FRI0366 Dmard use in the treatment of juvenile idiopathic arthritis: A cross-sectional analysis of the childhood arthritis and rheumatology research alliance (CARRA) registry

2013 ◽  
Vol 71 (Suppl 3) ◽  
pp. 438.1-438
Author(s):  
T. Beukelman ◽  
S. Ringold ◽  
T.E. Davis ◽  
E. Morgan DeWitt ◽  
C.F. Pelajo ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Cross Sectional ◽  
Rheumatology Research ◽  
Childhood Arthritis ◽  
Cross Sectional Analysis ◽  
Research Alliance ◽  
Sectional Analysis

scholarly journals Enthesitis-related Arthritis Is Associated with Higher Pain Intensity and Poorer Health Status in Comparison with Other Categories of Juvenile Idiopathic Arthritis: The Childhood Arthritis and Rheumatology Research Alliance Registry

2012 ◽  
Vol 39 (12) ◽  
pp. 2341-2351 ◽  
Author(s):  
PAMELA F. WEISS ◽  
TIMOTHY BEUKELMAN ◽  
LAURA E. SCHANBERG ◽  
YUKIKO KIMURA ◽  
ROBERT A. COLBERT
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Health Status ◽  
Pain Intensity ◽  
Physical Function ◽  
Physician Global Assessment ◽  
Enthesitis Related Arthritis ◽  
Rheumatology Research ◽  
Childhood Arthritis ◽  
Patient Reported ◽  
Research Alliance

Objective.To assess the relative effect of clinical factors and medications on pain intensity, physical function, and health status in juvenile idiopathic arthritis (JIA).Methods.We conducted a retrospective cross-sectional study of data from children with JIA enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry. We tested whether clinical characteristics of JIA were associated with pain intensity, physical function, and health status using multivariable linear and ordinal logistic regression.Results.During the study period, 2571 subjects with JIA enrolled in the CARRA Registry. Ratings of pain intensity, physical function, and health status differed significantly between JIA categories. In comparison to other categories of JIA, subjects with enthesitis-related arthritis (ERA) reported worse pain and function. In multivariable analyses, higher active joint count and current use of nonsteroidal antiinflammatory drugs (NSAID), biologics, or corticosteroids were associated with worse scores on all patient-reported measures. ERA and older age were significantly associated with higher pain intensity and poorer health status. Systemic JIA and uveitis were significantly associated with worse health status. Enthesitis, sacroiliac tenderness, and NSAID use were independently associated with increased pain intensity in ERA. The correlation was low between physician global assessment of disease activity and patient-reported pain intensity, physical function, and health status.Conclusion.Significant differences in pain intensity, physical function, and health status exist among JIA categories. These results suggest that current treatments may not be equally effective for particular disease characteristics more common in specific JIA categories, such as enthesitis or sacroiliac tenderness in ERA.

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

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Timothy Beukelman ◽  
Aimee Lougee ◽  
Roland A. Matsouaka ◽  
David Collier ◽  
Dax G. Rumsey ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Combination Therapy ◽  
Rheumatology Research ◽  
Childhood Arthritis ◽  
American College Of Rheumatology ◽  
Persistence Rates ◽  
Biologic Dmard ◽  
Parametric Statistics ◽  
Research Alliance ◽  
Rheumatic Drug

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

Biologic Switching among Non-Systemic Juvenile Idiopathic Arthritis Patients: A Cohort Study in the Childhood Arthritis and Rheumatology Research Alliance Registry

2020 ◽  
pp. jrheum.200437
Author(s):  
Melissa L. Mannion ◽  
Fenglong Xie ◽  
Daniel B. Horton ◽  
Sarah Ringold ◽  
Colleen K. Correll ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Current Treatment ◽  
Categorical Variables ◽  
Optimal Timing ◽  
Continuous Variables ◽  
Chi Square ◽  
Rheumatology Research ◽  
Childhood Arthritis ◽  
Research Alliance

