Clinical Observation Of Etanercept And Infliximab In Treating Children With Juvenile Idiopathic Arthritis

Objective:To observe and evaluate the clinical effects and adver se effects of the infliximab and etanercept in patients with juvenile i diopathic arthritis (JIA).Materials and methods:There were30patients of JIA treated with anti-TNF therapy from June2008to March2012. They were diagnosed and classified from JIA standard of ILAR in2001. All patients were divided into two groups including treated with infliximab (15patients) and etanercept (15patients). We assessed clinical effects by DAS28, inactive disease standards and clinical remission (CRM/CR). Evaluating adverse reactions of two drugs by routine urine index, liver and kidney functions. Infliximab was administered as an intravenous infusion (3-5mg.kg, once weeks0,2,6and then every8weeks, no more than34months) and Etanercept as subcutaneous injection (0.4mg.kg, twice a week, maximum25mg.dose, no more than31months). All patients also took methotrexate (MTX) at the same time.Results:Follow up for3-34months, the clinical symptoms and laboratory indexes of two groups were all improved. We have found statistical differences (p<0.05) in CRP of etanercept at the beginning of therapy and after6months, both the numbers of tender joints (or pain with activity) and swollen joint counts of Infliximab at the beginning of therapy and after3,6months (p<0.05), in etanercept of at the beginning of therapy and after3,6,12months (P<0.05). Our study also showed the statistically significant differences (p<0.05) in DAS28values at the beginning of therapy and after3,6months in etanercept (p<0.05), at the beginning of therapy and after3months in infliximab (p<0.05). We found no significant differences in the clinical symptoms, laboratory indexes duration, DAS28values or reaction effect between both drugs (all of P values>0.05). There were a obvious decrease of DAS28values in etanercept comparing with infliximab in the treatment of3,6months, but infliximab group lower than etanercept in12months. Three patients (20.0%) achieved inactive disease standards in infliximab and six patients (40.0%) in etanercept. One patients(6.7%) fulfilled criteria for clinical remission on medications in infliximab and five patients (33.3%) in etanercept. Redness, swell and pruritus of injection site were common adverse reactions in both groups.Conclusion:Both etanercept and infliximab in treating children with JIA performed well, maked DAS28values lower and improved patients joint function. We found no significant differences in the responses, remissions or adverse effects between both drugs in the short term. There were no serious adverse reactions in both groups.