Comparison of the outcomes between early and late anti-tumor necrosis factor therapy in patients with enthesitis-related subcategory of juvenile idiopathic arthritis: a multi-center study in Southeast Asia. (3rd October 2022)

• Record Type: Journal Article
• Authors: Vilaiyuk, Soamarat; Lerkvaleekul, Butsabong; Jino, Janejira; Charuvanij, Sirirat; Book, Yun Xin; Arkachaisri, Thaschawee
• Is Part Of: Expert opinion on biological therapy. Volume 22:Number 10(2022)
• Page Start: 1323
• Page End: 1332
• Publication Date: 2022-10-03
• Subjects: Biologic agent -- efficacy -- juvenile idiopathic arthritis -- long-term outcomes -- enthesitis-related arthritis -- tumor necrosis factor; Gene therapy -- Periodicals; Protein drugs -- Periodicals; Peptide drugs -- Periodicals; Immunotherapy -- Periodicals; Drug delivery systems -- Periodicals; 615.5
• DOI: 10.1080/14712598.2022.2105140
• Languages: English
• ISSNs: 1471-2598

Abstract

ABSTRACT: Background: Little is known about the impact of delayed initiation of anti-tumor necrosis factor (TNF) therapy in patients with enthesitis-related arthritis (ERA). Here, we compared the impact of delayed treatment on disease outcomes of ERA patients in Southeast Asia. Research design and methods: This retrospective study enrolled 149 ERA patients from Thailand and Singapore. Early (e-aTNF) and late (l-aTNF) treatment groups received anti-TNF therapy starting at ≤6 months and >6 months, respectively, after diagnosis. Outcomes included mean differences in disease activity parameters, Juvenile Spondyloarthritis Disease Activity (JSpADA) score, Juvenile Arthritis Diseases Activity (JADAS)-10 score, and American College of Rheumatology Pediatric (ACR Pedi) criteria, and the frequency of clinically inactive disease and first flare event. Results: The mean changes in JSpADA (p = 0.002) and JADAS-10 (p < 0.001) scores over time were significantly higher in the e-aTNF group than in the l-aTNF group. A significantly higher proportion of patients in the e-aTNF group than l-aTNF group satisfied ACR Pedi 100 criteria at 2 years (p = 0.042). All other long-term outcomes were not significantly different between the groups. Conclusions: Although early anti-TNF treatment improved disease activity parameters somewhat better than delayed anti-TNF therapy, there was no significant difference in long-term outcomes.