ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 274

Treatment Prescribing Patterns in a Cohort of Patients with Juvenile Idiopathic Arthritis (JIA). Data from the Childhood Arthritis Prospective Study

Rebecca Davies1, Roberto Carrasco2, Helen Foster3, Eileen Baildam4, Alice Chieng5, Joyce Davidson6, Yiannis Ioannou7, Lucy R. Wedderburn8, Wendy Thomson9, Kimme L. Hyrich10 and on Behalf Of Childhood Arthritis Prospective Study (CAPS)11, 1Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom, 2Centre for Musculoskeletal Research, Institute of Inflammation and Repair, The University of Manchester, Manchester, United Kingdom, 3Newcastle University, Newcastle, United Kingdom, 4Paediatric Rheumatology, Alder Hey Children's Foundation NHS Trust, Liverpool, United Kingdom, 5Manchester Children's Hospital, Manchester, United Kingdom, 6Royal Hospital for Sick Children, Glasgow, United Kingdom, 7Arthritis Research UK Centre for Adolescent Rheumatology, University College London, London, United Kingdom, 8Rheumatology Unit, Arthritis Research UK Centre for Adolescent Rheumatology at University College London, Great Ormond Street Hospital and UCLH, University College London, London, United Kingdom, 9Institute of Inflammation and Repair, The University of Manchester, Manchester, United Kingdom, 10Centre for Musculoskeletal Research, University of Manchester, Manchester, United Kingdom, 11university of Manchester, Manchester, United Kingdom

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Biologic drugs, DMARDs, juvenile idiopathic arthritis (JIA) and treatment options

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Session Title: Pediatric Rheumatology - Clinical and Therapeutic Aspects: Juvenile Idiopathic Arthritis

Session Type: Abstract Submissions (ACR)

Background/Purpose: Juvenile idiopathic arthritis (JIA) is a heterogenous disease, classified according to the International League of Associations for Rheumatology (ILAR). Initial treatment is based largely on disease severity; intra-articular injections for oligoarthritis, methotrexate (MTX) for polyarthritis and systemic presentations. The recent licensing of biologic therapies for use in JIA has revolutionised treatment. It is not known what proportion of children who present with polyarthritis will require biologic therapy. Although not studied formally, it is recognised a proportion of children with oligoarthritis, may also require systemic therapy to control symptoms.  Therefore, the aim of this study was to describe prescribing patterns within new onset JIA patients over the first 3 years following presentation to rheumatology.

Methods:

Children with at least 3 years of follow-up within the Childhood Arthritis Prospective Study (CAPS), a prospective observational inception study of inflammatory arthritis, were included.

For analysis, children were grouped into a disease pattern according to the physician-assigned ILAR category and number of active joints at first presentation (baseline): oligoarticular, polyarticular, systemic (sJIA) and enthesitis-related arthritis (ERA). Treatment exposures over the 3 year period were determined and categorised into NSAID, intra-articular steroids, disease modifying anti-rheumatic drug (DMARD) including MTX and biologics including etanercept (ETN) and infliximab (INF).

Results:

790 children had 3 years of follow-up. Of these, 78 had missing ILAR subtype data and were excluded, leaving 712 in total (406 oligoarticular, 221 polyarticular, 42 sJIA and 43 ERA). Over a 3 year period, almost 100% of children with polyarticular and 50% with oligoarticular presentation received a DMARD. 46% with polyarticular and 17% with oligoarticular presentation also received a biologic (Figure 1). The most recent ILAR category among children with oligoarticular onset who received a biologic included 39% extended oligoarthritis, 19% polyarthritis, 4% ERA, 11% other;  27% had persistent oligoarthritis. All sJIA patients were treated with DMARDs with 36% having biologics, primarily ETN and INF. 63% of ERA patients received a DMARD, with 26% later receiving a biologic.

Conclusion:

Over a three year period almost all patients with a polyarticular presentation received treatment with MTX and almost 50% also received a biologic therapy. A high proportion of children with an oligoarticular presentation also went on to receive DMARDs and biologics, with many children receiving this treatment for persistent oligoarthritis. This is despite the lack of clinical trial evidence for effectiveness in this subtype. Further studies on the efficacy/effectiveness in this subtype should be undertaken to ensure appropriate use of advanced therapies in this population.

Arthritis pattern at presentation

N

Ever had a DMARD, n(%)

Ever had a biologic, n(%)

Oligoarthritis

406

204 (50)

70 (17) 

 

Polyarthritis

221

217 (98)

 

98 (44)

 

Systemic arthritis

42

42 (100)

 

15 (36)

 

Enthesitis-related arthritis

43

27 (63)

 

11 (26)

 


Disclosure:

R. Davies,
None;

R. Carrasco,
None;

H. Foster,
None;

E. Baildam,
None;

A. Chieng,
None;

J. Davidson,
None;

Y. Ioannou,
None;

L. R. Wedderburn,
None;

W. Thomson,
None;

K. L. Hyrich,
None;

O. B. O. Childhood Arthritis Prospective Study (CAPS),
None.

  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/treatment-prescribing-patterns-in-a-cohort-of-patients-with-juvenile-idiopathic-arthritis-jia-data-from-the-childhood-arthritis-prospective-study/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.