Finding patterns of etanercept 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 as been useful in treating many types of JIA. Many doctors in the US use 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 etanercept. Not all patients with JIA were treated with etanercept. Following patients in the registry allowed researchers to learn more about how, when, and why doctors use etanercept to treat JIA patients.

Key Findings

Researchers found many patterns in how doctors used etanercept 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 etanercept in combination with methotrexate. Etanercept was given to most patients after a short time on methotrexate (about a few weeks or months later).

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

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

This study was able to find several patterns in etanercept 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 etanercept use for patients whose arthritis is doing well. Doctors are also curious to know which patients respond best to etanercept 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 etanercept use for treatment of JIA patients.

This study was supported by Amgen.