Disease-Modifying Antirheumatic Drugs in Children With Juvenile Idiopathic Arthritis
Controlled Studies in This CER: Adding Biologic DMARDs to JIA Treatment (2 of 2)
There are few studies of biologic DMARDs in children with JIA, and the numbers of treated and control patients are limited. Methotrexate or other nonbiologic DMARDs were permitted in the comparison group in most studies.
Two studies of etanercept were reviewed, but only one allowed methotrexate treatment. The first study included 62 patients with polyarticular disease, 6 with pauciarticular disease, and 34 with systemic disease. The second study included 12 patients with disease categorized as JRA with uveitis.
Three studies of intravenous immunoglobulin were reviewed, and all allowed methotrexate or other nonbiologic DMARDs. One study included 19 patients with polyarticular disease, another included 20 patients with disease defined as JCA, and the third included 43 patients with JIA, otherwise undefined.
Two comparative studies were reviewed. One study compared etanercept to infliximab, and both groups also received care that included methotrexate or sulfasalazine. 24 patients with JIA were included. One study compared infliximab alone or infliximab plus methotrexate, in 74 patients with polyarticular disease, 28 with pauciarticular disease and 19 patients with systemic onset.
IVIG = intravenous immunoglobulin
JCA = juvenile chronic arthritis
JIA = juvenile idiopathic arthritis
JRA = juvenile rheumatoid arthritis
MTX = methotrexate
NSAIDs = nonsteroidal anti-inflammatory drugs
SSZ = sulfasalazine
Keywords: juvenile idiopathic arthritis | JIA | JRA | juvenile rheumatoid arthritis | JCA | DMARDs | disease-modifying | antirheumatic | anti-rheumatic | rheumatic | TNF-alpha blockers | biologic DMARD | nonbiologic DMARD | non-biologic DMARD | anti-inflammatory | polyarticular | pauciarticular | oligoarticular | systemic onset | etanercept | infliximab | IVIG | intravenous immunoglobulin | methotrexate
- Kemper A, Coeytaux R, Sanders G, et al. Disease-Modifying Antirheumatic Drugs (DMARDs) in Children With Juvenile Idiopathic Arthritis (JIA). Comparative Effectiveness Review No. 28 (Prepared by the Duke Evidence-based Practice Center under Contract No. HHSA 290-2007-10066-I). Rockville, MD: Agency for Healthcare Research and Quality; September 2011. AHRQ Publication No. 11-EHC039-EF. Available at www.effectivehealthcare.ahrq.gov/dmardsjia.cfm.
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