Background:
Juvenile idiopathic arthritis (JIA) is a condition in children causing joint inflammation. Etanercept is a common medication for JIA, but the best dose for effectiveness is unclear. This study looks at whether increasing the dose of etanercept helps achieve better outcomes.
Study Design:
• Type: Single-blinded treatment-strategy trial.
• Participants: 94 children with different types of JIA.
• Groups: Patients were randomly assigned to one of three treatment strategies involving different combinations of drugs and dosages.
• Duration: 24 months, with follow-ups to adjust treatment based on disease activity.
Methods:
Patients could increase their etanercept dose from the standard to a higher dose (up to 1.6 mg/kg/week) if their disease was still active. The study compared those who did increase the dose with those who did not, despite being eligible for it.
Results:
• Participants: 32 patients received the high-dose etanercept.
• Improvements: Significant decreases in disease activity measures (e.g., pain and number of active joints) within 3 months.
• Comparison Group: 11 patients who did not escalate the dose saw similar improvements.
• Adverse Events: Higher rate of non-severe infections in the high-dose group, but no serious adverse events were noted.
Conclusion:
While increasing the etanercept dose led to clinical improvements, those who didn’t increase the dose saw similar benefits. Therefore, higher doses did not show superior outcomes and had a potential for more