Session Title: ACR/ARHP Combined Abstract Session: Pediatric Rheumatology
Session Type: Combined Abstract Sessions
To avoid the progression of joint damage, early decision making is important in JIA patients who failed to achieve sustainable clinical remission by the 1st biologic agents. Therefore, we examined whether the scores of DAS 28 at 3 months after initiating the 1st biologic therapy can predict subsequent sustainable remission with the 1st biologic agents in the polyarticular JIA (pJIA) patients.
pJIA patients who had started the 1st biologic agents at the Kagoshima University Hospital were involved in this study. The patients were divided into two groups according to the subsequent efficacy of the 1st biologic agents; patients who successfully maintained clinical remission with the 1st biologic agents (remission group) and the patients who were eventually obliged to switch to the 2nd biologic agents due to the lack of efficacy (switching group).
Scores of DAS28 of 14 pJIA patients involved in this study gradually improved after starting the 1st biologic agents. However, 6 of 14 patients (43%) failed to maintain their clinical remission and eventually switched to the 2nd biologic agents at 9 months (median, range 6-18 months) after initiating the 1st biologic agents (switching group). The rest of 8 patients (57%) achieved sustainable clinical remission with the 1st biologic agents (remission group).
There were no significant differences between the two patients’ groups as to sex ratio, age at onset, disease duration at initiating biologics. However, Das28 score at 3 months of the 1st biologic therapy was significantly higher in switching group (1.75±1.0) than that of remission group (3.8±0.87)(p=0.001) (Figure 1). The receiver operating characteristic (ROC) analysis revealed that the cut-off point of DAS28 to discriminate the two patients’ group was 2.37 (sensitivity 100%, specificity 88.9%).
Conclusion: Evaluating DAS28 at 3 month after initiating biologic therapy was useful in predicting subsequent sustainable clinical remission. Patients with DAS28 >2.37 at 3 month after initiating the 1st biologic agents should be considered to switch to the 2nd biologic agents in the treatment of pJIA.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/can-das-28-at-3-months-after-the-1st-biologic-therapy-predict-subsequent-sustainable-clinical-remission-in-polyarticular-juvenile-idiopathic-arthritis-patients/