Enthesitis-related arthritis (ERA) and juvenile psoriatic arthritis (JPsA) are types of juvenile idiopathic arthritis (JIA) that represent the paediatric correlates of axial spondyloarthritis and psoriatic arthritis. In the phase 3 JUNIPERA trial, presented by Nicolino Ruperto (Università di Genova Pediatria, Italy), the interleukin (IL)-17A inhibitor secukinumab significantly reduced the risk of disease flares in children and adolescents (aged 2–18 years) with ERA and JPsA. In the initial open-label phase of the trial, all patients received subcutaneous secukinumab (75 mg in patients <50 kg and 150 mg in patients ≥50 kg) for 12 weeks. 75 (90·4%) of 83 patients had a 30% improvement in JIA American College of Rheumatology (JIA ACR 30) response at week 12 and were randomly assigned (1:1) to blinded secukinumab or placebo once every 4 weeks until a disease flare, or until week 100. In the double-blind phase, there were 21 flares in the placebo group (n=38) and ten flares in the secukinumab group (n=37). Time to flare (the primary outcome) was significantly longer on secukinumab than on placebo, and risk of flare was reduced on secukinumab (hazard ratio 0·28; 95% CI 0·13–0·63; p<0·001). At week 104, 89·2% of patients on secukinumab had a JIA ACR 30 response compared with 64·9% of patients on placebo (p=0·014). Adverse events were similar between groups and no new safety signals were observed.
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