NOTE, original article title: Dosing variation at initiation of adalimumab and etanercept is not associated with clinical outcomes in juvenile idiopathic arthritis: A Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry study

Findings did not corroborate the hypothesis that increased dosing of tumor necrosis factor (TNF) inhibitors leads to improved treatment results in juvenile idiopathic arthritis (JIA). Although adjustment was done for risk factors of impaired treatment response, the observed negative associations are possibly explained by residual confounding by indication.

• Participants of the Childhood Arthritis and Rheumatology Research Alliance Registry who started TNF inhibition for JIA were included in this study to investigate the dose-response association of TNF inhibition in the treatment of JIA.

• Analyses involved patients treated with adalimumab (n=328) and etanercept (n=437) (median dose 0.82 [IQR 0.66-1.04] and 0.83 [IQR 0.75-0.95] mg/kg body weight, respectively).

• Most of the analyses did not demonstrate an association between dose and outcome.

• Where links were identified, results were conflicting.

• Alternative dosing features based on ideal body weight, fat free mass and lean body mass did not lead to stronger or more consistent links.