Journal
JOURNAL OF RHEUMATOLOGY
Volume 39, Issue 9, Pages 1867-1874Publisher
J RHEUMATOL PUBL CO
DOI: 10.3899/jrheum.120110
Keywords
JUVENILE IDIOPATHIC ARTHRITIS; DISEASE-MODIFYING ANTIRHEUMATIC DRUG; DRUG TOXICITY
Categories
Funding
- National Institutes of Health (NIH) [RC2AR058934]
- Arthritis Foundation
- Friends of CARRA
- NIH through University of Alabama at Birmingham Center for Clinical and Translational Science [5KL2 RR025776]
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Objective. To characterize disease-modifying antirheumatic drug (DMARD) use for children with juvenile idiopathic arthritis (JIA) in the United States and to determine patient factors associated with medication use. Methods. We analyzed cross-sectional baseline enrollment data from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from May 2010 through May 2011 for children with JIA. Current and prior medication use was included. We used parsimonious backward stepwise logistic regression models to calculate OR to estimate associations between clinical patient factors and medication use. Results. We identified 2748 children with JIA with a median disease duration of 3.9 years from 51 US clinical sites. Overall, 2023 (74%) had ever received a nonbiologic DMARD and 1246(45%) had ever received a biologic DMARD. Among children without systemic arthritis, methotrexate use was most strongly associated with uveitis (OR 5.2,95% Cl 3.6-7.6), anticitrullinated protein antibodies (OR 4.5, 95% CI 1.7-12), and extended oligoarthritis (OR 4.1, 95% CI 2.5-6.6). Among children without systemic arthritis, biologic DMARD use was most strongly associated with rheumatoid factor (RF)-positive polyarthritis (OR 4.3, 95% CI 2.9-6.6), psoriatic arthritis (PsA; OR 3.0, 95% CI 2.0-4.4), and uveitis (OR 2.8. 95% Cl 2.1-3.7). Among children with systemic arthritis, 160 (65%) ever received a biologic DMARD; tumor necrosis factor inhibitor use was associated with polyarthritis (OR 2.5, 95% CI 3.8-16), while interleukin I inhibitor use was not. Conclusion. About three-quarters of all children with HA in the CARRA Registry received nonbiologic DMARD. Nearly one-half received biologic DMARD, and their use was strongly associated with RF-positive polyarthritis, PsA, uveitis, and systemic arthritis. (First Release Aug 1 2012; J Rheumatol 2012;39:1867-74; doi:10.3899/jrheum.120110)
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