Table 4.
Drug class | Drug | Dose | Study (phase) | Study timec | Population | N | Age criteria | Agea | Background | Primary outcome/endpoint | Main conclusion |
---|---|---|---|---|---|---|---|---|---|---|---|
CD80/86 inhibitor | abatacept | 10 mg/kg q4w |
dIM101–033, NCT00095173 |
26 | PJIA, SJIA (without systemic features), extended OJIA | 190 | 6 to 17 | 12.4 | MTX, corticosteroids | Disease flare | Effective |
IL-1 inhibitor | anakinra | 1 mg/kg/d | e,b990758–990779, NCT00037648 (II) [52, 53] | 16 | PJIA | 86 | 2 to 17 | 12 | MTX | Safety | Efficacy is inconclusive |
2 mg/kg/d |
ANAJIS, NCT00339157 |
4.33 | SJIA | 24 | 2 to 20 | 8.5 | NSAID, corticosteroids | Modified ACR Pedi 30 | Effective | ||
canakinumab | 4 mg/kg single dose | fβ-SPECIFIC 1, NCT00886769 (III) [55–57] | 4.33 | SJIA | 84 | 2 to 19 | 8a | MTX, NSAID, corticosteroids | ACR Pedi 30 | Effective | |
4 mg/kg q4w | gβ-SPECIFIC 2, NCT00889863 (III) [55–57]b | 120 | SJIA | 177 | 2 to 19 | 8a | MTX, NSAID, corticosteroids | Disease flare | Effective | ||
rilonacept | 2.2 mg/kg qw |
RAPPORT, NCT00534495 |
24 | SJIA | 71 | 1 to 19 | 10 | NA | Modified ACR Pedi 30 | Effective | |
2.2 mg/kg qw, 4.4 mg/kg qw |
IL1T-AI-0504, NCT01803321 (II) [60] |
104 | SJIA | 24 | 4 to 20 | 12.6 | MTX, NSAID, corticosteroids | ACR Pedi 30 | Not effective | ||
IL-6 inhibitor | tocilizumab | 8 mg/kg q4w, 10 mg/kg q4w |
hCHERISH, NCT00988221 |
104 | PJIA, extended OJIA | 188 | 2 to 17 | 11 | MTX, corticosteroids | Disease flare | Effective |
8 mg/kg q2w, 12 mg/kg q2w |
iTENDER, NCT00642460 |
260 | SJIA | 112 | 2 to 17 | 9.7 | MTX, corticosteroids | Modified ACR Pedi 30 | Effective | ||
8 mg/kg q2w |
MRA316JP, NCT00144599 (III) [68]b |
18 | SJIA | 56 | 2 to 19 | 8.3 | corticosteroids | ACR Pedi 30 | Effective | ||
TNF inhibitor | adalimumab | 24 mg/m2 q2w |
jM11–328, NCT01166282 |
12 | ERA | 46 | 6 to 17 | 12.9 | MTX or SSZ, NSAID | Joints with active arthritis | Effective |
40 mg q2w | Horneff 2012, EudraCT 2007–003358-27(III) [72] | 12 | ERA | 32 | 12 to 17 | 15.3 | NSAID, corticosteroids | ASAS40 | Effective | ||
24 mg/m2 q2w |
k,bDE038, NCT00048542 |
48 | PJIA | 171 | 4 to 17 | 11.2 | MTX, NSAID, corticosteroids | Disease flare | Effective | ||
20 mg q2w, 40 mg q2w | SYCAMORE, EudraCT 2010–021141-41 (NA) [75, 76] | 78 | JIA-associated uveitis | 90 | 2 to 18 | 8.9 | MTX | Treatment failure | Effective | ||
24 mg/m2 q2w, 40 mg q2w | lADJUVITE, NCT01385826 (II/III) [77] | 52 | JIA-associated uveitis | 32 | > = 4 | 9.5a | MTX, corticosteroids (oral and topical) | LFP improvement > = 30% and no worsening on slit lamp | Effective | ||
etanercept | 0.8 mg/kg/qw | Horneff 2015, EudraCT 2010–020423-51 (III) [78] b | 48 | ERA | 38 | 6 to 17 | 13.3 | SSZ, NSAID, corticosteroids | Disease flare | Effective | |
0.8 mg/kg/qw | o16.0016 (NA) [79, 80] | 30.33 | PJIA | 69 | 4 to 17 | NA | NSAID, corticosteroids | Disease flare | Effective | ||
