Objective: The aims of this study were: (1) to assess functional status, emotional well-being and quality of life in patients with polyarticular and systemic juvenile rheumatoid arthritis (JRA) treated with etanercept, and (2) to determine the prevalence and significance of adverse events associated with etanercept therapy.
Patients and methods: All JRA patients (n = 21) who received etanercept in our rheumatology clinic over a 14-month period were evaluated. Patient demo-graphics, type of arthritis, dosing regimens, family history, measures of joint function and laboratory parameters were obtained for each patient. A questionnaire that comprised validated functional assessment and quality-of-life measures (the Childhood Health Assessment Questionnaire [CHAQtrade mark], the Juvenile Arthritis Function Assessment Report [JAFAR 5trade mark] and the Pediatric Quality of Life Inventory Version 4 [PedsQL Generic Scaletrade mark] scales) was administered to patients and parents to assess physical and emotional function, pain, adverse drug events and quality of life at each clinic visit.
Results: Functional status and quality of life improved in patients with poly-articular and systemic disease. A significant difference between pre- and post-etanercept functional assessment (JAFARtrade mark and CHAQtrade mark) and quality-of-life assessment by parents and patients was found (p = 0.009, p = 0.002, p </= 0.001, p </= 0.001, respectively). The JAFARtrade mark results concurred with those of the CHAQtrade mark test, and did not distinguish between patients with polyarticular and systemic disease. Laboratory parameters indicative of toxicity did not differ between patients with polyarticular and systemic JRA and the number of adverse events reported was low. Underlying disease did not appear to predict improvement.
Conclusion: Etanercept appeared to improve functional status, emotional well-being, quality of life and activity level with minimal toxicity in patients with polyarticular and systemic JRA.