{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T01:15:25Z","timestamp":1788830125276,"version":"build-2803163510"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T00:00:00Z","timestamp":1603929600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T00:00:00Z","timestamp":1603929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pfizer Germany"},{"DOI":"10.13039\/100006484","name":"AbbVie Deutschland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006484","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Roche Germany"},{"name":"MSD Germany"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>At present, etanercept represents the most commonly prescribed biologic agent for juvenile idiopathic arthritis (JIA) treatment. Children and adolescents with JIA are often treated with etanercept over long periods, sometimes even into adulthood. The objectives of this analysis were to determine the long-term safety of etanercept compared to a biologic-na\u00efve cohort and to assess the long-term treatment response upon continuous etanercept exposure using data from the German biologics registry (BiKeR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>JIA patients newly exposed to etanercept were documented in the BiKeR registry from January 2001 to March 2019, and baseline characteristics, effectiveness, and safety parameters were analysed. Response to treatment was assessed according to 10-joint Juvenile Arthritis Disease Activity Score (JADAS10), JADAS-defined minimal disease activity and remission, JIA-American College of Rheumatology (ACR) improvement criteria, and ACR-inactive disease definition. Safety assessments were based on adverse event (AE) reports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2725 new etanercept users with a diagnosis of JIA were registered. Of these, etanercept was received as a first-line biologic by 95.8% and as monotherapy without concomitant methotrexate by 31.5%. After nine\u00a0years on continuous treatment, 68.1% of patients presented minimal disease activity, 43.1% JADAS-defined remission on drug, and 36.6% ACR-inactive disease. JIA-ACR30\/50\/70\/90 response rates were still 82\/79\/71\/54% after nine\u2009years of treatment. Overall, 2053 AEs (34.3\/100PY), including 226 serious AEs (SAE, 3.8\/100PY), were observed upon etanercept, compared to 1345 AEs [35.6\/100PY;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.3] and 52 SAEs (1.4\/100PY;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001) in the biologic-na\u00efve cohort. Respective exposure-adjusted rates for etanercept and biologic-na\u00efve patients were 0.9\/100PY and 0.2\/100PY (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001) for serious infections, 0.4\/100PY and 0.1\/100PY (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) for zoster reactivation, 0.3\/100PY and 0.03\/100PY (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015) for inflammatory bowel disease, and 1.9\/100PY and 1.4\/100PY (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.09) for uveitis. Three and two malignancies were documented in the etanercept and biologic-na\u00efve groups, as well as three and one deaths, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>No new safety signal was observed, especially no increased risk for malignancies or autoimmune disorders other than inflammatory bowel disease. However, SAEs and serious infections, though infrequent, were more often reported on etanercept than in biologic-na\u00efve patients. In addition, etanercept demonstrated a long-term maintenance of clinical benefits up to nine\u00a0years of continuous treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13075-020-02326-5","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T09:03:09Z","timestamp":1603962189000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Long-term safety and effectiveness of etanercept in JIA: an 18-year experience from the BiKeR registry"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6429-6718","authenticated-orcid":false,"given":"Giulia","family":"Armaroli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariane","family":"Klein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Ganser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Ruehlmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Dressler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Hospach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Minden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Trauzeddel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Foeldvari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmin","family":"Kuemmerle-Deschner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Weller-Heinemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Urban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Horneff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,29]]},"reference":[{"key":"2326_CR1","first-page":"819","volume":"77","author":"A Ravelli","year":"2018","unstructured":"Ravelli A, Consolaro A, Horneff G, Laxer RM, Lovell DJ, Wulffraat NM, et al. 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Written informed consent was obtained from patients and parents\/legal guardians and repeated if patient became adult. Only pseudonymized data were collected.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"AK has received congress travel fees from Sobi and Sandoz as well as advisory board honoraria from Celgene. FD has received honoraria for lectures from Pfizer, Abbvie, and Novartis. AH has received advisory board honoraria from Novartis, Chugai-Roche, and Sobi. KM has received honoraria from Abbvie, GSK, Biermann, Medac, and Sanofi. IF discloses advisory board participation for Novartis, Genzyme, Bayer, Lilly, Pfizer, Abbvie, and Sanofi. JKD has received consultant\/speaker fees from Novartis and Sobi, as well as pharmaceuticals and grant support from Sobi and Novartis. FWH has received speaker honoraria from Pfizer, Abbvie, Novartis, Sobi, and Roche. GH has received research funds, advisory board membership, and honorary fees from Abbvie, Pfizer, Novartis, and Roche\/Chugai. The other authors have declared no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"258"}}