RT Journal Article
SR Electronic
T1 Disease-modifying Antirheumatic Drug Use in the Treatment of Juvenile Idiopathic Arthritis: A Cross-sectional Analysis of the CARRA Registry
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.120110
DO 10.3899/jrheum.120110
A1 Timothy Beukelman
A1 Sarah Ringold
A1 Trevor E.  Davis
A1 Esi Morgan  DeWitt
A1 Christina F.  Pelajo
A1 Pamela F.  Weiss
A1 Yukiko Kimura
YR 2012
UL http://www.jrheum.org/content/early/2012/07/26/jrheum.120110.abstract
AB Objective To characterize disease-modifying antirheumatic drug (DMARD) use for children with juvenile idiopathic arthritis (JIA) in the United States and to determine patient factors associated with medication use. Methods We analyzed cross-sectional baseline enrollment data from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from May 2010 through May 2011 for children with JIA. Current and prior medication use was included. We used parsimonious backward stepwise logistic regression models to calculate OR to estimate associations between clinical patient factors and medication use. Results We identified 2748 children with JIA with a median disease duration of 3.9 years from 51 US clinical sites. Overall, 2023 (74%) had ever received a nonbiologic DMARD and 1246 (45%) had ever received a biologic DMARD. Among children without systemic arthritis, methotrexate use was most strongly associated with uveitis (OR 5.2, 95% CI 3.6–7.6), anticitrullinated protein antibodies (OR 4.5, 95% CI 1.7–12), and extended oligoarthritis (OR 4.1, 95% CI 2.5–6.6). Among children without systemic arthritis, biologic DMARD use was most strongly associated with rheumatoid factor (RF)-positive polyarthritis (OR 4.3, 95% CI 2.9–6.6), psoriatic arthritis (PsA; OR 3.0, 95% CI 2.0–4.4), and uveitis (OR 2.8, 95% CI 2.1–3.7). Among children with systemic arthritis, 160 (65%) ever received a biologic DMARD; tumor necrosis factor inhibitor use was associated with polyarthritis (OR 2.5, 95% CI 3.8–16), while interleukin 1 inhibitor use was not. Conclusion About three-quarters of all children with JIA in the CARRA Registry received nonbiologic DMARD. Nearly one-half received biologic DMARD, and their use was strongly associated with RF-positive polyarthritis, PsA, uveitis, and systemic arthritis.