Treatment prescribing patterns in patients with juvenile idiopathic arthritis (JIA): Analysis from the UK Childhood Arthritis Prospective Study (CAPS)☆☆,

https://doi.org/10.1016/j.semarthrit.2016.06.001Get rights and content
Under a Creative Commons license
open access

Abstract

Objective

Initial treatment of juvenile idiopathic arthritis (JIA) is largely based on the extent of joint involvement, disease severity and ILAR category. The licensing of biologic therapies for JIA has expanded treatment options.

The aims of the study are (1) to describe treatment prescribing patterns in JIA over the first 3 years following first presentation to paediatric rheumatology and (2) to determine whether patterns of treatment have changed as biologics have become more widely available.

Methods

Children with at least 3 years of follow-up within the Childhood Arthritis Prospective Study (CAPS) were included.

For analysis, children were placed into one of five groups according to their initial presentation to paediatric rheumatology: oligoarthritis (oJIA), polyarthritis (pJIA), systemic (sJIA), enthesitis-related arthritis (ERA) and psoriatic arthritis (PsA). Treatment patterns over 3 years were described.

Results

Of 1051 children, 58% received synthetic disease-modifying anti-rheumatic drugs (sDMARD) and 20% received biologics over the 3 years. Use of sDMARDs and biologics was higher in more severe disease presentations (sJIA and pJIA); however, 35% and 10% who presented with oJIA were also treated with sDMARDs and biologics, respectively. The number of children receiving sDMARD after 2006 was higher (p = 0.02); however, there was no difference in biologic prescribing before and after 2006 (p = 0.4).

Conclusions

A high proportion of children presenting with JIA received sDMARDs plus/minus biologics during 3 years of follow-up. This was most common for patients with severe JIA but was also prescribed for patients with oligoarticular disease, despite the lack of evidence for effectiveness in this category.

Keywords

Juvenile idiopathic arthritis
Biologic therapy
DMARD therapy
Treatment

Cited by (0)

We thank the Arthritis Research UK for their support of Childhood Arthritis prospective Study: Arthritis Research UK grant number 20542.

This report includes independent research supported by the National Institute for Health Research Biomedical Research Unit Funding Scheme. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

Y.I. is supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre and Arthritis Research UK Grant 20164.

☆☆

R.D.—none, R.C.—none, H.E.F.—Pfizer, Abbvie, Sobi, Roche, Chugai Educational & Travel Bursaries (Honoraria), E.M.B.—none, S.E.A.C.—none, J.E.D.—AbbVie travel expenses, Y.I.—none, L.R.W.—none, W.T.—none, and K.L.H.—Abbvie & Pfizer Inc. (Honoraria).

The Childhood Arthritis Prospective Study (CAPS) is funded by a research grant to the University of Manchester, United Kingdom from Arthritis Research UK, United Kingdom (Grant no. 20542). This research is also supported by the National Institute for Health, United Kingdom Research Biomedical Research Unit Funding Scheme.

1

W.T. and K.L.H. contributed equally to this study.