(HealthDay News) – Two drugs show promise in the treatment of active systemic juvenile idiopathic arthritis (JIA), according to two studies published in the Dec. 20 issue of the New England Journal of Medicine.
In the first study, Fabrizio De Benedetti, MD, PhD, from IRCCS Ospedale Pediatrico Bambino Gesù in Rome, and colleagues randomly assigned 112 children with active systemic JIA resistant to nonsteroidal anti-inflammatory drugs to placebo or tocilizumab every two weeks for 12 weeks. The researchers found that tocilizumab was more effective than placebo, reducing fever and improving disease (85% vs. 24%). Adverse effects such as infection, neutropenia, and increased aminotransferase levels were common, and more occurred in the tocilizumab group.
In the second study, Nicolino Ruperto, MD, MPH, from the Università di Genova in Italy, and colleagues randomly assigned children with active systemic JIA to placebo or canakinumab as part of two trials. In the first trial, 84 children were assigned to a single dose of placebo or canakinumab. In the second trial (open-label), 177 children were assigned to canakinumab, and the 100 children who responded were randomly assigned to continue canakinumab or receive placebo. The researchers found that, in the first trial, more patients responded to canakinumab (84% vs. 10%), and in the second trial, the risk of flare was lower in the group that continued to receive canakinumab (hazard ratio, 0.36).
“There is no doubt that the agents tested in these trials signal a new era in the treatment of systemic JIA and will shed light on the mechanisms driving this enigmatic disorder,” write the authors of an accompanying editorial.
The De Benedetti study was funded by Hoffmann-La Roche and the Ruperto study was funded by Novartis; several authors from both studies and the editorial disclosed financial ties to these and/or other pharmaceutical companies.