Predictors of inactive disease and remission in children and young adults with juvenile idiopathic arthritis treated with etanercept.

Abstract

To identify predictors of clinically inactive disease (CID) and clinical remission (CR) in patients with juvenile idiopathic arthritis receiving etanercept during the 2-year, phase 3 b, open-label CLIPPER study (NCT00962741) and the 8-year extension study, CLIPPER2 (NCT01421069). Patients with extended oligoarthritis (2-17 years), enthesitis-related arthritis or psoriatic arthritis (each 12-17 years) were enrolled in CLIPPER/CLIPPER2. Predictors of CID (according to Juvenile Arthritis Disease Activity Score [JADAS] and JIA-ACR response criteria) and CR (≥6 months of CID) were identified using a multivariate stepwise logistic regression model. Two-thirds of patients met the criteria for CID at any point and 34-43% achieved CR. Height Z score >-0.74, age at onset ≤12 years, normal CRP levels, HLA-B27+ status, JADAS low disease activity (LDA) at 3 months, and ≤4 swollen joints were predictive of JADAS CID. BMI Z score >0.80, age at onset ≤12 years, normal CRP levels, and JADAS LDA at 3 months were predictors of JIA-ACR CID. JADAS LDA at 3 months was a predictor of JADAS CR, and height Z score >1.23, JADAS LDA at 3 months, and >12 swollen joints were identified as predictors of JIA-ACR CR. In patients with JIA treated with etanercept, early responses to treatment in line with treat-to-target recommendations, younger age, HLA-B27+ status and lower disease activity at baseline were associated with clinically inactive disease and clinical remission. ClinicalTrials.gov IDs: CLIPPER (NCT00962741); CLIPPER2 (NCT01421069).