TY - JOUR
T1 - Comparative Effectiveness of a Second Tumor Necrosis Factor Inhibitor Versus a Non–Tumor Necrosis Factor Biologic in the Treatment of Patients With Polyarticular-Course Juvenile Idiopathic Arthritis
AU - for the Childhood Arthritis and Rheumatology Research Alliance Registry Investigators and the UK Juvenile Idiopathic Arthritis Biologics Register Investigators
AU - Mannion, Melissa L.
AU - Amin, Shahla
AU - Balevic, Stephen
AU - Chang, Min Lee
AU - Correll, Colleen K.
AU - Kearsley-Fleet, Lianne
AU - Hyrich, Kimme L.
AU - Beukelman, Timothy
AU - Aamir, R.
AU - Abulaban, K.
AU - Adams, A.
AU - Aguiar Lapsia, C.
AU - Akinsete, A.
AU - Akoghlanian, S.
AU - Al Manaa, M.
AU - AlBijadi, A.
AU - Allenspach, E.
AU - Almutairi, A.
AU - Alperin, R.
AU - Amarilyo, G.
AU - Ambler, W.
AU - Amoruso, M.
AU - Angeles-Han, S.
AU - Ardoin, S.
AU - Armendariz, S.
AU - Asfaw, L.
AU - Aviran Dagan, N.
AU - Bacha, C.
AU - Balboni, I.
AU - Balevic, S.
AU - Ballinger, S.
AU - Baluta, S.
AU - Barillas-Arias, L.
AU - Basiaga, M.
AU - Baszis, K.
AU - Baxter, S.
AU - Becker, M.
AU - Begezda, A.
AU - Behrens, E.
AU - Beil, E.
AU - Benseler, S.
AU - Bermudez-Santiago, L.
AU - Bernal, W.
AU - Bigley, T.
AU - Bingham, C.
AU - Binstadt, B.
AU - Black, C.
AU - Blackmon, B.
AU - Harel, L.
AU - Levinsky, Y.
N1 - Publisher Copyright:
© 2024 The Authors. Arthritis Care & Research published by Wiley Periodicals LLC on behalf of American College of Rheumatology.
PY - 2024/8
Y1 - 2024/8
N2 - Objective: The objective of this study was to compare the effectiveness of a second tumor necrosis factor inhibitor (TNFi) versus a non-TNFi biologic following discontinuation of a TNFi for patients with polyarticular-course juvenile idiopathic arthritis (pJIA). Methods: Using the Childhood Arthritis and Rheumatology Research Alliance Registry, patients with pJIA who started receiving a second biologic following a first TNFi were identified. Patients were required to have no active uveitis on the index date and a visit six months after the index date. Outcome measures included Clinical Juvenile Arthritis Disease Activity Score with a maximum of 10 active joints (cJADAS10), cJADAS10 inactive disease (ID; ≤2.5) and cJADAS10 minimal disease activity (MiDA; ≤5). Multiple imputation was used to account for missing data. Adjusted odds ratios (aORs) were calculated using propensity score quintiles to compare outcomes at six months following second biologic initiation. Results: There were 216 patients included, 84% initially received etanercept, and most patients stopped receiving it because of its ineffectiveness (74%). A total of 183 (85%) started receiving a second TNFi, and 33 (15%) started receiving a non-TNFi. Adalimumab was the most common second biologic received (71% overall, 84% of second TNFi), and tocilizumab was the most common non-TNFi second biologic received (9% overall, 58% of non-TNFi). There was no difference between receiving TNFi versus non-TNFi in cJADAS10 ID (29% vs 25%; aOR 1.23, 95% confidence interval [CI] 0.47–3.20) or at least MiDA (43% vs 39%; aOR 1.11, 95% CI 0.47–2.62) at six months. Conclusion: Most patients with pJIA started receiving TNFi rather than non-TNFi as their second biologic, and there were no differences in disease activity at six months. (Figure presented.).
AB - Objective: The objective of this study was to compare the effectiveness of a second tumor necrosis factor inhibitor (TNFi) versus a non-TNFi biologic following discontinuation of a TNFi for patients with polyarticular-course juvenile idiopathic arthritis (pJIA). Methods: Using the Childhood Arthritis and Rheumatology Research Alliance Registry, patients with pJIA who started receiving a second biologic following a first TNFi were identified. Patients were required to have no active uveitis on the index date and a visit six months after the index date. Outcome measures included Clinical Juvenile Arthritis Disease Activity Score with a maximum of 10 active joints (cJADAS10), cJADAS10 inactive disease (ID; ≤2.5) and cJADAS10 minimal disease activity (MiDA; ≤5). Multiple imputation was used to account for missing data. Adjusted odds ratios (aORs) were calculated using propensity score quintiles to compare outcomes at six months following second biologic initiation. Results: There were 216 patients included, 84% initially received etanercept, and most patients stopped receiving it because of its ineffectiveness (74%). A total of 183 (85%) started receiving a second TNFi, and 33 (15%) started receiving a non-TNFi. Adalimumab was the most common second biologic received (71% overall, 84% of second TNFi), and tocilizumab was the most common non-TNFi second biologic received (9% overall, 58% of non-TNFi). There was no difference between receiving TNFi versus non-TNFi in cJADAS10 ID (29% vs 25%; aOR 1.23, 95% confidence interval [CI] 0.47–3.20) or at least MiDA (43% vs 39%; aOR 1.11, 95% CI 0.47–2.62) at six months. Conclusion: Most patients with pJIA started receiving TNFi rather than non-TNFi as their second biologic, and there were no differences in disease activity at six months. (Figure presented.).
UR - http://www.scopus.com/inward/record.url?scp=85192273021&partnerID=8YFLogxK
U2 - 10.1002/acr.25339
DO - 10.1002/acr.25339
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C2 - 38556945
AN - SCOPUS:85192273021
SN - 2151-464X
VL - 76
SP - 1090
EP - 1098
JO - Arthritis Care and Research
JF - Arthritis Care and Research
IS - 8
ER -