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Drug Shown Safe, Effective in Youth with Juvenile Rheumatoid Arthritis

By Janet Howard

Enbrel (etanercept) has been shown to be a safe and effective drug in the treatment of children and teenagers with polyarticular juvenile rheumatoid arthritis (JRA), according to clinical trial results reported in the New England Journal of Medicine.

In this trial, 69 children, ages 4 to 17, were injected with Enbrel twice a week; 74 percent responded with measurable improvement when treated for 3 months. At the end of 3 months of treatment, on average, there was a 56 percent decrease in the number of joints with active arthritis, a 75 percent decrease in the amount of joint stiffness and a 63 percent decrease in the amount of joint pain. All measures of arthritis impact — symptoms, joint abnormalities, ability to perform daily functions and laboratory tests — were dramatically improved. The drug was well tolerated.

The trial was coordinated at the National Institute of Arthritis and Musculoskeletal and Skin Diseases Multipurpose Arthritis and Musculoskeletal Diseases Center at Children's Hospital Medical Center of Cincinnati. Its success is the culmination of many years of basic research supported by NIAMS and other NIH components.

"These findings show a significant — often profound — improvement for most children with JRA when treated with Enbrel compared to placebo," said Dr. Daniel J. Lovell, principal investigator and lead author. "Before Enbrel, many children with severe JRA had a poor response to existing treatment options. Often, they would have to stop attending school. Now, there is hope for these children."

JRA is a type of arthritis that causes joint inflammation and stiffness for more than 6 weeks, beginning when the child is 16 years of age or less. There are three types of JRA: polyarticular (affecting five or more joints), pauciarticular (affecting four or fewer joints) and systemic, also called Still's disease (joint swelling, fever, rash and organ involvement).

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