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Lookup NU author(s): Emerita Professor Helen Foster
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
OBJECTIVES:To investigate real-world short-term outcomes among patients with systemic JIA starting tocilizumab or anakinra.METHODS:This analysis included all systemic JIA patients within the UK Biologics for Children with Rheumatic Diseases study starting tocilizumab or anakinra between 2010 and 2016. Disease activity was assessed at baseline and one year. At one year the following outcomes were assessed: minimal disease activity, clinically inactive disease, 90% ACR Paediatric response (ACRPedi90). Univariable logistic regression was used to identify baseline characteristics associated with these outcomes. Multiple imputation was used to account for missing data.RESULTS:Seventy-six systemic JIA patients were included (54 tocilizumab; 22 anakinra). More patients starting anakinra as their first biologic compared with tocilizumab (86% vs 63%; P = 0.04), with shorter disease duration (1 vs 2 years; P = 0.003) and higher frequency of prior macrophage activation syndrome (37% vs 8%; P = 0.004). Overall, at one year, 42% achieved ACRPedi90, 51% minimal disease activity, and 39% clinically inactive disease, with similar responses seen between the two drugs. Response was not associated with baseline disease characteristics. Fifteen (20%) patients stopped biologic treatment by one year. Treatment survival was better with tocilizumab (89% at one year vs 59% anakinra; P = 0.002), with three stopping for anakinra injection-related problems.CONCLUSION:In this real-world cohort of patients with systemic JIA receiving tocilizumab or anakinra, approximately half achieved a minimal disease state by one year. Treatment responses appeared similar between the two therapies albeit with better persistence observed with tocilizumab.
Author(s): Kearsley-Fleet L, Beresford MW, Davies R, De Cock D, Baildam E, Foster HE, Southwood TR, Thomson W, Hyrich KL
Publication type: Article
Publication status: Published
Journal: Rheumatology
Year: 2019
Volume: 58
Issue: 1
Pages: 94-102
Print publication date: 01/01/2019
Online publication date: 21/08/2018
Acceptance date: 17/07/2018
Date deposited: 08/11/2018
ISSN (print): 1462-0324
ISSN (electronic): 1462-0332
Publisher: Oxford University Press
URL: https://doi.org/10.1093/rheumatology/key262
DOI: 10.1093/rheumatology/key262
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