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Drugs Can Ease Juvenile Rheumatoid Arthritis

3 trials show some success in helping children

FRIDAY, Nov. 9 (HealthDay News) -- Certain drugs may be effective in treating juvenile rheumatoid arthritis, according to studies presented this week at the American College of Rheumatology (ACR) meeting in Boston.

One study found that abatacept, used to treat adults with moderate to severe rheumatoid arthritis, may be a well-tolerated treatment for children and adolescents with severe, treatment-resistant juvenile rheumatoid arthritis, also known as juvenile idiopathic arthritis (JIA).

"The results of this randomized double blind trial of abatacept were very encouraging for both efficacy and safety in these children with severe polyarticular JIA. Abatacept was effective for many of the children who had already failed anti-TNF therapy. Because of its unique mechanism of action, abatacept is an important new treatment approach for children with JIA," Dr. Daniel J. Lovell, professor of pediatrics at Cincinnati Children's Hospital Medical Center and a lead investigator in the study, said in a prepared statement.

Lovell was lead investigator of a second study that found that treatment with adalimumab (brand name Humira) reduced disease flare-ups and promoted improvement in patients with juvenile rheumatic arthritis (JRA). After 16 weeks of therapy with the drug, 77 percent of patients had a decrease of at least 50 percent in disease symptoms, and 58 percent of patients had at least a 70 percent decrease in ACR Pedi Response (measurement criteria that assess disease activity in JRA patients).

After 32 weeks, patients who received adalimumab had significantly fewer disease flare-ups and better ACR Pedi Responses than those who took a placebo. Patients who continued taking the drug for two years showed substantial and sustained improvement, according to the researchers.

A third study concluded that etanercept (brand name Enbrel) is safe in the long-term treatment of patients with JRA. The injectable drug blocks TNF-alpha, a protein that causes the pain and tenderness associated with rheumatic disease.

In this study, 42 JRA patients took etanercept for four years, and 26 of them continued to take it for eight years. Reasons for discontinuing use of the drug included: parental/guardian desire to remove patient from the study; poor treatment response; adverse effects, and a doctor's decision.

The study found that 23 percent of patients reported a total of 39 serious adverse events, but the overall rate of serious adverse events didn't increase with long-term use of the drug. There were no reported cases of lupus, demyelinating disorders, tuberculosis, malignancies, lymphomas, or deaths.

"The drug had a sustainable efficacy profile with a very beneficial safety profile. Only one serious infection, pyelonephritis (a kidney infection), was observed in the remaining patients during the past four years," investigator Dr. Andreas Reiff, head of the division of rheumatology, Keck School of Medicine, University of California, Children's Hospital Los Angeles, said in a prepared statement.

More information

The Nemours Foundation has more about juvenile rheumatoid arthritis.

-- Robert Preidt

SOURCE: American College of Rheumatology, news releases, Nov. 7, 2007

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