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Abstract Number: 2386

Secukinumab Is a Promising Treatment for Patients with Juvenile Enthesitis Related Arthritis Nonresponsive to Anti-TNF Treatment

Ivan Foeldvari and Jean Baer, Hamburg Center for Pediatric and Adolescent Rheumatology, Hamburg, Germany

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Juvenile idiopathic arthritis-enthesitis (ERA), pediatric rheumatology and treatment options

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Session Information

Date: Tuesday, October 23, 2018

Title: Pediatric Rheumatology – Clinical Poster III: Juvenile Idiopathic Arthritis and Uveitis

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:

Secukinumab (SEC) is licensed to treat adults with spondyloarthritis. It is not licensed for pediatric patients with Juvenile Idiopathic Enthesitis related Arthritis (enthJIA) yet. Only anti-TNF is licensed as biologic treatment for enthJIA. Not all patients get into remission with an anti-TNF therapy. We review our first patients, who did not reach remission under anti-TNF and were switched to SEC.

Methods:

We conducted a retrospective chart review in our unit of patients with enthJIA, who were treated with SEC.

Results:

14 patients were treated with SEC. 85 % of them were female. All patients were diagnosed with enthJIA. The mean age of the patients at the start of the treatment was 18.7 years and the mean weight 61.6 kilograms. The patients received before SEC in average 1.93 different anti-TNF´s, where they reached no remission, the JADAS-10 was 8.07 at the time initiation of SEC. SEC was applied according the adult dosing schedule. The mean dose at week 0 was 192 mg/dose and at 12 months 262 mg/dose. At month three already 3 of 14 patients, at month six 6 of 10 patients and at months twelve 6 of 8 patients received 300 mg per application. Mean follow up of the patients under SEC was 6 months. JADAS 10 decreased from 8.07 at timepoint 0 to 6.35 at months 3 (n=14 patients); 5.2 at months 6 (n=10 patients) and 6.00 at months 12 (n=8 patients). The mean number of active enthesitis points decreased from 0.86 at timepoint 0 to 0.25 at months 3, 0.3 at months 6 and 0.25 at months 12. The CHAQ/HAQ score stayed stable around 0.4 during the whole observation period. No patient discontinued the treatment because of AE or SAE.

Conclusion:

In this small sample of anti-TNF nonresponder patients SEC showed quite good effectiveness regarding the improvement in JADAS 10 score, at 6 months the JADAS score reached acceptable disease activity (<5.4) and the number of active enthesitic sites decreased. The 150 mg dose seemed to be not sufficient, in over half of the patients the dose had to be increased to 300 mg /dose per application.


Disclosure: I. Foeldvari, Novartis, BMF, Bayer, Genentech, Sanofi, Abbvie, Chugai; Medac, BMS, Pfizer, 5, 8; J. Baer, None.

To cite this abstract in AMA style:

Foeldvari I, Baer J. Secukinumab Is a Promising Treatment for Patients with Juvenile Enthesitis Related Arthritis Nonresponsive to Anti-TNF Treatment [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/secukinumab-is-a-promising-treatment-for-patients-with-juvenile-enthesitis-related-arthritis-nonresponsive-to-anti-tnf-treatment/. Accessed .
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