Biologic switching patterns among children with non-systemic juvenile idiopathic arthritis
Authors' conclusion
During a median 6.3-year follow-up biologic switching was observed in more than one third, primarily due to inefficacy.
Study context
- Population
- Children with non-systemic juvenile idiopathic arthritis (JIA) initiating their first biologic drug between January 1st, 2012, and March 1st, 2021
- Participants
- 200 children
- Exposure
- Non-switchers vs switchers; early switchers vs late switchers
- Outcome
- Pattern, timing, frequency and reasons for bDMARD switching
Methodological detailsretrospective observational, electronic medical records
- Retrospective observational
- Electronic medical records
Main finding
As reported in the abstract
bDMARD switching · median 6.3 years
- Switched to a different biologic disease-modifying antirheumatic drugs (bDMARD)
- 37%
- Switched at least twice
- 17.5%
- Switched three or more times
- 6%
- Reason for switching: inefficacy
- 57%
- Reason for switching: injection/infusion reactions
- 15%
- Reason for switching: uveitis
- 13%
- Late switchers (> 6 months), switched primarily due to inefficacy
- 77%
Observational data: associations, not effects.
Further findings
First-line bDMARD (all started a tumor necrosis factor inhibitor (TNFi))
- Etanercept (ETN) as initial bDMARD
- 49.5%
- Other TNFis as initial bDMARD
- 50.5%
- Starting ETN first-line more likely to be switchers than starting another TNFi
Age at diagnosis
- Median age at diagnosis (years)
- 7.7
Original publication
Biologic switching patterns among children with non-systemic juvenile idiopathic arthritis. Pediatr Rheumatol Online J. Published 23 September 2023. doi:10.
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