Evidence map›Paper›PMID 33863349›Full record

ArticleArthritis research & therapy2021

Re-treatment with etanercept is as effective as the initial firstline treatment in patients with juvenile idiopathic arthritis.

Jens Klotsche, Ariane Klein, Martina Niewerth, Paula Hoff, Daniel Windschall, Ivan Foeldvari, Johannes-Peter Haas, Gerd Horneff, Kirsten Minden

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Arthritis research & therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Jens KlotscheGerman Rheumatism Research Centre, Leibniz Institute, 10117, Berlin, Germany. jens.klotsche@drfz.de.ORCID 0000-0002-2954-5755
Ariane KleinCentre for Paediatric Rheumatology, Department of Paediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin, Germany.
Martina NiewerthGerman Rheumatism Research Centre, Leibniz Institute, 10117, Berlin, Germany.
Paula HoffEndokrinologikum Berlin, 10117, Berlin, Germany.
Daniel WindschallDepartment of Paediatric and Adolescent Rheumatology, North-Western German Centre for Rheumatology, St. Josef-Stift Sendenhorst, Sendenhorst, Germany.
Ivan FoeldvariHamburg Centre for Pediatric and Adolescent Rheumatology, Hamburg, Germany.
Johannes-Peter HaasGerman Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany.
Gerd Horneff *Centre for Paediatric Rheumatology, Department of Paediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin, Germany.
Kirsten Minden *German Rheumatism Research Centre, Leibniz Institute, 10117, Berlin, Germany.
German Rheumatism Research Centre · DEAsklepios Klinik Sankt Augustin · DEEndokrinologikum · DEGerman Center for Pediatric and Adolescent Rheumatology · DEUniversity of Cologne · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo determine (i) correlates for etanercept (ETA) discontinuation after achieving an inactive disease and for the subsequent risk of flare and (ii) to analyze the effectiveness of ETA in the re-treatment after a disease flare.

methodsData from two ongoing prospective registries, BiKeR and JuMBO, were used for the analysis. Both registries provide individual trajectories of clinical data and outcomes from childhood to adulthood in juvenile idiopathic arthritis (JIA) patients treated with biologic disease-modifying anti-rheumatic drugs (bDMARDs) and conventional synthetic DMARDs (csDMARDs).

resultsA total of 1724 patients were treated first with ETA treatment course (338 with second, 54 with third ETA course). Similar rates of discontinuation due to ineffectiveness and adverse events could be observed for the first (19.4%/6.2%), second (18.6%/5.9%), and third (14.8%/5.6%) ETA course. A total of 332 patients (+/-methotrexate, 19.3%) discontinued ETA after achieving remission with the first ETA course. Younger age (hazard ratio (HR) 1.08, p < 0.001), persistent oligoarthritis (HR 1.89, p = 0.004), and shorter duration between JIA onset and ETA start (HR 1.10, p < 0.001), as well as good response to therapy within the first 6 months of treatment (HR 1.11, p < 0.001) significantly correlated to discontinuation with inactive disease. Reoccurrence of active disease was reported for 77% of patients with mean time to flare of 12.1 months. We could not identify any factor correlating to flare risk. The majority of patients were re-treated with ETA (n = 117 of 161; 72.7%) after the flare. One in five patients (n = 23, 19.7%) discontinued ETA again after achieving an inactive disease and about 70% of the patients achieved an inactive disease 12 months after restarting ETA.

conclusionThe study confirms the effectiveness of ETA even for re-treatment of patients with JIA. Our data highlight the association of an early bDMARD treatment with a higher rate of inactive disease indicating a window of opportunity.

Indexed as

Antirheumatic AgentsArthritis, JuvenileAdolescentChildEtanerceptHumansInfantMethotrexateProspective StudiesTreatment OutcomeYoung AdultAntirheumatic AgentsEtanerceptMethotrexateDisease flareEffectivenessEtanerceptInactive diseaseJuvenile idiopathic arthritisRemissionWindow of opportunity

Identifiers

PMID33863349
PMCPMC8050932
OpenAlexW3155782585

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.