Objective Biologic medications have significantly improved disease control and outcomes of patients with juvenile idiopathic arthritis (JIA). Current treatment recommendations suggest escalating therapy; including changing biologics if needed, when inactive or low disease activity is not attained. The patterns and reasons for switching biologics in clinical practice in North America are not well described. Methods We used the Childhood Arthritis and Rheumatology Research Alliance Registry and included individuals with JIA if they newly started a biologic after January 1, 2008 and had at least 12 months of subsequent observable time. Subjects with systemic JIA were excluded. We compared characteristics of switchers and non-switchers using chi-square for categorical variables and Wilcoxon rank sum testing for continuous variables and used linear regression for time analysis. Results 1361 eligible children with JIA in the registry started a biologic (94% tumor necrosis factor TNF inhibitors [TNFi]). Median follow-up time was 30 months, and 349 (26%) switched biologics. Among biologic switchers, ineffectiveness/disease flare was the most common reason for switch (202, 58%). The most common documented switch was from etanercept to another TNFi (221, 63%). The median time to switch to a second biologic decreased substantially from 55.2 months in 2008 to 7.2 months in 2016. Conclusion In a multicenter cohort of patients with JIA starting a biologic, one-quarter switched to a second biologic, and the time to switching decreased in recent years. Additional studies should evaluate the outcomes and optimal timing of switching and preferred sequence of biologic use.

Race, Ethnicity, and Disease Outcomes in Juvenile Idiopathic Arthritis: A Cross-sectional Analysis of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry

2013 ◽  
Vol 40 (6) ◽  
pp. 936-942 ◽  
Author(s):  
Sarah Ringold ◽  
Timothy Beukelman ◽  
Peter A. Nigrovic ◽  
Yukiko Kimura ◽  
Keyword(s):  
African American ◽  
Race And Ethnicity ◽  
Functional Ability ◽  
Joint Damage ◽  
Cross Sectional ◽  
White Children ◽  
Childhood Arthritis ◽  
Disease Outcomes ◽  
Research Alliance ◽  
Sectional Analysis

Objective.To measure the associations between self-reported race and ethnicity and disease outcomes, including joint damage, pain, and functional ability, in children with juvenile idiopathic arthritis (JIA).Methods.A cross-sectional analysis of children with JIA enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry between May 2010 and March 2012. Mann-Whitney U test and chi-square testing were used to compare patient characteristics between race (white, African American, or Asian) and ethnicity (Non-Hispanic and Non-Latino; Hispanic or Latino) categories. Logistic regression was used to measure the associations between each race or ethnicity category and the outcome of interest.Results.Race category was available for 4292 of 4682 children (93% white, 5% African American, Asian 3%). Ethnicity data were available for 4644 (11% Hispanic or Latino). African American children with polyarticular-course JIA had an elevated OR for joint damage on radiographic imaging compared to white children (OR 1.9, 95% CI 1.0–3.1; p = 0.04). Hispanic/Latino children had increased odds of having disability scores > 75th percentile (OR 1.5, 95% CI 1.1–2.1; p < 0.01) compared to non-Hispanic/Latino children; however, these odds were no longer significant when the cohort was limited to children with polyarticular-course JIA. Asian children had decreased odds of higher pain and functional disability compared to white children (p < 0.05).Conclusion.Race and ethnicity were variably associated with joint damage, pain, and functional ability. Understanding outcome variation between different race and ethnicity groups may help to optimize care for children with JIA.

scholarly journals Risk Markers of Juvenile Idiopathic Arthritis-associated Uveitis in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry

2013 ◽  
Vol 40 (12) ◽  
pp. 2088-2096 ◽  
Author(s):  
Sheila T. Angeles-Han ◽  
Christina F. Pelajo ◽  
Larry B. Vogler ◽  
Kelly Rouster-Stevens ◽  
Christine Kennedy ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Clinical Course ◽  
Early Age ◽  
Risk Markers ◽  
Rheumatology Research ◽  
Related Data ◽  
Childhood Arthritis ◽  
Younger Age ◽  
Research Alliance ◽  
Hispanic White

