ArticleArthritis research & therapy2023
Influence of the timing of biological treatment initiation on Juvenile Idiopathic Arthritis long-term outcomes.
Article in Arthritis research & therapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 12 citations in OpenAlex.
- Effect of Time to Start of Biologic Therapy on Treatment Response in Childhood Arthritis: Results From the UCAN CAN-DU Cohort.Arthritis & rheumatology (Hoboken, N.J.) · 2026Article
- Use of biologic drugs in juvenile idiopathic arthritis patients followed in an adult rheumatology clinic: real-life data from the HUR-BIO biologic registry.Clinical rheumatology · 2026Article
- A retrospective study of pediatric rheumatology referrals reveals large discrepancies in referring providers' musculoskeletal exams.Pediatric rheumatology online journal · 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
- Epidemiology and comorbidity of juvenile idiopathic arthritis in Poland- a nationwide study.Pediatric rheumatology online journal · 2025Article
- What have we learned from long-term studies in juvenile idiopathic arthritis? - Prediction, classification, transition.Pediatric rheumatology online journal · 2025Review
- Frequency of remission achievement in the pre-treat-to-target decade in juvenile idiopathic arthritis.Pediatric rheumatology online journal · 2025Article
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Authors and funding
15 authors at 13 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundJuvenile idiopathic arthritis (JIA) treatment is aimed at inducing remission to prevent joint destruction and disability. However, it is unclear what is the long-term impact on health-related outcomes of the timing of biological disease-modifying antirheumatic drug (bDMARD) initiation in JIA. Our aim was to evaluate the long-term impact of the time between JIA onset and the initiation of a bDMARD in achieving clinical remission, on physical disability and health-related quality of life (HRQoL).
methodsAdult JIA patients registered in the Rheumatic Diseases Portuguese Register (Reuma.pt) and ever treated with bDMARD were included. Data regarding socio-demographic, JIA-related characteristics, disease activity, physical disability (HAQ-DI), HRQoL (SF-36), and treatments were collected at the last visit. Patients were divided into 3 groups (≤ 2 years, 2-5 years, or > 5 years), according to the time from disease onset to bDMARD initiation. Regression models were obtained considering remission on/off medication, HAQ-DI, SF-36, and joint surgeries as outcomes and time from disease onset to bDMARD start as an independent variable.
resultsThree hundred sixty-one adult JIA patients were evaluated, with a median disease duration of 20.3 years (IQR 12.1; 30.2). 40.4% had active disease, 35.1% were in remission on medication, and 24.4% were in drug-free remission; 71% reported some degree of physical disability. Starting a bDMARD > 5 years after disease onset decreased the chance of achieving remission off medication (OR 0.24; 95% CI 0.06, 0.92; p = 0.038). Patients who started a bDMARD after 5 years of disease onset had a higher HAQ and worse scores in the physical component, vitality, and social function domains of SF-36, and more joint surgeries when compared to an earlier start.
conclusionLater initiation of bDMARDs in JIA is associated with a greater physical disability, worse HRQoL, and lower chance of drug-free remission in adulthood.
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