Infections in children with juvenile idiopathic arthritis treated with etanercept.

What is it about?

The association between anti-TNF therapies such as etanercept and increased rate of infection is widely documented in adults with rheumatoid arthritis. Findings in children with juvenile idiopathic arthritis (JIA) have been less well documented. The aims of this analysis were (1) to compare rates of medically significant infection and hospitalised infection in children with JIA treated with etanercept versus methotrexate and (2) to compare rates between etanercept and methotrexate when taken together and etanercept take alone. To 31/5/2013, 852 etanercept and 260 methotrexate treated children had been recruited to the BSPAR Etanercept Cohort Study. From registering into the study, patients are then followed up at 6 months, 12 months and annually thereafter and data is collected on current drug treatments and adverse events. Medically significant infections included infections resulting in death, hospitalisation, or deemed medically significant by clinicians. There were 133 medically significant infections in total (109 on etanercept, 24 on methotrexate). Patients receiving etanercept were twice as likely to develop an infection than those receiving methotrexate. The risk of infection was higher whether patients were receiving etanercept and methotrexate together or etanercept alone. There was no difference in hospitalised infection rates between groups.

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Why is it important?

Taking etanercept is associated with an increased risk of medically significant infections, however this disappears when looking at infections that required hospital treatment which were much less common.