Incidence and reasons for biologic and targeted synthetic DMARD switching in juvenile idiopathic arthritis: a real- life stratified analysis
Authors' conclusion
This real-life study provides data on different switch patterns in various subtypes of JIA, confirming that patients with systemic JIA needed more switching, did more swapping strategies, and had more risk for switching due to inefficacy.
Study context
- Population
- Juvenile idiopathic arthritis (JIA) patients prescribed ≥ 1 b/tsDMARD, multi-hospital electronic health record (EHR) registry, 2000–2024321 courses
- Participants
- 213 patients
- Exposure
- JIA subtypes: oligoarticular, polyarticular, juvenile spondyloarthritis (JSpA) and systemic JIA
- Oligoarticularn = 69
- Polyarticularn = 76
- JSpAn = 43
- Systemic JIAn = 25
- Outcome
- b/tsDMARD switching rates and switching due to inefficacy (IR per 100 patient-years)
Methodological detailsmulti-hospital EHR registry, stratified analysis, Cox multivariate regression
- Multi-hospital EHR registry
- Stratified analysis
- Cox multivariate regression
Main finding
As reported in the abstract
b/tsDMARD switching, IR per 100 patient-years
Systemic JIA
17.01
Incidence rates (IR) · CI 11.20–25.84 · per 100 patients-year
- Overall switching IR per 100 patient-years
- 7.32 [6.01-8.90]
- Total b/tsDMARD switches
- 100
- Patients switched at least once
- 32.05%
- Systemic JIA more likely to swap
- P ≤ 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Systemic JIA | HR (CI) | P value | |
|---|---|---|---|---|
| Switching due to inefficacy, IR per 100 patient-yearsAdjusted multivariate Cox model | IR 9.28 (CI 5.27–16.34) per 100 patients-year | 2.43 (1.01–5.89) | P = 0.04 | |
| 0.20.5125Hazard ratio (log scale) |
- Switching due to inefficacy, IR per 100 patient-years — Global IR of switching due to inefficacy
- 4.53 [3.53-5.82]
Original publication
Incidence and reasons for biologic and targeted synthetic DMARD switching in juvenile idiopathic arthritis: a real- life stratified analysis. Pediatr Rheumatol Online J. Published 24 April 2025. doi:10.
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