A decade of progress in juvenile idiopathic arthritis treatments and outcomes in Canada: results from ReACCh-Out and the CAPRI registry
Author:
Nguyen Kelly1, Barsalou Julie2, Basodan Daniah3, Batthish Michelle4ORCID, Benseler Susanne M5ORCID, Berard Roberta A6ORCID, Blanchette Nicholas7, Boire Gilles8ORCID, Bolaria Roxana1, Bruns Alessandra8, Cabral David A1, Cameron Bonnie9, Campillo Sarah10, Cellucci Tania4, Chan Mercedes1, Chédeville Gaëlle10, Chetaille Anne-Laure11, Chhabra Amieleena1, Couture Julie2, Dancey Paul12, De Bruycker Jean-Jacques2, Demirkaya Erkan6, Dhalla Muhammed5, Duffy Ciarán M13, Feldman Brian M9ORCID, Feldman Debbie E2, Gerschman Tommy1, Haddad Elie2, Heale Liane4, Herrington Julie4, Houghton Kristin1ORCID, Huber Adam M14ORCID, Human Andrea1, Johnson Nicole5, Jurencak Roman13, Lang Bianca14, Larché Maggie4, Laxer Ronald M9, LeBlanc Claire M10, Lee Jennifer J Y9, Levy Deborah M9, Lim Lillian3, Lim Lily S H15, Luca Nadia13, McGrath Tara3, McMillan Tamara15, Miettunen Paivi M5, Morishita Kimberly A1, Ng Hon Yan16, Oen Kiem15, Park Jonathan6ORCID, Petty Ross E1, Proulx-Gauthier Jean-Philippe11, Ramsey Suzanne14, Roth Johannes13, Rosenberg Alan M16ORCID, Rozenblyum Evelyn9, Rumsey Dax G3, Schmeling Heinrike5, Schneider Rayfel9, Scuccimarri Rosie10, Shiff Natalie J16ORCID, Silverman Earl9, Soon Gordon717, Spiegel Lynn9, Stringer Elizabeth14, Tam Herman1, Tse Shirley M9, Tucker Lori B1, Turvey Stuart1, Twilt Marinka5, Duffy Karen Watanabe13, Yeung Rae S M9, Guzman Jaime1ORCID
Affiliation:
1. Department of Pediatrics, University of British Columbia , Vancouver, BC, Canada 2. Department of Pediatrics, Université de Montréal , Montréal, QC, Canada 3. Department of Pediatrics, University of Alberta , Edmonton, AB, Canada 4. Department of Pediatrics, McMaster University , Hamilton, ON, Canada 5. Department of Pediatrics, University of Calgary , Calgary, AB, Canada 6. Department of Pediatrics, Western University , London, ON, Canada 7. Health Sciences North , Sudbury, ON, Canada 8. Department of Pediatrics, Université de Sherbrooke , Sherbrooke, QC, Canada 9. Department of Pediatrics, University of Toronto , Toronto, ON, Canada 10. Department of Pediatrics, McGill University , Montreal, QC, Canada 11. Department of Pediatrics, CHU de Québec-Université Laval , Québec, Canada 12. Department of Pediatrics, Memorial University , St. John’s, NL, Canada 13. Department of Pediatrics, University of Ottawa , Ottawa, ON, Canada 14. Department of Pediatrics, Dalhousie University , Halifax, NS, Canada 15. Department of Pediatrics, University of Manitoba , Winnipeg, MB, Canada 16. Department of Pediatrics, University of Saskatchewan , Saskatoon, SK, Canada 17. North York General Hospital , North York, Toronto, ON, Canada
Abstract
Abstract
Objective
To assess changes in juvenile idiopathic arthritis (JIA) treatments and outcomes in Canada, comparing 2005–2010 and 2017–2021 inception cohorts.
Methods
Patients enrolled within three months of diagnosis in the Research in Arthritis in Canadian Children Emphasizing Outcomes (ReACCh-Out) and the Canadian Alliance of Pediatric Rheumatology Investigators Registry (CAPRI) cohorts were included. Cumulative incidences of drug starts and outcome attainment within 70 weeks of diagnosis were compared with Kaplan–Meier survival analysis and multivariable Cox regression.
Results
The 2005–2010 and 2017–2021 cohorts included 1128 and 721 patients, respectively. JIA category distribution and baseline clinical juvenile idiopathic arthritis disease activity (cJADAS10) scores at enrolment were comparable. By 70 weeks, 6% of patients (95% CI 5, 7) in the 2005–2010 and 26% (23, 30) in the 2017–2021 cohort had started a biologic DMARD (bDMARD), and 43% (40, 47) and 60% (56, 64) had started a conventional DMARD (cDMARD), respectively. Outcome attainment was 64% (61, 67) and 83% (80, 86) for inactive disease (Wallace criteria), 69% (66, 72) and 84% (81, 87) for minimally active disease (cJADAS10 criteria), 57% (54, 61) and 63% (59, 68) for pain control (<1/10), and 52% (47, 56) and 54% (48, 60) for good health-related quality of life (≥9/10).
Conclusion
Although baseline disease characteristics were comparable in the 2005–2010 and 2017–2021 cohorts, cDMARD and bDMARD use increased with a concurrent increase in minimally active and inactive disease. Improvements in parent and patient-reported outcomes were smaller than improvements in disease activity.
Funder
Canadian Institutes of Health Research
Publisher
Oxford University Press (OUP)
Subject
Pharmacology (medical),Rheumatology
|
|