0.8 mg/kg/qw | o20021616, NCT03780959 (II/III) [81]b | 30.33 | PJIA | 69 | 4 to 18 | 10.5 | NSAID | Disease flare | Effective | ||
0.8 mg/kg/qw |
20021628, NCT03781375 (III) [82] |
52 | PJIA | 25 | NA | 10.1 | MTX | ACR Pedi 30 | NA | ||
0.8 mg/kg/qw |
TREAT, NCT00443430 |
52 | PJIA | 85 | 2 to 17 | 10.5 | MTX | Clinical inactive disease | Not effective | ||
0.8 mg/kg/qw, 1.6 mg/kg/qw |
b20021631, NCT00078806 (III) [85] |
39 | SJIA | 19 | 2 to 18 | 9.1 | MTX, NSAID, corticosteroids | Disease flare | NA | ||
0.8 mg/kg/qw | BeSt for Kids, NTR1574 (NA) [86, 87] | 12 | PJIA,RF−; OJIA, JPsA | 94 | 2 to 16 | 8.8a | MTX | Unclear | Effective | ||
golimumab | 30 mg/m2 q4w | mGO KIDS, NCT01230827 (III) [88, 89]b | 48 | PJIA, SJIA (without systemic features), PsA | 154 | 2 to 17 | 11.1 | MTX, corticosteroids | Disease flare | Not effective | |
infliximab |
3 mg/kg, 6 mg/kg |
CR004774, NCT00036374 (III) [90] | 58 | PJIA | 122 | 4 to 17 | 11.2 | MTX, NSAID, corticosteroids | ACR Pedi 30 | Not effective | |
3–5 mg/kg | ACUTE-JIA, NCT01015547 (III) [91] | 54 | PJIA | 60 | 4 to 15 | 9.6 |
MTX, other DMARDs |
ACR Pedi 75 | Effective | ||
JAK inhibitor | tofacitinib | 2–5 mg BID | nA3921104, NCT02592434 (III) [92]b | 44 | ERA, PJIA, PsA | 225 | 2 to 17 | 13a | NA | Disease flare | Effective |
Abbreviations: Drug class: IL interleukin, TNF tumour necrosis factor, JAK Janus Kinase; Dose: mg milligram, kg kilogram, d per day, qw once per week, q2w once per every 2 weeks, q4w once per every 4 weeks, BID twice a day; Population: ERA enthesitis-related juvenile idiopathic arthritis, PsA psoriatic juvenile idiopathic arthritis, OJIA oligoarticular juvenile idiopathic arthritis, PJIA juvenile Polyarticular idiopathic arthritis, RF− rheumatoid factor negative, SJIA systemic juvenile idiopathic arthritis; Background: MTX methotrexate, HCQ hydroxycloroquine, NSAID non-steroidal anti-inflammatory drugs, DMARDS disease modifying antirheumatic drugs, SSZ sulfasalazine; Outcome: ACR Pedi 30 ACR Pedi 30% response criteria, ACR Pedi 75 ACR Pedi 75% response criteria, LFP laser flare photometry, ASAS40 assessment in ankylosing spondylitis response criteria 40%; NA not available
amedian age, otherwise mean age across all arms of the study, bwithdrawal study design instead of parallel, cduration in weeks, dAlso registered under EudraCT 2005–000443-28; eAlso registered under EudraCT 2015–002466-22; fAlso registered under EudraCT 2008–005476-27; gAlso registered under EudraCT 2008–005479-82; hAlso registered under EudraCT 2009–011593-15; iAlso registered under EudraCT 2007–00872-18; jAlso registered under EudraCT 2009–017938-46; kAlso registered under EudraCT 2011–001661-40; lAlso registered under EudraCT 2010–019441-26; mAlso registered under EudraCT 2009–015019-42; nAlso registered under EudraCT 2015–001438-46; osame study