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Children with juvenile idiopathic arthritis frequently experience interruptions to their medical therapy

Kalliopi Kazamia1, Lars Holmquist, Anders Fagerlund

  • 1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|February 13, 2014
PubMed

Insights

High rates of treatment interruptions occurred in children with juvenile idiopathic arthritis (JIA) due to adverse events or inefficacy. Methotrexate and biologic agents rarely caused severe side effects, indicating a need for better predictive factors to guide JIA therapy.

Area of Science:

  • Pediatric Rheumatology
  • Pharmacovigilance
  • Clinical Pharmacology

Background:

  • Juvenile idiopathic arthritis (JIA) is a chronic autoimmune disease requiring long-term management.
  • Treatment decisions in JIA involve balancing efficacy with safety and tolerability.
  • Understanding real-world drug discontinuation patterns is crucial for optimizing pediatric rheumatologic care.

Purpose of the Study:

  • To investigate drug treatment discontinuations and safety profiles in a Swedish cohort of JIA patients over an eleven-year period.
  • To analyze the frequency and reasons for therapy interruptions in juvenile idiopathic arthritis.
  • To assess the incidence of adverse events associated with methotrexate and biologic agents in JIA.

Main Methods:

  • Prospective and retrospective review of clinical charts for incident and prevalent JIA cases.
  • Inclusion of hereditary diseases, clinical data, and pharmacological treatment aspects.
  • Analysis of 225 treatment periods across 156 JIA patients (108 girls, 48 boys) over a median of 8.6 years.

Main Results:

  • 37.3% of treatment periods were interrupted due to adverse events or inefficacy.
  • Adverse events occurred in 22.6% of methotrexate treatments and 19.2% of biologic treatments (p=0.71).
  • Treatment discontinuation rates were similar for methotrexate (38.7%) and biologic agents (33.3%) (p=0.53).

Conclusions:

  • A significant percentage of JIA therapies are interrupted due to adverse events or lack of efficacy.
  • Severe adverse events from methotrexate and biologic agents were infrequent in this cohort.
  • The findings underscore the necessity for improved predictive factors to guide therapeutic choices in JIA.
Abstract

Keywords:
arthritisjuvenilepharmacologicaltreatment

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