Evidence map›Paper›PMID 38556945›Full record

ArticleArthritis care & research2024

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.

Melissa L Mannion, Shahla Amin, Stephen Balevic, Min-Lee Chang, Colleen K Correll, Lianne Kearsley-Fleet, Kimme L Hyrich, Timothy Beukelman, Childhood Arthritis and Rheumatology Research Alliance Registry Investigators and the UK Juvenile Idiopathic Arthritis Biologics Register Investigators

Open access · bronzeAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Arthritis care & research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.3field-weighted citation impact, top 12% 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

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. [Clinical characteristics and outcomes of children with rheu-matoid factor-positive polyarticular juvenile idiopathic arthritis].Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2026
    Article
  3. Article
  4. Review
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

9 authors at 6 institutions in 2 countries.

Melissa L MannionUniversity of Alabama at Birmingham.ORCID 0000-0002-2216-970X
Shahla AminChildhood Arthritis and Rheumatology Research Alliance, Washington, DC.
Stephen BalevicDuke University and Duke Clinical Research Institute, Durham, North Carolina.ORCID 0000-0002-4016-1680
Min-Lee ChangBoston Children's Hospital, Massachusetts.
Colleen K CorrellUniversity of Minnesota, Minneapolis.ORCID 0000-0002-5451-1936
Lianne Kearsley-FleetThe University of Manchester, Manchester, United Kingdom.ORCID 0000-0003-0377-1575
Kimme L HyrichThe University of Manchester and NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
Timothy BeukelmanChildhood Arthritis and Rheumatology Research Alliance, Washington, DC.
Childhood Arthritis and Rheumatology Research Alliance Registry Investigators and the UK Juvenile Idiopathic Arthritis Biologics Register Investigators
Childhood Arthritis and Rheumatol­ogy Research Alliance · USUniversity of Manchester · GBBoston Children's Hospital · USDuke University · USUniversity of Alabama at Birmingham · USUniversity of Minnesota · US

Funding

Optimal Dosing for Biologic Agents in Obese Patients with Rheumatoid and Juvenile ArthritisK23AR075874 · NIAMS · DUKE UNIVERSITY · PI BALEVIC, STEPHEN JOSEPH · 2020 to 2024
$830k
Developing a tool to support shared decision making in JIA between adolescents, parents, and providersK23AR081410 · NIAMS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Melissa Mannion · 2023 to 2026
$704k
Childhood Arthritis and Rheumatology Research AllianceManchester Biomedical Research Centre NIHR203308NIAMS NIH HHS K23 AR075874NIAMS NIH HHS K23 AR081410NIH HHSPatient-Centered Outcomes Research InstitutePurdue PharmaRheumatology Research Foundation Norman B Gaylis, MD Clinical Research AwardU.S. Food and Drug Administration
6 · The paper itself

Abstract

objectiveThe objective of this study was to compare the effectiveness of a second tumor necrosis factor inhibitor (TNFi) versus a non-TNFi biologic following discontinuation of a TNFi for patients with polyarticular-course juvenile idiopathic arthritis (pJIA).

methodsUsing the Childhood Arthritis and Rheumatology Research Alliance Registry, patients with pJIA who started receiving a second biologic following a first TNFi were identified. Patients were required to have no active uveitis on the index date and a visit six months after the index date. Outcome measures included Clinical Juvenile Arthritis Disease Activity Score with a maximum of 10 active joints (cJADAS10), cJADAS10 inactive disease (ID; ≤2.5) and cJADAS10 minimal disease activity (MiDA; ≤5). Multiple imputation was used to account for missing data. Adjusted odds ratios (aORs) were calculated using propensity score quintiles to compare outcomes at six months following second biologic initiation.

resultsThere were 216 patients included, 84% initially received etanercept, and most patients stopped receiving it because of its ineffectiveness (74%). A total of 183 (85%) started receiving a second TNFi, and 33 (15%) started receiving a non-TNFi. Adalimumab was the most common second biologic received (71% overall, 84% of second TNFi), and tocilizumab was the most common non-TNFi second biologic received (9% overall, 58% of non-TNFi). There was no difference between receiving TNFi versus non-TNFi in cJADAS10 ID (29% vs 25%; aOR 1.23, 95% confidence interval [CI] 0.47-3.20) or at least MiDA (43% vs 39%; aOR 1.11, 95% CI 0.47-2.62) at six months.

conclusionMost patients with pJIA started receiving TNFi rather than non-TNFi as their second biologic, and there were no differences in disease activity at six months.

Indexed as

Antirheumatic AgentsArthritis, JuvenileEtanerceptRegistriesAdalimumabAdolescentAntibodies, Monoclonal, HumanizedBiological ProductsChildChild, PreschoolComparative Effectiveness ResearchFemaleHumansMaleTreatment OutcomeTumor Necrosis Factor-alphaAdalimumabAntibodies, Monoclonal, HumanizedAntirheumatic AgentsBiological ProductsEtanercepttocilizumabTumor Necrosis Factor-alpha

Identifiers

PMID38556945
PMCPMC11288784
OpenAlexW4393390008

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.