Objective.To characterize the epidemiology and clinical course of children with juvenile idiopathic arthritis-associated uveitis (JIA-U) in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry and explore differences between African American (AA) and non-Hispanic white (NHW) children.Methods.There were 4983 children with JIA enrolled in the CARRA Registry. Of those, 3967 NHW and AA children were included in this study. Demographic and disease-related data were collected from diagnosis to enrollment. Children with JIA were compared to those with JIA-U. Children with JIA-U were also compared by race.Results.There were 459/3967 children (11.6%) with JIA-U in our cohort with a mean age (SD) of 11.4 years (± 4.5) at enrollment. Compared to children with JIA, they were younger at arthritis onset, more likely to be female, had < 5 joints involved, had oligoarticular JIA, and were antinuclear antibody (ANA)-positive, rheumatoid factor (RF)-negative, and anticitrullinated protein antibody-negative. Predictors of uveitis development included female sex, early age of arthritis onset, and oligoarticular JIA. Polyarticular RF-positive JIA subtype was protective. Nearly 3% of children with JIA-U were AA. However, of the 220 AA children with JIA, 6% had uveitis; in contrast, 12% of the 3721 NHW children with JIA had uveitis.Conclusion.In the CARRA registry, the prevalence of JIA-U in AA and NHW children is 11.6%. We confirmed known uveitis risk markers (ANA positivity, younger age at arthritis onset, and oligoarticular JIA). We describe a decreased likelihood of uveitis in AA children and recommend further exploration of race as a risk factor in a larger population of AA children.

Lung function in children with juvenile idiopathic arthritis: A cross‐sectional analysis

2019 ◽  
Author(s):  
Marina Attanasi ◽  
Marta Lucantoni ◽  
Daniele Rapino ◽  
Marianna I. Petrosino ◽  
Manuela Marsili ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Lung Function ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

The Systemic Juvenile Idiopathic Arthritis Cohort of the Childhood Arthritis and Rheumatology Research Alliance Registry: 2010–2013

2016 ◽  
Vol 43 (9) ◽  
pp. 1755-1762 ◽  
Author(s):  
Ginger Janow ◽  
Laura E. Schanberg ◽  
Soko Setoguchi ◽  
Victor Hasselblad ◽  
Elizabeth D. Mellins ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Disease Activity ◽  
Disease Duration ◽  
Interleukin 1 ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Medication Usage ◽  
Rheumatology Research ◽  
Childhood Arthritis ◽  
Systemic Symptoms ◽  
Research Alliance

Objective.We aimed to identify the (1) demographic/clinical characteristics, (2) medication usage trends, (3) variables associated with worse disease activity, and (4) characteristics of patients with persistent chronic arthritis in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry’s systemic juvenile idiopathic arthritis (sJIA) cohort.Methods.Demographics, disease activity measures, and medications at enrollment of patients with sJIA in the CARRA Registry were analyzed using descriptive statistics. Multivariate analyses were conducted to identify associations with increased disease activity. Medication usage frequencies were calculated by year.Results.There were 528 patients with sJIA enrolled in the registry (2010–2013). There were 435 patients who had a complete dataset; of these, 372 met the International League of Associations for Rheumatology criteria and were included in the analysis. At enrollment, median disease duration and joint count were 3.7 years and 0, respectively; 16.4% had a rash and 6.7% had a fever. Twenty-six percent were taking interleukin 1 (IL-1) inhibitors and 29% glucocorticoids. Disease-modifying antirheumatic drugs and tumor necrosis factor inhibitors use decreased, while IL-6 inhibitor use increased between 2010 and 2013. African American patients had worse joint counts (p = 0.003), functional status (p = 0.01), and physician’s global assessment (p = 0.008). Of the 255 subjects with > 2 years of disease duration, 56% had no arthritis or systemic symptoms, while 32% had persistent arthritis only.Conclusion.Most patients in the largest sJIA cohort reported to date had low disease activity. Practice patterns for choice of biologic agents appeared to change over the study period. Nearly one-third had persistent arthritis without systemic symptoms > 2 years after onset. African Americans were associated with worse disease activity. Strategies are needed to improve outcomes in subgroups with poor prognosis.

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