Pharmacological treatment patterns in patients with juvenile idiopathic arthritis in the Netherlands: a real-world data analysis
Authors' conclusion
This paper reveals the complexity of pharmacological treatment in JIA, as indicated by: the variety of mono- and combination therapies prescribed, substantial variation in medication prescriptions between subtypes, most patients receiving two or more treatment lines, and the large number of unique treatment sequences.
Study context
- Population
- JIA patients aged 0–18 years receiving systemic therapy, 1 April 2011 to 31 March 2019, single centre, the Netherlandsmedian 4.2 years follow-up
- Participants
- 236 patients
- Exposure
- Non-systemic JIA vs Systemic JIA
- Outcome
- Medication prescription patterns, incl. duration, sequence and reasons for discontinuation
Methodological detailssingle-centre, retrospective analysis of prospective data, electronic medical records, descriptive statistics, Sankey diagrams and Kaplan-Meier survival methods
- Single-centre
- Retrospective analysis of prospective data
- Electronic medical records
- Descriptive statistics, Sankey diagrams and Kaplan-Meier survival methods
Main finding
As reported in the abstract
Medication prescription patterns
- Medicines analysed (prescribed as monotherapy or combination therapy)
- 20
- Monotherapy medicines
- 15
- Unique combinations
- 48
- Non-systemic JIA: synthetic DMARDs (always incl. MTX)
- 99.5%
- Non-systemic JIA: biologic DMARD (mostly adalimumab or etanercept)
- 43.9%
- Biologic DMARD, oligoarticular persistent ANA-positive JIA
- 30.9%
- Biologic DMARD, polyarticular RF-positive JIA
- 90.9%
- Systemic JIA: biologic DMARD (always incl. anakinra)
- 91.7%
- Prescriptions by class involving combination therapy
- 32.6%
- Patients with subsequent treatment lines after unsuccessful first-line treatment
- 56.8%
- Unique treatment sequences
- 68
Observational data: associations, not effects.
Further findings
Reasons for DMARD discontinuation
- Remission (most common)
- 44.7%
- Adverse events
- 28.9%
- Ineffectiveness
- 22.1%
Safety
DMARD discontinuation due to adverse events
- Adverse events as reason for DMARD discontinuation
- 28.9%
Original publication
Pharmacological treatment patterns in patients with juvenile idiopathic arthritis in the Netherlands: a real-world data analysis. Rheumatology (Oxford). Published 18 May 2022. doi:10.
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