Patterns of etanercept use in juvenile idiopathic arthritis in the Childhood Arthritis and Rheumatology Research Alliance Registry

Pediatric Rheumatology Online Journal

for the CARRA Registry Investigators¹  Scott Stryker²  Jennifer Schenfeld²  Roland A. Matsouaka³  Marinka Twilt⁴  Timothy Beukelman⁵  Dax G. Rumsey⁶  Aimee Lougee⁷  David Collier⁸  Yukiko Kimura⁹ 

[1] ;Center for Observational Research, Amgen Inc., One Amgen Center Drive;Department of Biostatistics and Bioinformatics, Duke University, Duke Clinical Research Institute;Department of Pediatrics, Alberta Children’s Hospital, Cumming School of Medicine, University of Calgary;Department of Pediatrics, University of Alabama at Birmingham;Department of Pediatrics, University of Alberta;Duke University, Duke Clinical Research Institute;Global Medical Affairs, Amgen Inc., One Amgen Center Drive;Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center, Hackensack Meridian School of Medicine;

关键词: Arthritis, juvenile;    Cohort studies;    Etanercept;    Anti-TNF;    Paediatric rheumatology;    Registry;   

DOI  :  10.1186/s12969-021-00625-y

来源: DOAJ

【 摘 要 】

Abstract Background We aimed to characterize etanercept (ETN) use in juvenile idiopathic arthritis (JIA) patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry. Methods The CARRA Registry is a convenience cohort of patients with paediatric onset rheumatic diseases, including JIA. JIA patients treated with ETN for whom the month and year of ETN initiation were available were included. Patterns of ETN and methotrexate (MTX) use were categorized as follows: combination therapy (ETN and MTX started concurrently), step-up therapy (MTX started first and ETN added later), switchers (MTX started and then stopped when or before ETN started), MTX add-on (ETN started first and MTX added later), and ETN only (no MTX use). Data were described using parametric and non-parametric statistics as appropriate. Results Two thousand thirty-two of the five thousand six hundred forty-one patients with JIA met inclusion criteria (74% female, median age at diagnosis 6.0 years [interquartile range 2.0, 11.0]. Most patients (66.9%) were treated with a non-biologic disease modifying anti-rheumatic drug (DMARD), primarily MTX, prior to ETN. There was significant variability in patterns of MTX use prior to starting ETN. Step-up therapy was the most common approach. Only 34.0% of persistent oligoarticular JIA patients continued treatment with a non-biologic DMARD 3 months or more after ETN initiation. ETN persistence overall was 66.3, 49.4, and 37.3% at 24, 36 and 48 months respectively. ETN persistence among spondyloarthritis patients (enthesitis related arthritis and psoriatic JIA) varied by MTX initiation pattern, with higher ETN persistence rates in those who initiated combination therapy (68.9%) and switchers/ETN only (73.3%) patients compared to step-up (65.4%) and MTX add-on (51.1%) therapy. Conclusion This study characterizes contemporary patterns of ETN use in the CARRA Registry. Treatment was largely in keeping with American College of Rheumatology guidelines.

【 授权许可】

Unknown