Session Information
Session Type: Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Tofacitinib (TOFA, NCT02592434) and Baricitinib (BARI, NCT03773978) are Janus kinase inhibitors (JAKi) that are approved for or being tested for nsJIA treatment. We aim to evaluate the effectiveness and safety profiles of JAKi, vs. biological agent (BA) with or without Methotrexate (MTX) combination in treating children with nsJIA.
Methods: Studies written in English language and published in ClinicalTrial.gov, PubMed, EMBASE, Cochrane are searched from establishment of the databases to May 2023. Randomized studies conducted in the nsJIA population, investigated effectiveness of JAKi or BA, and reported JIA-ACR responses with/without adverse event outcomes are eligible. The primary outcome of clinical efficacy was measured by JIA-ACR70 responses at 16+/-4 weeks and secondary outcomes include serious adverse events (SAE). Bayesian Network meta-analyses (BNMA) evaluate the effectiveness and safety outcomes of JAKis and BAs with/without MTX.BNMA are conducted separately for efficacy and safety outcomes. League table reports results for all pairwise comparisons.
Results: The initial search query yielded 2,475 citations. Fifteen randomized controlled trials (RCT, 6 parallel and 9 withdrawal trials) met the study inclusion criteria. The meta-analyses investigated 6 BA, 3 BA+MTX combination, and two JAKi (i.e. TOFA and BARI). MTX background treatment was allowed, rarely mandated. The trial design and sample characteristics are summarized in Table 1. The aggregate summary statistics reported for the efficacy and safety outcomes are presents in Figure 1. The BNMA analyzed data from a total of 1,796 patients, estimates of odds ratio (OR) and corresponding 90% credible intervals are reported in Table 2 for the efficacy (upper triangle) and safety outcomes (lower triangle).
Conclusion: No significant differences are observed for pairwise comparisons among TOFA, BARI and BAs either alone or in combination with MTX for efficacy and safety outcomes when used for treating children with nsJIA. The BNMA indirect comparisons are limited, given that trials differ greatly in participants age, duration of disease, % of MTX background therapy, whether the trial mandate patients with inadequate responses to composition of DMARD or NSAID to be eligible, as well as the composition of JIA subtypes. The SAE may be defined differently in different studies. Future studies will expand the meta-analyses by including non RCT studies and individual patients’ data.
To cite this abstract in AMA style:
Huang B, Li Y, Yue X, Andorf S, Lovell D, Brunner H. Network Meta Analyses of the Effectiveness and Safety Profiles of Janus Kinase Inhibitors and Biologic Agents in Treating Children with Non-systemic Juvenile Idiopathic Arthritis (nsJIA) [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/network-meta-analyses-of-the-effectiveness-and-safety-profiles-of-janus-kinase-inhibitors-and-biologic-agents-in-treating-children-with-non-systemic-juvenile-idiopathic-arthritis-nsjia/. Accessed .« Back to ACR Convergence 2023
ACR Meeting Abstracts - https://acrabstracts.org/abstract/network-meta-analyses-of-the-effectiveness-and-safety-profiles-of-janus-kinase-inhibitors-and-biologic-agents-in-treating-children-with-non-systemic-juvenile-idiopathic-arthritis-nsjia/