Insurance Status and Tumor Necrosis Factor Inhibitor Initiation Among Children With Juvenile Idiopathic Arthritis in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry
Authors' conclusion
Children who were publicly insured had more severe disease and polyarticular involvement at registry enrollment compared to those who were privately insured. Whereas overall TNFi use did not differ between children with different insurance types, publicly insured children were escalated more quickly, consistent with their increased disease severity.
Study context
- Population
- Children with newly diagnosed juvenile idiopathic arthritis (JIA) in the CARRA Registry
- Participants
- 1,086 children
- Exposure
- Public vs private insurance
- Outcome
- Odds of starting a TNFi in the first year and time from cDMARD to TNFi initiation
- Follow-up
- First year
Methodological detailsregistry-based
- Registry-based
Main finding
As reported in the abstract
- Odds of any TNFi use in the first year did not differ between publicly and privately insured children
- Publicly insured children escalated from cDMARD to TNFi more quickly than privately insured children
Observational data: associations, not effects.
Further findings
Disease severity at enrollment · enrollment visit
- Publicly insured children had significantly higher active joint counts and parent/patient global assessment scores
- Publicly insured children more likely to have polyarticular arthritis vs private insurance
Original publication
Insurance Status and Tumor Necrosis Factor Inhibitor Initiation Among Children With Juvenile Idiopathic Arthritis in the CARRA Registry. J Rheumatol. Published 15 December 2022. doi:10.
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