Disease-modifying antirheumatic drug use in the treatment of juvenile idiopathic arthritis: a cross-sectional analysis of the CARRA Registry.

TitleDisease-modifying antirheumatic drug use in the treatment of juvenile idiopathic arthritis: a cross-sectional analysis of the CARRA Registry.
Publication TypeJournal Article
Year of Publication2012
AuthorsBeukelman T, Ringold S, Davis TE, DeWitt EMorgan, Pelajo CF, Weiss PF, Kimura Y
Corporate AuthorsCARRA Registry Investigators
JournalJ Rheumatol
Volume39
Issue9
Pagination1867-74
Date Published2012 Sep
ISSN0315-162X
KeywordsAdolescent, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Antirheumatic Agents, Arthritis, Juvenile, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Male, Methotrexate, Physician's Practice Patterns, Registries, Tumor Necrosis Factor-alpha
Abstract

OBJECTIVE: To characterize disease-modifying antirheumatic drug (DMARD) use for children with juvenile idiopathic arthritis (JIA) in the United States and to determine patient factors associated with medication use.

METHODS: We analyzed cross-sectional baseline enrollment data from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from May 2010 through May 2011 for children with JIA. Current and prior medication use was included. We used parsimonious backward stepwise logistic regression models to calculate OR to estimate associations between clinical patient factors and medication use.

RESULTS: We identified 2748 children with JIA with a median disease duration of 3.9 years from 51 US clinical sites. Overall, 2023 (74%) had ever received a nonbiologic DMARD and 1246 (45%) had ever received a biologic DMARD. Among children without systemic arthritis, methotrexate use was most strongly associated with uveitis (OR 5.2, 95% CI 3.6-7.6), anticitrullinated protein antibodies (OR 4.5, 95% CI 1.7-12), and extended oligoarthritis (OR 4.1, 95% CI 2.5-6.6). Among children without systemic arthritis, biologic DMARD use was most strongly associated with rheumatoid factor (RF)-positive polyarthritis (OR 4.3, 95% CI 2.9-6.6), psoriatic arthritis (PsA; OR 3.0, 95% CI 2.0-4.4), and uveitis (OR 2.8, 95% CI 2.1-3.7). Among children with systemic arthritis, 160 (65%) ever received a biologic DMARD; tumor necrosis factor inhibitor use was associated with polyarthritis (OR 2.5, 95% CI 3.8-16), while interleukin 1 inhibitor use was not.

CONCLUSION: About three-quarters of all children with JIA in the CARRA Registry received nonbiologic DMARD. Nearly one-half received biologic DMARD, and their use was strongly associated with RF-positive polyarthritis, PsA, uveitis, and systemic arthritis.

DOI10.3899/jrheum.120110
Alternate JournalJ. Rheumatol.
PubMed ID22859354
PubMed Central IDPMC3763075
Grant List5KL2 RR025776 / RR / NCRR NIH HHS / United States
KL2 RR025776 / RR / NCRR NIH HHS / United States
RC2AR058934 / AR / NIAMS NIH HHS / United States