When should the use of biological agents be considered in persistent oligoarticular juvenile idiopathic arthritis patients?


Polat M. C., Çelikel E., Tekin Z., Kurt T., Kaplan M. M., Güngörer V., ...More

European Journal of Pediatrics, vol.183, no.6, pp.2725-2731, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 183 Issue: 6
  • Publication Date: 2024
  • Doi Number: 10.1007/s00431-024-05538-y
  • Journal Name: European Journal of Pediatrics
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE
  • Page Numbers: pp.2725-2731
  • Keywords: Biological agents, Biological disease modifying antirheumatic drugs, Conventional disease modifying antirheumatic drugs, Methotrexate, Oligoarticular JIA
  • Ankara Yıldırım Beyazıt University Affiliated: No

Abstract

The purpose of this study was to compare the demographic and clinical characteristics of the groups with and without bDMARDs added to the treatment of persistent oligoarticular juvenile idiopathic arthritis (JIA) patients on methotrexate (MTX) and also to determine the predictors of adding bDMARDs to treatment. This study included 86 oligoarticular JIA patients on MTX. Patients were divided into two groups receiving MTX (n = 69) and MTX plus bDMARD (n = 17). Predictors of adding bDMARDs were investigated by comparing demographic, clinical features and laboratory findings. Gender, age at diagnosis, time elapsed from the onset of symptoms to diagnosis, and disease duration, the number and distribution of affected joint at the time of diagnosis were similar in both groups. The mean JADAS10 at the time of diagnosis were 18.8 ± 4.2 and 19.5 ± 6.4 in the MTX and MTX plus bDMARDs groups, respectively (p = 0.68). JADAS10 at 3rd and 6th month were significantly higher in patients on MTX plus bDMARDs (p = 0.001, p = 0.004, respectively). In multivariate analysis, the risk of adding bDMARD was shown to increase 1.24-fold (p = 0.004, 95% CI: 1.07–1.43) for each point increase on the JADAS 10 at 3rd months. The number (p = 0.64) or type (p = 0.18) of joint involvement at disease onset were not predictors of adding a bDMARD. Conclusion: JADAS10 indicating ongoing severe disease activity at 3rd and 6th months rather than baseline JADAS10 is associated with the addition of bDMARDs. (Table presented.)