Biologics with or without methotrexate in treatment of polyarticular juvenile idiopathic arthritis: effectiveness, safety and drug survival
Authors' conclusion
Additionally given MTX improves the effectiveness of biologic treatment in polyarticular JIA without seriously compromising treatment safety.
Study context
- Population
- Patients with polyarticular JIA treated with a first biologic (TNFi or tocilizumab), BIKER registry
- Participants
- 2,148 patients
- Exposure
- Biologic plus MTX vs biologic monotherapy
- Combination therapyn = 1,464
- Monotherapyn = 684reference
- Outcome
- Effectiveness, safety and drug survival
Methodological detailsnon-randomised, propensity score matching, BIKER registry
- Non-randomised
- Propensity score matching
- BIKER registry
Main finding
As reported in the abstract
- Disease activity declined significantly more upon combination therapy than upon biologic monotherapy
- In adjusted cohorts, patients receiving TNFi gained more benefit from additional MTX than patients treated with tocilizumab
- Propensity score matched cohorts
Observational data: associations, not effects.
Further findings
Median survival time of biologic therapy · Kaplan-Meier analysis
log rank test: P = 0.002
Safety
Serious adverse events
- Equal rate in both cohorts (events per 100 patient-years)
- 3.6
Gastrointestinal and hepatic adverse events
- Increased incidence with additional MTX; safety profile moderately affected
Original publication
Biologics with or without methotrexate in treatment of polyarticular juvenile idiopathic arthritis: effectiveness, safety and drug survival. Rheumatology (Oxford). Published 12 October 2022. doi:10.
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