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This Week in JAMA
December 7, 2011

This Week in JAMA

JAMA. 2011;306(21):2293. doi:10.1001/jama.2011.1787

Several studies have reported serious infections in patients taking tumor necrosis factor (TNF)-α antagonists. Grijalva and colleagues analyzed retrospective data from 16 022 patients with autoimmune diseases to assess whether initiation of TNF-α antagonists compared with nonbiologic therapies was associated with an increased risk of serious infections requiring hospitalization. In their analyses of disease-specific and propensity score–matched patient cohorts the authors found that initiation of TNF-α antagonists was not associated with an increased risk of hospitalization for serious infections. In an editorial, Dixon and Felson discuss the safety of anti-TNF therapy.

To investigate factors associated with response to etanercept, a TNF-α antagonist, in juvenile idiopathic arthritis (JIA), Otten and colleagues analyzed data from 262 patients with JIA who had initiated etanercept treatment. The authors report that 15 months after starting etanercept, 85 patients had achieved an excellent response, which was associated with low baseline disability scores, low prior use of disease-modifying antirheumatic drugs, and younger age at disease onset. Poor treatment response (in 85 patients) was associated with systemic JIA and female sex.