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Abstract Number: 0312

Efficacy and Safety of Tocilizumab in Children with Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis

Kainat Jahangir1, Meer Murtaza2, Rida Ul Jannat3, Muhammad Arham4, Najam Gohar5, Faseeh Haider6, Rohma Ahmed7, FNU Raja8, Rabie Habib9, Mahnoor Umar10, Hira Saleem11, Faizan Ahmed12, Tehmasp Mirza13, Momina Siddiqui14, Muhammad Umer15, Haziq Ahmed16, Maryam Anwar17, Rehab Bint e Tahir18, Yusra Junaid19 and Ramsha Ali20, 1Dow Medical College, Karachi, Pakistan, 2Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan, 3Wake Forest University, Winston Salem North Carolina, Winston-Salem, NC, 4Sheikh Zayed Medical College, Lahore, Pakistan, 5Ameer Ud Din Medical College, Sialkot, Pakistan, 6Allama Iqbal Medical college, Lahore, Punjab, Pakistan, 7Fatima Jinnah Medical University, Lahore, Pakistan, 8Federal Medical and Dental College, Islamabad, Pakistan, 9Baylor College of Medicine, Texas, Pakistan, 10Nassau University Medical Center, New York, 11Houston Methodist Hospital, Texas, 12Corewell health, dearborn, MI, 13Shalamar Medical and Dental College, Lahore, Pakistan, 14Rawalpindi Medical Univeristy, Rawalpindi, Punjab, Pakistan, 15King Edward Medical College, Lahore, Pakistan, 16Sheikh Khalifa bin zayed Alnahyan Medical College, Lahore, Punjab, Pakistan, 17Baqai Medical University, Karachi, Pakistan, 18-, lahore, 19Dow University of health and sciences, karachi, Pakistan, 20Peoples University of Medical and Health Sciences SBA, NawabShah, Pakistan

Meeting: ACR Convergence 2025

Keywords: Juvenile idiopathic arthritis

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Session Information

Date: Sunday, October 26, 2025

Title: (0306–0336) Osteoarthritis – Clinical Poster I

Session Type: Poster Session A

Session Time: 10:30AM-12:30PM

Background/Purpose: Juvenile idiopathic arthritis (JIA) encompasses various chronic inflammatory conditions in children that lead to joint discomfort and potential disability. Tocilizumab, an antibody targeting interleukin-6, has shown effectiveness in treating rheumatoid arthritis and may also help children with JIA. Due to the distinct characteristics of the disease, its efficacy and safety in children require assessment.

Methods: A systematic literature review was conducted by searching PUBMED, EMBASE, COCHRANE, SCIENCE DIRECT, and SCOPUS for RCTs and non-RCTs assessing the efficacy and safety of Tocilizumab in Juvenile Idiopathic Arthritis up to 2025. The primary outcomes assessed were disease activity improvement, joint inflammation reduction, Functional enhancements (i.e., CHAQ score), and QOL scores. Statistical analysis was conducted in R (v2025.05.0+496).

Results: A meta-analysis involving 11 studies with a total of 929 children diagnosed with Juvenile Idiopathic Arthritis (JIA) indicated that Tocilizumab led to improved disease activity, achieving a pooled risk ratio of 3.77 (95% CI 2.32-6.13, p=0.060) when compared to the control group. When examining study types, the subgroup analysis revealed proportions of 0.04 (95% CI 0.03-0.07) for non-RCTs and 0.10 (95% CI 0.07-0.14) for RCTs (p=0.0040). The average Childhood Health Assessment Questionnaire (CHAQ) score was 1.67, indicating functional improvement; the quality of life score was 45.74. In terms of JIA subtypes, the proportions were 0.11 (95% CI 0.06-0.18) for polyarticular JIA and 0.06 (95% CI 0.04-0.08) for systemic JIA (p=0.0502). Adverse events were reported in 7% of the participants (pooled proportion 0.07, 95% CI 0.05-0.09), primarily mild infections, with no serious adverse events noted. Sensitivity analysis demonstrated the stability of the results (range 0.06-0.07), with moderate heterogeneity (I²=48.8%).

Conclusion: Our findings support using Tocilizumab in managing Juvenile Idiopathic Arthritis, demonstrating improved outcomes without significantly increasing adverse events. These results offer a clearer understanding of its clinical value and underscore the need for further high-quality randomized trials.

Supporting image 1Graphical Abstract


Disclosures: K. Jahangir: None; M. Murtaza: None; R. Jannat: None; M. Arham: None; N. Gohar: None; F. Haider: None; R. Ahmed: None; F. Raja: None; R. Habib: None; M. Umar: None; H. Saleem: None; F. Ahmed: None; T. Mirza: None; M. Siddiqui: None; M. Umer: None; H. Ahmed: None; M. Anwar: None; R. Bint e Tahir: None; Y. Junaid: None; R. Ali: None.

To cite this abstract in AMA style:

Jahangir K, Murtaza M, Jannat R, Arham M, Gohar N, Haider F, Ahmed R, Raja F, Habib R, Umar M, Saleem H, Ahmed F, Mirza T, Siddiqui M, Umer M, Ahmed H, Anwar M, Bint e Tahir R, Junaid Y, Ali R. Efficacy and Safety of Tocilizumab in Children with Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/efficacy-and-safety-of-tocilizumab-in-children-with-juvenile-idiopathic-arthritis-a-systematic-review-and-meta-analysis/. Accessed .
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