Abatacept improves health‐related quality of life, pain, sleep quality, and daily participation in subjects with juvenile idiopathic arthritis

Abstract

Objective. To assess health-related quality of life (HRQOL) in abatacept-treated children/adolescents with juvenile idiopathic arthritis (JIA).Methods. In this phase III, double-blind, placebo-controlled trial, subjects with active polyarticular course JIA and an inadequate response/intolerance to >1 disease-modifying antirheumatic drug (including biologics) received abatacept 10 mg/kg plus methotrexate (MTX) during the 4-month open-label period (period A). Subjects achieving the American College of Rheumatology Pediatric 30 criteria for improvement (defined "responders") were randomized to abatacept or placebo (plus MTX) in the 6-month double-blind withdrawal period (period B). HRQOL assessments included 15 Child Health Questionnaire (CHQ) health concepts plus the physical (PhS) and psychosocial summary scores (PsS), pain (100-mm visual analog scale), the Children's Sleep Habits Questionnaire, and a daily activity participation questionnaire. Results. A total of 190 subjects from period A and 122 from period B were eligible for analysis. In period A, there were substantial improvements across all of the CHQ domains (greatest improvement was in pain/discomfort) and the PhS (8.3 units) and PsS (4.3 units) with abatacept. At the end of period B, abatacept-treated subjects had greater improvements versus placebo in all domains (except behavior) and both summary scores. Similar improvement patterns were seen with pain and sleep. For participation in daily activities, an additional 2.6 school days/month and 2.3 parents' usual activity days/month were gained in period A responders with abatacept, and further gains were made in period B (1.9 versus 0.9 [P ‫؍‬ 0.033] and 0.2 versus ؊1.3 [P ‫؍‬ 0.109] school days/month and parents' usual activity days/month, respectively, in abatacept-versus placebo-treated subjects). Conclusion. Improvements in HRQOL were observed with abatacept, providing real-life tangible benefits to children with JIA and their parents/caregivers.

Assessment and Management of Pain in Juvenile Idiopathic Arthritis

“…An evaluation of 521 children treated with methotrexate for six months reported dramatic improvements in pain, physical function and ability to participate in activities (57). Similar improvements have been demonstrated after treatment with etanercept (58) and abatacept (59).…”

Results of the Iv Phase of the Open Clinical Trial on Efficacy and Safety of Abatacept Usage in Children and Adolescents With Polyarticular Juvenile Idiopathic Arthritis Without Systemic Manifestations in Russia

“…Традиционные иммунодепрессанты и инги-биторы ФНО ␣ при этом варианте заболевания не всегда эффективны [2][3][4][5][6][7][8]. Длительное применение глюкокор-тикоидов приводит к развитию тяжелых нежелательных явлений и не предотвращает развития деструктивных изменений в суставах [37].…”

“…На фоне лечения отмечено статистически значимое снижение СОЭ, сыво-роточной концентрации СРБ (рис. 4,5).…”

“…Это самое распространенное хроническое ревматическое заболевание у детей, при-водящее к значительному снижению качества их жизни [1][2][3]. ЮИА -иммуноагрессивное заболевание, важную роль в развитии которого играют как генетические, так и внешние факторы [1,2,4].…”

Treatment in juvenile rheumatoid arthritis and new treatment options

“…However, multiple sclerosis was found in one patient (39). In another study, improvement was shown in the measurements of quality of life (40). It has been recommended by ARC in cases of unresponsiveness to tumor necrosis factor-alpha inhibitors (41).…”