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Rheumatology (Oxford). 2016 Apr;55(4):697-703. doi: 10.1093/rheumatology/kev398. Epub 2015 Dec 15.

Effectiveness and long-term retention of anti-tumour necrosis factor treatment in juvenile and adult patients with juvenile idiopathic arthritis: data from Reuma.pt.

Author information

1
Rheumatology Research Unit, Instituto de Medicina Molecular, Rheumatology Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, CEDOC, Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisbon, afilipamourao@gmail.com.
2
Rheumatology Research Unit, Instituto de Medicina Molecular, Rheumatology Department, Hospital Garcia de Orta, Almada.
3
Instituto Português de Reumatologia.
4
Rheumatology Research Unit, Instituto de Medicina Molecular, Portuguese Society of Rheumatology.
5
Portuguese Society of Rheumatology.
6
Rheumatology Department, Lisbon Academic Medical Center, Lisbon.
7
Pediatrics Department, Centro Universitário Hospitalar de Coimbra, Coimbra.
8
Pediatrics Department, Unidade de Imunologia Clínica, Centro Hospitalar do Porto, Porto.
9
Pediatrics Department, Centro Hospitalar do Médio-Ave, Famalicão.
10
Rheumatology Department, ULSAM - Hospital Conde de Bertiandos, Ponte de Lima.
11
Rheumatology Department, Hospital de São João, Faculdade de Medicina da Universidade do Porto, Porto.
12
Rheumatology Department, Centro Universitário Hospitalar de Coimbra, Coimbra.
13
Rheumatology Department, Hospital do Divino Espírito Santo, S. Miguel, Açores.
14
Rheumatology Research Unit, Instituto de Medicina Molecular.
15
Rheumatology Research Unit, Instituto de Medicina Molecular, Rheumatology Department, Hospital de Santo Espírito, Angra do Heroísmo, Terceira and.
16
Rheumatology Department, Centro Hospitalar do Algarve, Faro, Portugal.
17
Rheumatology Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, CEDOC, Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisbon.
18
Rheumatology Research Unit, Instituto de Medicina Molecular, Rheumatology Department, Lisbon Academic Medical Center, Lisbon.

Abstract

OBJECTIVES:

Assess the effectiveness and safety of biologic therapy as well as predictors of response at 1 year of therapy, retention rate in biologic treatment and predictors of drug discontinuation in JIA patients in the Portuguese register of rheumatic diseases.

METHODS:

We prospectively collected patient and disease characteristics from patients with JIA who started biological therapy. Adverse events were collected during the follow-up period. Predictors of response at 1 year and drug retention rates were assessed at 4 years of treatment for the first biologic agent.

RESULTS:

A total of 812 JIA patients [65% females, mean age at JIA onset 6.9 years (s.d. 4.7)], 227 received biologic therapy; 205 patients (90.3%) were treated with an anti-TNF as the first biologic. All the parameters used to evaluate disease activity, namely number of active joints, ESR and Childhood HAQ/HAQ, decreased significantly at 6 months and 1 year of treatment. The mean reduction in Juvenile Disease Activity Score 10 (JADAS10) after 1 year of treatment was 10.4 (s.d. 7.4). According to the definition of improvement using the JADAS10 score, 83.3% respond to biologic therapy after 1 year. Fourteen patients discontinued biologic therapies due to adverse events. Retention rates were 92.9% at 1 year, 85.5% at 2 years, 78.4% at 3 years and 68.1% at 4 years of treatment. Among all JIA subtypes, only concomitant therapy with corticosteroids was found to be univariately associated with withdrawal of biologic treatment (P = 0.016).

CONCLUSION:

Biologic therapies seem effective and safe in patients with JIA. In addition, the retention rates for the first biologic agent are high throughout 4 years.

KEYWORDS:

biological treatment; efficacy; juvenile idiopathic arthritis; safety

PMID:
26672905
DOI:
10.1093/rheumatology/kev398
[Indexed for MEDLINE]

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