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

Lookup NU author(s): Emerita Professor Helen Foster

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


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-mpdifying 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 5DMARDs 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. (C) 2016 The Authors. Published by Elsevier HS Journals, Inc.


Publication metadata

Author(s): Davies R, Carrasco R, Foster HE, Baildam EM, Chieng SEA, Davidson JE, Ioannou Y, Wedderburn LR, Thomson W, Hyrich KL

Publication type: Review

Publication status: Published

Journal: Seminars in Arthritis and Rheumatism

Year: 2016

Volume: 46

Issue: 2

Pages: 190-195

Print publication date: 01/10/2016

Online publication date: 08/06/2016

Acceptance date: 01/01/1900

ISSN (print): 0049-0172

ISSN (electronic): 1532-866X

Publisher: W B SAUNDERS CO-ELSEVIER INC

URL: http://dx.doi.org/10.1016/j.semarthrit.2016.06.001

DOI: 10.1016/j.semarthrit.2016.06.001


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