Affiliation:
1. Department of Pediatrics, Kagoshima University Hospital , Kagoshima, Japan
2. Department of Pediatrics, Kagoshima City Hospital , Kagoshima, Japan
Abstract
ABSTRACT
Objectives
Currently, no indicators on which biologic disease-modifying anti-rheumatic drugs (bDMARDs) should be used first for juvenile idiopathic arthritis (JIA) have been established. Thus, this study aimed to determine the useful biomarkers in JIA to enable the best selection of the first bDMARDs without primary failure.
Methods
This retrospective study used data of patients examined for JIA between 2015 and 2021 at Kagoshima University Hospital in Japan.
Results
Altogether, 67 cases of non-systemic JIA were analyzed, excluding cases that had been treated for <6 months. Of the 67 cases, 52 were treated with bDMARDs and all rheumatoid factor (RF)+ types (32 cases) were treated with bDMARDs. Eleven cases (31.4&) (all were RF+ types and used anti-tumor necrosis factor (TNF)α agents) switched to other bDMARDs because of primary failure, and nine cases had secondary failure (6;anti-TNF, 3;anti-Interleukin-6). A significant difference in pre-treatment RF values (177.9 vs 25.7 IU/ml, p = 0.002) and presence (Odds Ratio 1.952,p = 0.004) were observed between the primary failure group and effective group.
Conclusions
RF+ JIA required bDMARDs with high probability. JIA with high titre of RF tends to be refractory to anti-TNFα agents. Tocilizumab or abatacept could be a first-choice bDMARD in such cases.
Publisher
Oxford University Press (OUP)
Reference15 articles.
1. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001;Petty;J Rheumatol,2004
2. Efficacy and safety of tocilizumab in patients with systemic-onset juvenile idiopathic arthritis: a randomized, double-blind, placebo-controlled, withdrawal phase III trial;Yokota;Lancet,2008
3. Anakinra as first-line disease-modifying therapy in systemic juvenile idiopathic arthritis: report of forty-six patients from an international multicenter series;Nigrovic;Arthritis Rheumatol,2011
4. Childhood Arthritis and Rheumatology Research Alliance, Pediatric Rheumatology International Trials Organization, Pediatric Rheumatology Collaborative Study Group. Preliminary criteria for clinical remission for select categories of juvenile idiopathic arthritis;Wallace;J Rheumatol,2004
5. 2019 American College of Rheumatology/Arthritis Foundation guideline for the treatment of juvenile idiopathic arthritis: therapeutic approaches for non-systemic polyarthritis, sacroiliitis, and enthesitis;Ringold;Arthritis Rheumatol,2019
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