G. Gaslini, Genova, Italy.
Ruperto
N
N
Gerloni
V
V
Simonini
G
G
Cortis
E
E
Lepore
L
L
Alpigiani
M G
MG
Zulian
F
F
Corona
F
F
Alessio
M
M
Barcellona
R
R
Gallizzi
R
R
Rossi
F
F
Magni-Manzoni
S
S
Lombardini
G
G
Filocamo
G
G
Raschetti
R
R
Martini
A
A
Ravelli
A
A
D001171:Arthritis, Juvenile / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D050279:Metacarpal Bones / Q000000981:diagnostic imaging; D011859:Radiography; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012042:Registries; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept