title: Etanercept improves lipid profile and oxidative stress measures in patients with juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To investigate the effect of 1-year treatment with the anti-tumor necrosis factor-α (TNF-α) drug etanercept on lipid profile and oxidative stress in children and adolescents with juvenile idiopathic arthritis (JIA).
  
  
  METHODS
  Thirty children with JIA (22 females; mean age 12.3 ± SD 5.7 yrs), all eligible for anti-TNF-α treatment, were assessed at baseline and after 6- and 12-month treatment with etanercept. Disease activity was determined using the Juvenile Arthritis Disease Activity Score (JADAS). Blood samples were drawn to measure the acute-phase reactants C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), lipids, and the proinflammatory cytokines TNF-α, interleukin-1β (IL-1β), IL-6 and interferon-γ. To measure the oxidative stress marker 8-iso-prostaglandin F2α, 24-h urine samples were collected.
  
  
  RESULTS
  Inflammatory indicators (CRP and ESR) and JADAS scores improved significantly after 1 year of etanercept treatment (all p < 0.001). Proinflammatory cytokines showed significant reduction during the study period (all p < 0.001). Similar reductions were detected in total cholesterol (p < 0.001), low-density lipoprotein cholesterol (p = 0.04), and triglycerides (p < 0.001), whereas no significant change was found in high-density lipoprotein cholesterol. No side effects were observed during the treatment period.
  
  
  CONCLUSIONS
  This study shows for the first time that anti-TNF-α therapy for JIA is associated not only with a beneficial effect on clinical disease activity and inflammatory indexes, but also with improved lipid profile and oxidative stress. These findings suggest that TNF-α blockers might reduce atherosclerotic risk in children with JIA.
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy. luciana.breda@tin.it
authors.forename: Sara
authors.initials: S
authors.lastname: De Sanctis
authors.forename: M Loredana
authors.initials: ML
authors.lastname: Marcovecchio
authors.forename: Stefania
authors.initials: S
authors.lastname: Gaspari
authors.forename: Marianna
authors.initials: M
authors.lastname: Del Torto
authors.forename: Angelika
authors.initials: A
authors.lastname: Mohn
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiarelli
authors.forename: Luciana
authors.initials: L
authors.lastname: Breda
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism; D000293:Adolescent; D018501:Antirheumatic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000188:drug therapy* / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D016207:Cytokines / Q000097:blood; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000494:pharmacology / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*; D008297:Male; D018384:Oxidative Stress / Q000187:drug effects*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000209:Acute-Phase Proteins; D018501:Antirheumatic Agents; D016207:Cytokines; D007074:Immunoglobulin G; D008055:Lipids; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D000068800:Etanercept
keywords: ATHEROSCLEROSIS; CHILDREN; ETANERCEPT; JUVENILE IDIOPATHIC ARTHRITIS; LIPID PROFILE; OXIDATIVE STRESS