ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 795

Second TNF-Inhibitor Or Alternative Biologic In Juvenile Idiopathic Arthritis (JIA) Patients Failing a First TNF-Inhibitor

Kirsten Minden1, Klaus Tenbrock2, Gerd Horneff3 and Hans-Iko Huppertz4, 1Children’s University Hospital Charite/German Rheumatism Research Centre Berlin, Berlin, Germany, 2University Aachen, Aachen, Germany, 3Department of Pediatrics, Asklepios Klinik Sankt Augustin, Sankt Augustin, Germany, 4Prof. Hess Childrens Hospital, Bremen, Germany

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Abatacept, Adalimumab, etanercept, juvenile idiopathic arthritis (JIA) and tocilizumab

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Session Title: Pediatric Rheumatology: Clinical and Therapeutic Disease: Juvenile Idiopathic Arthritis

Session Type: Abstract Submissions (ACR)

Background/Purpose: Patients with incomplete response to initial anti-TNF treatment often are switched to other biologic treatments. However, little is known about the efficacy of switching to a second anti-TNF or a non-TNF biologic treatment since comparative clinical trials are lacking.

Methods: Data of the German BIKER registry were used to analyse treatment response after switching from a TNF-inhibitor to a second TNF-inhibitor or to a non-TNF-inhibitor biologic. Efficacy analyses were performed with the patients´ disease activity assessed by the Juvenile Arthritis Disease Activity Score (JADAS)-10 and functional status assessed by the Childhood Health Assessment Score-Disability Index (CHAQ-DI) as outcomes.

Results:

1725 JIA patients receiving Etanercept (ETA) as first biologic were identified in the BIKER registry. 279 patients received a second biologic, which was again a TNF-inhibitor in 219 (Adalimumab (ADA) 190, Infliximab (INF) 30, Golimumab (GOL) 5,) and a non-TNF inhibitor biologic in 60 cases (Abatacept (ABA) 16, Anakinra (ANA) 31, Tocilizumab (TOC) 13). Switchers more often had systemic JIA (15.1% vs 6.6%; p<0.001; Odd-R 2.5(1.7-3.7)) but less often enthesitis related arthritis (ERA) (9.7% vs.15. 9%; p=0.008, Odd-R 0.6 (0.4-0.9)) than non-switchers. Comparison of JADAS10 at last follow up to start of ETA gave a marked improvement of disease activity while a considerable residual disease activity persisted. 215 JIA patients had follow up forms after switching to a second biologic enabling the analysis of efficacy. After switching the biologic agent, a decrease of disease activity parameters could be observed in all cohorts. At last follow up, lowest JADAS10 (mean±SD) was reached in the patient cohort switching from ETA to ADA (6.2±6.1) followed by INF (9.7±9.9) and TOC (10.2±7.2). Patients on ABA had higher JADAS10 (12.5±10.2) at last follow up (table 1). Also the CHAQ-DI decreased in all cohorts. Lowest CHAQ-DI (mean±SD) was reached in patients switching from ETA to INF (0.21±0.52) or ADA (0.29±0.46), followed by TOC (0.4±0.67) and ABA (0.73±0.78). Follow-up data from few patients only switching to GOL and from patients switching to ANA (all but 3 systemic JIA) were not shown.

 

Switching from Etanercept to:

Time of analysis

JADAS-10

CHAQ-DI

Adalimumab

 N=163

 

 

first on ETA

17.1+/-7.4

0.72+/-0.70

last on ETA

8.4+/-7.0

0.40+/-0.54

first on ADA

9.9+/-8,0

0.37+/-0.52

last on ADA

6.2+/-6.1

0.29+/-0.46

Infliximab

 N=19

 

 

first on ETA

19.4+/-8.0

1.03+/0.71

last on ETA

10.9+/-9.5

0.44+/-0.58

first on IFN

10.7+/-9.2

0.47+/-0.66

last on IFN

9.7+/-9.9

0.21+/-0.52

Tocilizumab

 N=20

 

 

first on ETA

18.9+/-6.0

0.93+/-0.85

last on ETA

9.4+/-7.5

0.67+/-0.76

first on TOC

13.2+/-10.0

0.75+/-0.72

last on TOC

10.2+/-7.2

0.40+/-0.67

Abatacept

 N=13

 

 

first on ETA

18.3+/-6.-3

0.68+/-0.56

last on ETA

13.5+/-10.5

0.43+/-0.62

first on ABA

17.4+/-6.5

0.57+/-0.51

last on ABA

12.5+/-10.2

0.73+/-0.78

Conclusion:

JIA patients failing ETA can successfully be switched to another biologic. Interestingly, switching within the class of biologics, from a first TNF- to a second TNF-inhibitor also gave favourable results.


Disclosure:

K. Minden,

Pfizer Inc,

8,

Abbott Immunology Pharmaceuticals,

8,

Roche Pharmaceuticals,

5;

K. Tenbrock,
None;

G. Horneff,

AbbVie, Pfizer, Roche,

2,

AbbVie, Novartis, Pfizer, Roche,

8;

H. I. Huppertz,

Abbott Laboratories,

5,

Chugai ,

8,

Pfizer Inc,

8.

  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/second-tnf-inhibitor-or-alternative-biologic-in-juvenile-idiopathic-arthritis-jia-patients-failing-a-first-tnf-inhibitor/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.