ArticleRheumatology (Oxford, England)2021
Comparative effectiveness and persistence of TNFi and non-TNFi in juvenile idiopathic arthritis: a large paediatric rheumatology centre in the USA.
Article in Rheumatology (Oxford, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 13 citations in OpenAlex.
- Uptake and Use of Biologic Therapies in Paediatric Immune-Mediated Inflammatory Diseases: An Australian Population-Based Study.Pharmacoepidemiology and drug safety · 2026Article
- Literature analysis and implication of biologic therapy for children with non-systemic juvenile idiopathic arthritis in real-world settings.Intractable & rare diseases research · 2025Review
- Update on Biologic Therapy in Juvenile Idiopathic Arthritis: A Five-year Narrative Review.Biologics : targets & therapy · 2025Review
- Disease activity and treatment in patients with juvenile idiopathic arthritis before transfer to adult care: the first survey in China.Frontiers in pediatrics · 2025Article
- Infiltrations of plasma cells in synovium predict inadequate response to Adalimumab in Rheumatoid Arthritis patients.Arthritis research & therapy · 2024Article
- Comparative Effectiveness of a Second Tumor Necrosis Factor Inhibitor Versus a Non-Tumor Necrosis Factor Biologic in the Treatment of Patients With Polyarticular-Course Juvenile Idiopathic Arthritis.Arthritis care & research · 2024Article
- Developing electronic health record algorithms that accurately identify patients with juvenile idiopathic arthritis.Seminars in arthritis and rheumatism · 2023Article
- Research progress in drug therapy of juvenile idiopathic arthritis.World journal of pediatrics : WJP · 2022Review
- Biologic Disease-Modifying and Other Anti-Rheumatic Drugs Use in Patients with Moderate-to-Severe Juvenile Idiopathic Arthritis Based on a Japanese Nationwide Claims Database.Therapeutics and clinical risk management · 2022Article
- Off-label medication use in rare pediatric diseases in the United States.Intractable & rare diseases research · 2021Review
- Prescribing Patterns and Impact of Factors Associated with Time to Initial Biologic Therapy among Children with Non-systemic Juvenile Idiopathic Arthritis.Paediatric drugs · 2021Article
- Characterization of TNF-Alpha Inhibitor Induced Paradoxical Psoriasiform Dermatitis at a Single Center via Retrospective Chart Review.Pediatric dermatologyArticle
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo evaluate the persistence and effectiveness of TNF inhibitors (TNFi) vs non-TNFi among newly diagnosed JIA patients after initiation of biologic DMARD (bDMARD).
methodsUsing longitudinal patient-level data extracted from electronic medical records in a large Midwestern paediatric hospital from 2009 to 2018, we identified JIA patients initiating TNFi and non-TNFi treatment. Treatment effectiveness was assessed based on disease activity. Inverse probability of treatment weighting of propensity score was used to estimate the treatment effectiveness and Kaplan-Meier analyses were conducted to assess persistence.
resultsOf 667 JIA patients, most (92.0%) were prescribed one of the class of TNFi as their initial biologic treatment. Etanercept was the most frequently prescribed (67.1%) treatment, followed by adalimumab (27.5%). Only around 5% of patients were prescribed off-label bDMARDs as their first-course treatment; however, >20% were prescribed off-label biologics as their second-course therapy. Some 7.2% of patients received four or more bDMARDs. The median persistence of the first-course bDMARD is 320 days, with TNFi being significantly longer than the non-TNFi (395 vs 320 days, P = 0.010). The clinical Juvenile Disease Activity Score (cJADAS) reduction of TNFi users (6.6, 95% CI 5.7, 7.5) was significant greater compared with non-TNFi users (3.0, 95% CI 1.5, 4.6, P < 0.0001) at 6-month follow-up visit.
conclusionPersistence was significantly longer among patients initiating TNFi as their first biologic therapy than those receiving non-TNFi. Patients receiving TNF therapy had significant greater reduction of cJADAS at the 6-month follow-up visit compared with patients in the non-TNF cohort.
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