Evidence map›Paper›PMID 35410419›Full record

Observational studyPediatric rheumatology online journal2022

Real-world data reveals the complexity of disease modifying anti-rheumatic drug treatment patterns in juvenile idiopathic arthritis: an observational study.

Luiza R Grazziotin, Gillian Currie, Marinka Twilt, Maarten J Ijzerman, Michelle M A Kip, Hendrik Koffijberg, Susanne M Benseler, Joost F Swart, Sebastiaan J Vastert, Nico M Wulffraat and 2 more

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Pediatric rheumatology online journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
6.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 43 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 2 countries.

Luiza R GrazziotinDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Gillian CurrieDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Marinka TwiltAlberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
Maarten J IjzermanDepartment of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, the Netherlands.
Michelle M A KipDepartment of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, the Netherlands.
Hendrik KoffijbergDepartment of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, the Netherlands.
Susanne M BenselerAlberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
Joost F SwartDepartment of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital / UMC Utrech, Utrecht, The Netherlands.
Sebastiaan J VastertDepartment of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital / UMC Utrech, Utrecht, The Netherlands.
Nico M WulffraatDepartment of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital / UMC Utrech, Utrecht, The Netherlands.
Rae S M YeungDepartments of Paediatrics, Immunology and Medical Science, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
Deborah A MarshallDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. damarsha@ucalgary.ca.
University of Calgary · CAUniversity of Twente · NLWilhelmina Children's Hospital · NLAlberta Children's Hospital · CAAlberta Health Services · CAHospital for Sick Children · CAUtrecht University · NL

Funding

CIHR 381280genome canada OGI-150
6 · The paper itself

Abstract

objectivePharmacological treatment is a cornerstone of care for children with juvenile idiopathic arthritis (JIA). The objective of this study is to evaluate prescription patterns of conventional and biologic disease modifying anti-rheumatic drugs (c-DMARDs and b-DMARDs) for patients with JIA.

methodsWe conducted a retrospective cohort study of children diagnosed with JIA at a rheumatology pediatric clinic. Eligibility criteria were defined as children and youth newly diagnosed with enthesis-related arthritis, polyarticular, or oligoarticular JIA between 2011 and 2019, with at least one year of observation. Data on c-DMARDs and b-DMARDs prescriptions were obtained from electronic medical charts. We used descriptive statistics, Kaplan-Meier survival methods, and Sankey diagrams to describe treatment prescription patterns.

resultsA total of 325 patients with JIA were included, with a median observation time of 3.7 years. The most frequently prescribed c-DMARD and b-DMARD were methotrexate and etanercept, respectively. Within the first year of rheumatology care, 62% and 21% of patients had a c-DMARD and a b-DMARD prescribed, respectively. These proportions varied greatly by JIA subtype. Among the 147 (147/325, 45%) patients that had at least one b-DMARD prescribed, 24% were prescribed a second, and 7% a third-line of b-DMARD. A total of 112 unique treatment sequences were observed, with c-DMARD monotherapy followed by the addition of either a b-DMARD (56%) or another c-DMARD (30%) being the two most prevalent patterns in this cohort.

conclusionWe observed a variety of treatment trajectories, with many patients experiencing multiple treatment lines, illustrating the complexity of the overall JIA treatment path.

Indexed as

Antirheumatic AgentsArthritis, JuvenileAdolescentChildEtanerceptHumansMethotrexateRetrospective StudiesTreatment OutcomeAntirheumatic AgentsEtanerceptMethotrexateBiologic therapyDisease modifying anti-rheumatic drugsJuvenile idiopathic arthritisTreatment patterns

Identifiers

PMID35410419
PMCPMC8996666
OpenAlexW4223453407

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.