TY - JOUR
T1 - Trends in prescription of biological agents and outcomes of juvenile idiopathic arthritis
T2 - results of the Dutch national Arthritis and Biologics in Children Register
AU - Otten, Marieke H.
AU - Anink, Janneke
AU - Prince, Femke H. M.
AU - Twilt, Marinka
AU - Vastert, S. J.
AU - ten Cate, Rebecca
AU - Hoppenreijs, Esther P. A. H.
AU - Armbrust, Wineke
AU - Gorter, Simone L.
AU - van Pelt, Philomine A.
AU - Kamphuis, Sylvia S. M.
AU - Dolman, Koert M.
AU - Swart, Joost F.
AU - van den Berg, J. Merlijn
AU - Koopman-Keemink, Yvonne
AU - van Rossum, Marion A. J.
AU - Wulffraat, NM
AU - van Suijlekom-Smit, Lisette W. A.
PY - 2015/7
Y1 - 2015/7
N2 - 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.
AB - 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.
KW - RHEUMATOID-ARTHRITIS
KW - TREATMENT RESPONSE
KW - ETANERCEPT
KW - THERAPY
KW - REMISSION
KW - FEATURES
KW - TRIAL
KW - JIA
U2 - 10.1136/annrheumdis-2013-204641
DO - 10.1136/annrheumdis-2013-204641
M3 - Article
C2 - 24641940
SN - 0003-4967
VL - 74
SP - 1379
EP - 1386
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
IS - 7
ER -