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


Journal

Pediatric rheumatology online journal
ISSN: 1546-0096
Titre abrégé: Pediatr Rheumatol Online J
Pays: England
ID NLM: 101248897

Informations de publication

Date de publication:
21 Aug 2021
Historique:
received: 18 05 2021
accepted: 31 07 2021
entrez: 22 8 2021
pubmed: 23 8 2021
medline: 11 1 2022
Statut: epublish

Résumé

We aimed to characterize etanercept (ETN) use in juvenile idiopathic arthritis (JIA) patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry. 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. 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. This study characterizes contemporary patterns of ETN use in the CARRA Registry. Treatment was largely in keeping with American College of Rheumatology guidelines.

Sections du résumé

BACKGROUND 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 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 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 CONCLUSIONS
This study characterizes contemporary patterns of ETN use in the CARRA Registry. Treatment was largely in keeping with American College of Rheumatology guidelines.

Identifiants

pubmed: 34419107
doi: 10.1186/s12969-021-00625-y
pii: 10.1186/s12969-021-00625-y
pmc: PMC8380401
doi:

Substances chimiques

Immunosuppressive Agents 0
Tumor Necrosis Factor Inhibitors 0
Etanercept OP401G7OJC
Methotrexate YL5FZ2Y5U1

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

131

Subventions

Organisme : Amgen
ID : (none)

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Informations de copyright

© 2021. The Author(s).

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Auteurs

Timothy Beukelman (T)

Department of Pediatrics, University of Alabama at Birmingham, CPPN G10, 1600 7th Ave South, Birmingham, AL, 35233, USA. tbeukelman@peds.uab.edu.

Aimee Lougee (A)

Duke University, Duke Clinical Research Institute, 200 Morris Street, Durham, NC, 27701, USA.

Roland A Matsouaka (RA)

Department of Biostatistics and Bioinformatics, Duke University, Duke Clinical Research Institute, 200 Morris Street, Durham, NC, 27701, USA.

David Collier (D)

Global Medical Affairs, Amgen Inc., One Amgen Center Drive, Thousand Oaks, California, 91320-1799, USA.

Dax G Rumsey (DG)

Department of Pediatrics, University of Alberta, 3-502 ECHA; 11405 87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada.

Jennifer Schenfeld (J)

Center for Observational Research, Amgen Inc., One Amgen Center Drive, Thousand Oaks, California, 91320-1799, USA.

Scott Stryker (S)

Center for Observational Research, Amgen Inc., One Amgen Center Drive, Thousand Oaks, California, 91320-1799, USA.

Marinka Twilt (M)

Department of Pediatrics, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada.

Yukiko Kimura (Y)

Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ, USA.

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