Finding patterns of etanercept (Enbrel) use in patients with Juvenile Idiopathic Arthritis (JIA)



The purpose of this study was to find patterns in how etanercept (a medication) is used to treat juvenile idiopathic arthritis (JIA).  For more than 20 years, etanercept (also called Enbrel®) has been useful in treating many types of JIA. Many doctors in the US use Enbrel to treat JIA, but it is not known when or how often it is used. This study looked at 2,032 patients with JIA enrolled in the CARRA Registry who were treated with Enbrel. Not all patients with JIA were treated with Enbrel. Following patients in the registry allowed researchers to learn more about how, when, and why doctors use Enbrel to treat JIA patients.

Key Findings

Researchers found many patterns in how doctors used Enbrel (AMGEN) as part of the treatment plan for JIA. Often, doctors prescribed one or more different medicines to treat JIA. In this study, researchers found that doctors often prescribed Enbrel in combination with methotrexate. Enbrel was given to most patients after a short time on methotrexate (about a few weeks or months later).

Among patients who were treated with Enbrel, researchers also found the following patterns of Enbrel use:

  • More than one-half of patients treated with Enbrel started it within 6 months of being diagnosed with JIA. Patients most commonly added Enbrel after being treated for a short time with methotrexate. Some patients started Enbrel and methotrexate at the same time, and some patients started Enbrel by itself without any methotrexate use.
  • Patients with more severe symptoms started Enbrel sooner (within 3 months of being diagnosed with JIA). Many had a higher number of joints affected by JIA and/or had more severe pain.
  • Doctors were most likely to treat patients with a type of JIA called enthesitis related arthritis (ERA) with Enbrel only. Unlike most children with JIA, some patients with ERA did not receive methotrexate before or during treatment with Enbrel.
  • Patients with a type of JIA called persistent OligoJIA (oligoarthritis) were most likely to stop methotrexate treatment around the same time as starting Enbrel.
  • Doctors used Enbrel as a long-term treatment option. In most cases, doctors prescribed Enbrel with or without methotrexate for several months and years. Enbrel was often prescribed for 3 years or longer. 

This study was able to find several patterns in Enbrel use. But there is more to learn. For example, researchers and families hope to learn more about when and how doctors decide to lower or stop Enbrel use for patients whose arthritis is doing well. Doctors are also curious to know which patients respond best to Enbrel treatment compared to other available medications. Future studies like this can use the CARRA Registry to help doctors provide better care for patients with JIA and other rheumatic diseases.

Next Steps

Learn more about what other CARRA research projects are finding from their work.

View the full contents of this article to learn more about patterns in Enbrel use for treatment of JIA patients.

This study was supported by Amgen Pharmaceuticals.