Trends in prescription of biological agents and outcomes of juvenile idiopathic arthritis: results of the Dutch national Arthritis and Biologics in Children Register.
Ann Rheum Dis
; 74(7): 1379-86, 2015 Jul.
Article
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| MEDLINE
| ID: mdl-24641940
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 12â 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 12â 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 0.4â 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 15â 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.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Artritis Juvenil
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Pautas de la Práctica en Medicina
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Factores Biológicos
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Sistema de Registros
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Child
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Child, preschool
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Female
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Humans
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Male
País/Región como asunto:
Europa
Idioma:
En
Revista:
Ann Rheum Dis
Año:
2015
Tipo del documento:
Article
País de afiliación:
Países Bajos