“Fortunately, this still means that cancer in children with JIA treated with etanercept is very uncommon – about one case of cancer in every 1,500 children with JIA treated with etanercept.” In other words, relatively modest.
Dominick Co of Children's Hospital of Wisconsin, Milwaukee, said, “We have a number of very difficult poly-JIA patients who seem to have an initial response to some of the biologics and then after several months will not respond, and we'll switch them. Have you had a similar experience with cycling through biologics?”
Dr. Lovell responded that he saw poly-JIA patients treated with biologics “where there was an initial excellent response and then a secondary loss of response. We went back to the families and the patients and discussed the situation with them. In about half of the patients (usually adolescents), that loss of response was due to the patient developing poor compliance with taking the biologic since they felt so well. In other cases the loss of response was more difficult to understand, but it certainly occurs and we have dealt with it by either increasing the dose of the biologic or changing to another biologic.”
Dr. Lovell disclosed consulting fees or other remuneration from Centocor, Amgen, Abbott, Pfizer, Regeneron, Hoffman-La Roche, Novartis, UBC, Xoma, and Wyeth.