Marieke H Otten1, Janneke Anink1, Femke H M Prince1, Marinka Twilt1, S J Vastert2, Rebecca ten Cate3, Esther P A H Hoppenreijs4, Wineke Armbrust5, Simone L Gorter6, Philomine A van Pelt1, Sylvia S M Kamphuis1, Koert M Dolman7, Joost F Swart2, J Merlijn van den Berg8, Yvonne Koopman-Keemink9, Marion A J van Rossum10, Nico M Wulffraat2, Lisette W A van Suijlekom-Smit1. 1. Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands. 2. Department of Pediatrics/Pediatric Rheumatology, Utrecht MC Wilhelmina Children's Hospital, Utrecht, The Netherlands. 3. Department of Pediatrics/Pediatric Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands. 4. Department of Pediatrics/Pediatric Rheumatology, St Maartenskliniek and Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. 5. Department of Pediatrics/Pediatric Rheumatology, Beatrix Children's Hospital, University Medical Centre Groningen, Groningen, The Netherlands. 6. Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands. 7. Department of Pediatrics/Pediatric Rheumatology, St Lucas Andreas Hospital and Reade Institute, Amsterdam, The Netherlands. 8. Department of Pediatrics/Pediatric Rheumatology, Emma Children's Hospital, Amsterdam, The Netherlands. 9. Department of Paediatrics, Hagaziekenhuis Juliana Children's Hospital, The Hague, The Netherlands. 10. Department of Pediatrics/ Pediatric Rheumatology, Emma Children's Hospital/Academic Medical Centre and Reade Institute, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Treatment of juvenile idiopathic arthritis (JIA) has changed dramatically since the introduction of biological agents in 1999. OBJECTIVE: To evaluate trends in prescription patterns of biological agents and the subsequent outcome of JIA. METHODS: The Arthritis and Biologics in Children register (multicentre prospective observational study) aimed to include all consecutive patients with JIA in the Netherlands who had started biological agents since 1999. Patients were divided according to year of introduction of first biological agent. Patient characteristics at introduction of the first biological agent and its effectiveness were analysed over 12 years. RESULTS: 335 patients with non-systemic JIA and 86 patients with systemic JIA started a biological agent between 1999 and 2010. Etanercept remained the most often prescribed biological agent for non-systemic JIA; anakinra became first choice for systemic JIA. The use of systemic glucocorticoids and synthetic disease-modifying antirheumatic drugs before biological agents decreased. During these 12 years of observation, biological agents were prescribed earlier in the disease course and to patients with lower baseline JADAS (Juvenile Arthritis Disease Activity Score) disease activity. All baseline disease activity parameters were lowered in patients with non-systemic JIA. In systemic JIA, prescription patterns changed towards very early introduction of biological agents (median 0.4 years of disease duration) in patients with a low number of joints with active arthritis and high erythrocyte sedimentation rates. These changes for both systemic and non-systemic JIA resulted in more patients with inactive disease after 3 and 15 months of treatment. CONCLUSIONS: Biological agents are increasingly prescribed, earlier in the disease and in patients with JIA with lower disease activity. These changes are accompanied by better short-term disease outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: Treatment of juvenile idiopathic arthritis (JIA) has changed dramatically since the introduction of biological agents in 1999. OBJECTIVE: To evaluate trends in prescription patterns of biological agents and the subsequent outcome of JIA. METHODS: The Arthritis and Biologics in Children register (multicentre prospective observational study) aimed to include all consecutive patients with JIA in the Netherlands who had started biological agents since 1999. Patients were divided according to year of introduction of first biological agent. Patient characteristics at introduction of the first biological agent and its effectiveness were analysed over 12 years. RESULTS: 335 patients with non-systemic JIA and 86 patients with systemic JIA started a biological agent between 1999 and 2010. Etanercept remained the most often prescribed biological agent for non-systemic JIA; anakinra became first choice for systemic JIA. The use of systemic glucocorticoids and synthetic disease-modifying antirheumatic drugs before biological agents decreased. During these 12 years of observation, biological agents were prescribed earlier in the disease course and to patients with lower baseline JADAS (Juvenile Arthritis Disease Activity Score) disease activity. All baseline disease activity parameters were lowered in patients with non-systemic JIA. In systemic JIA, prescription patterns changed towards very early introduction of biological agents (median 0.4 years of disease duration) in patients with a low number of joints with active arthritis and high erythrocyte sedimentation rates. These changes for both systemic and non-systemic JIA resulted in more patients with inactive disease after 3 and 15 months of treatment. CONCLUSIONS: Biological agents are increasingly prescribed, earlier in the disease and in patients with JIA with lower disease activity. These changes are accompanied by better short-term disease outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Entities:
Keywords:
Anti-TNF; DMARDs (biologic); Epidemiology; Juvenile Idiopathic Arthritis; Outcomes Research
Authors: Sarah Ringold; Sheila T Angeles-Han; Timothy Beukelman; Daniel Lovell; Carlos A Cuello; Mara L Becker; Robert A Colbert; Brian M Feldman; Polly J Ferguson; Harry Gewanter; Jaime Guzman; Jennifer Horonjeff; Peter A Nigrovic; Michael J Ombrello; Murray H Passo; Matthew L Stoll; C Egla Rabinovich; Rayfel Schneider; Olha Halyabar; Kimberly Hays; Amit Aakash Shah; Nancy Sullivan; Ann Marie Szymanski; Marat Turgunbaev; Amy Turner; James Reston Journal: Arthritis Care Res (Hoboken) Date: 2019-04-25 Impact factor: 4.794
Authors: Sarah Ringold; Sheila T Angeles-Han; Timothy Beukelman; Daniel Lovell; Carlos A Cuello; Mara L Becker; Robert A Colbert; Brian M Feldman; Polly J Ferguson; Harry Gewanter; Jaime Guzman; Jennifer Horonjeff; Peter A Nigrovic; Michael J Ombrello; Murray H Passo; Matthew L Stoll; C Egla Rabinovich; Rayfel Schneider; Olha Halyabar; Kimberly Hays; Amit Aakash Shah; Nancy Sullivan; Ann Marie Szymanski; Marat Turgunbaev; Amy Turner; James Reston Journal: Arthritis Rheumatol Date: 2019-04-25 Impact factor: 10.995
Authors: Xiaomeng Yue; Bin Huang; Ana L Hincapie; Patricia R Wigle; Tingting Qiu; Yuxiang Li; Esi M Morgan; Jeff J Guo Journal: Paediatr Drugs Date: 2021-03-02 Impact factor: 3.022
Authors: Jorge A Zamora-Legoff; Megan L Krause; Cynthia S Crowson; Theresa Wampler Muskardin; Thomas Mason; Eric L Matteson Journal: Clin Rheumatol Date: 2016-01-29 Impact factor: 2.980