Skip to main content
SpringerLink
Log in

Quality-of-Life Measurements in Juvenile Rheumatoid Arthritis Patients Treated with Etanercept

  • Original Research Article
  • Published:
Clinical Drug Investigation Aims and scope Submit manuscript

Abstract

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 demographics, 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 [CHAQ™], the Juvenile Arthritis Function Assessment Report [JAFAR 5™] and the Pediatric Quality of Life Inventory Version 4 [PedsQL Generic Scale™] 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 polyarticular and systemic disease. A significant difference between pre- and post-etanercept functional assessment (JAFAR™ and CHAQ™) 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 JAFAR™ results concurred with those of the CHAQ™ 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Table I
Table II

Similar content being viewed by others

References

  1. Ilowite NT. Current treatment of juvenile rheumatoid arthritis. Pediatrics 2002; 109(1): 109–15

    Article  PubMed  Google Scholar 

  2. Perez MD, Abrams SA, Loddeke L, et al. Effects of rheumatic disease and corticosteroid treatment on calcium metabolism and bone density in children assessed one year after diagnosis, using stable isotopes and dual energy x-ray absorptiometry. J Rheumatol 2000; 27 Suppl. 58: 38–43

    Google Scholar 

  3. Haverson PB. Extaarticular manifestations of rheumatoid arthritis. Orthop Nurs 1995; 14(4): 47–50

    Article  Google Scholar 

  4. Lamblin C, Bergoin C, Saelens T, et al. Interstitial lung diseases in collagen vascular diseases. Eur Respir J 2001; 32 Suppl.: 69s–80s

    CAS  Google Scholar 

  5. Schwartz D, Averbuch M, Pines A, et al. Disseminated intravascular coagulation with renal and liver damage as the predominant manifestations of recurrent relapses in systemic juvenile rheumatoid arthritis. Ann Rheum Dis 1992; 51(3): 347–9

    Article  PubMed  CAS  Google Scholar 

  6. Flato B, Aasland A, Vinje O, et al. Outcome and predictive factors in juvenile rheumatoid arthritis and juvenile spondyloarthropathy. J Rheumatol 1998; 25(2): 366–75

    PubMed  CAS  Google Scholar 

  7. Petty RE. Prognosis in children with rheumatic diseases: justification for consideration of new therapies. Rheumatology (Oxford) 1999; 38(8): 739–42

    Article  CAS  Google Scholar 

  8. Maini R, Taylor P. Anti-cytokine therapy for rheumatoid arthritis. Annu Rev Med 2000; 51: 207–29

    Article  PubMed  CAS  Google Scholar 

  9. De Benedetti F, Ravelli A, Martini A. Cytokines in juvenile rheumatoid arthritis. Curr Opin Rheumatol 1997; 9: 428–33

    Article  Google Scholar 

  10. Woo P. Cytokines in juvenile chronic arthritis. Baillieres Clin Rheumatol 1998; 12(2): 219–28

    Article  PubMed  CAS  Google Scholar 

  11. Feldmann M, Brennan F, Maini R. Role of cytokines in rheumatoid arthritis. Annu Rev Immunol 1996; 14: 397–440

    Article  PubMed  CAS  Google Scholar 

  12. Fox DA. Cytokine blockade as a new strategy to treat rheumatoid arthritis: inhibition of tumor necrosis factor. Arch Intern Med 2000; 160(4): 437–44

    Article  PubMed  CAS  Google Scholar 

  13. Burger D, Dayer JM. Cytokines, acute-phase proteins, and hormones: IL-1 and TNF-alpha production in contact-mediated activation of monocytes by T lymphocytes. Ann N Y Acad Sci 2002; 966: 464–73

    Article  PubMed  CAS  Google Scholar 

  14. Kaneko M, Tomita T, Nakase T, et al. Expression of proteinases and inflammatory cytokines in subchondral bone regions in the destructive joint of rheumatoid arthritis. Rheumatology (Oxford) 2001; 40(3): 247–55

    Article  CAS  Google Scholar 

  15. Lovell D, Giannini E, Reiff A, et al. Etanercept in children with polyarticular juvenile rheumatoid arthritis. Pediatric Rheumatology Collaborative Study Group. N Engl J Med 2000; 342(11): 763–9

    Article  PubMed  CAS  Google Scholar 

  16. Woo P. The cytokine network in juvenile chronic arthritis. Ann Med 1997; 29(2): 145–7

    Article  PubMed  CAS  Google Scholar 

  17. Moreland L, Schiff M, Baumgartner S, et al. Etanercept therapy in rheumatoid arthritis: a randomized, controlled trial. Ann Intern Med 1999; 130(6): 478–86

    PubMed  CAS  Google Scholar 

  18. Mathias S, Colwell H, Miller D, et al. Health-related quality of life and functional status of patients with rheumatoid arthritis randomly assigned to receive etanercept or placebo. Clin Ther 2000; 22(1): 128–39

    Article  PubMed  CAS  Google Scholar 

  19. Moreland L, Baumgartner S, Schiff M, et al. Treatment of rheumatoid arthritis with a recombinant human tumor necrosis factor receptor (p75)-Fc fusion protein. N Engl J Med 1997; 337(3): 141–7

    Article  PubMed  CAS  Google Scholar 

  20. Kietz DA, Pepmueller PH, Moore TL. Therapeutic use of etanercept in polyarticular course juvenile idiopathic arthritis over a two year period. Ann Rheum Dis 2002; 61(2): 171–3

    Article  PubMed  CAS  Google Scholar 

  21. Takei S, Groh D, Bernstein B, et al. Safety and efficacy of high dose etanercept in treatment of juvenile rheumatoid arthritis. J Rheumatol 2001; 28(7): 1677–80

    PubMed  CAS  Google Scholar 

  22. Singh G, Athreya B, Fries J, et al. Measurement of health status in children with juvenile rheumatoid arthritis. Arthritis Rheum 1994; 37(12): 1761–9

    Article  PubMed  CAS  Google Scholar 

  23. Duffy CM, Tucker L, Burgos-Vargas R. Update on functional assessment tools. J Rheumatol 2000; 27 Suppl. 58: 11–4

    Google Scholar 

  24. Murphy F, Enzenauer R, Battafarano D, et al. Etanercept associated injection-site reactions. Arch Dermatol 2000; 136(4): 556–7

    Article  PubMed  CAS  Google Scholar 

  25. Korth-Bradley JM, Rubin A, Hanna R, et al. The pharmacokinetics of etanercept in healthy volunteers. Ann Pharmacother 2000; 34(2): 161–4

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors have provided no information on sources of funding or on conflicts of interest directly relevant to the content of this study.

Author information

Authors and Affiliations

  1. The Ohio State University and Children’s Hospital, Columbus, Ohio, USA

    Renee F. Robinson,  Milap C. Nakata, John R. Hayes, Robert Rennebohm & Gloria Higgins

Authors
  1. Renee F. Robinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Milap C. Nakata
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John R. Hayes
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert Rennebohm
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gloria Higgins
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Milap C. Nakata.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Robinson, R.F., Nakata, M.C., Hayes, J.R. et al. Quality-of-Life Measurements in Juvenile Rheumatoid Arthritis Patients Treated with Etanercept. Clin. Drug Investig. 23, 511–518 (2003). https://doi.org/10.2165/00044011-200323080-00003

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00044011-200323080-00003

Keywords

Search

Navigation