title: The 'head-to-head' comparison of etanercept and infliximab in treating children with juvenile idiopathic arthritis.
abstract: OBJECTIVE
  Our aim was to assess long-term efficacy and tolerability of etanercept and infliximab in patients with JIA.
  
  
  METHODS
  This was an observational, retrospective study of 41 patients treated with anti-TNF therapy. We assessed clinical remission, flare, ACR improvement, improvement of DAS28, and JADAS. Some patients with polyarticular JIA were scored according to the modified SHARP criteria.
  
  
  RESULTS
  Twenty-four weeks after beginning of therapy 35 patients (92.1%) achieved ACR 20, 33 patients (86.8%) ACR 30, 31 patients (81.6%) ACR 50, 28 patients (73.7%) ACR 70 and 20 patients (52.6%) ACR 90. In the same period 19 patients (50%) had good DAS28 response, 12 patients (31.6%) had moderate response, and 5 patients (13.2%) did not respond to therapy. Statistically significant difference was shown in the average value of JADAS-71 before the beginning and 24 weeks after introduction of anti-TNF therapy. Eleven patients had a flare in the study period (28.9%); five on etanercept (13.1%), three on infliximab (7.9%), and three flared on both of the medications (7.9%). After 12 months, fifteen patients fulfilled criteria for clinical remission on medications. Seven of them were on infliximab and eight on etanercept. Eleven patients have fulfilled criteria for clinical remission off of medications: three were taking etanercept, seven infliximab, and one was switched from etanercept to infliximab.
  
  
  CONCLUSIONS
  In our patient cohort, both etanercept and infliximab performed well, since we found no significant difference in the duration, response, flare, resistance or adverse effects between both drugs, however long term remissions are rare.
authors.affiliation: University of Zagreb, Faculty of Medicine, Zagreb, Croatia. lovro.lamot@gmail.com
authors.forename: Lovro
authors.initials: L
authors.lastname: Lamot
authors.forename: Lana T
authors.initials: LT
authors.lastname: Bukovac
authors.forename: Mandica
authors.initials: M
authors.lastname: Vidovic
authors.forename: Marina
authors.initials: M
authors.lastname: Frleta
authors.forename: Miroslav
authors.initials: M
authors.lastname: Harjacek
mesh_terms: D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D000068800:Etanercept; D005260:Female; D006304:Health Status; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D000069285:Infliximab; D007596:Joints / Q000503:physiopathology; D008297:Male; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000069285:Infliximab; D000068800:Etanercept