Comparing Canadian paediatric rheumatology practice to the 2019 ACR Juvenile Idiopathic Arthritis guidelines: results from the CAPRI Registry
Authors' conclusion
Canadian paediatric rheumatology practices were in line with many 2019 JIA guideline recommendations before their publication, except for frequent use of oral MTX and infrequent direct escalation from NSAIDs to bDMARDs in sacroiliitis and enthesitis.
Study context
- Population
- Newly diagnosed children with JIA, CAPRI Registry, Canada, 2017 to 2019; Canadian paediatric rheumatologists (survey)25/61 physicians surveyed
- Participants
- 266 participants
- Exposure
- Observed Canadian JIA practice vs 2019 ACR JIA guideline recommendations
- Outcome
- Observed adherence rates to 2019 ACR JIA guideline recommendations vs a priori target adherence rates
Methodological detailsprospectively collected registry data, Kaplan-Meier survival curves
- Prospectively collected registry data
- Kaplan-Meier survival curves
Main finding
As reported in the abstract
Adherence to guideline recommendations
- Recommendations that would have met proposed targets
- 13/19 (68%)
- Recommendations with ≥80% observed adherence
- 10/19 (53%)
- Use of subcutaneous vs oral MTX
- 53%
- Escalation from NSAIDs to bDMARDs in sacroiliitis
- 31%
- Escalation from NSAIDs to bDMARDs in enthesitis
- 0%
Observational data: associations, not effects.
Further findings
Survey: physicians' proposed adherence targets
- Survey response rate
- 25/61 (41%)
- Respondents who felt targets should vary by strength of recommendation and quality of evidence
- 64%
- Mean target, strong recommendations with high-quality evidence
- 84%
- Mean target, conditional recommendations with very low-quality evidence
- 29%
Cumulative incidence of DMARD start · 12 weeks
- Polyarthritis receiving sDMARDs
- 95%
- Systemic JIA receiving bDMARDs
- 38%
- Sacroiliitis receiving bDMARDs
- 22%
- Kaplan-Meier estimates
Original publication
Comparing Canadian paediatric rheumatology practice to the 2019 ACR Juvenile Idiopathic Arthritis guidelines: results from the CAPRI Registry. Rheumatology (Oxford). Published 17 August 2022. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →