Background/Purpose: Several countries have implemented non-pharmaceutical interventions (NPIs) against the coronavirus disease 2019 (COVID-19) pandemic. We investigated the impact of NPIs on the incidence of juvenile idiopathic arthritis (JIA) and rheumatoid arthritis (RA) in Korea and that of the COVID-19 pandemic on healthcare services and medical expenses for patients with JIA and RA.

Methods: We included all cases of JIA and RA reported between January 2016 and February 2021 based on the National Health Insurance Service data. NPI period was defined as February 2020–February 2021. We evaluated the change in incidence trends for JIA and RA before and after NPI implementation using segmented regression analysis. Changes in health care utilization and medical costs for JIA and RA before and after NPI implementation were also investigated.

Results: A significant decreasing trend was observed over time in the pre-NPI period for both JIA and RA (-0.015 per 1,000,000, 95% confidence interval [CI] -0.021 to -0.009, p < 0.001 in JIA; -0.110 per 1,000,000, 95% CI -0.177 to -0.044, p=0.002 in RA). However, there was no significant change in the incidence trend between the NPI period and the pre-NPI period for both JIA and RA. A significant decrease was observed in the annual average number of hospitalizations, the mean days of hospitalization and the number of annual OPD visits for any cause per patient during the NPI period for RA, whereas there was no statistically significant change for JIA. Further, the prescription days per OPD visit significantly increased during the NPI period compared to those in the pre-NPI period for RA, conversely, they significantly decreased during the NPI period compared to those in the pre-NPI period for JIA (28.0±29.6 vs 23.0±29.0, p < 0.001). Although the total annual medical costs per patient for RA decreased during the NPI period, there was no significant difference in those for JIA compared to before NPI.

Conclusion: There was no change in the incidence of RA and JIA during the COVID pandemic period. In RA, there were changes in the medical utilization pattern and cost of treatment during the pandemic period, whereas no significant changes were observed in JIA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/incidence-and-disease-burden-of-juvenile-idiopathic-arthritis-and-rheumatoid-arthritis-after-non-pharmaceutical-interventions-in-the-covid-19-era-a-nationwide-observational-study-in-korea/