Persistence and adherence to biologic therapies in juvenile idiopathic arthritis

Abstract

Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease that often requires biological therapy to control its activity. Medication persistence and adherence are important aspects on which we have scarce information. We performed a longitudinal, retrospective, and observational study based on data from the daily clinical management of JIA patients. We recorded clinical remission at 6 and 12 months. Persistence of biological therapy was evaluated using Kaplan–Meier curves, and adherence was assessed using the medication possession ratio (MPR). We included 68 patients who received biological therapy. Of these, 11 (16.2%) and 5 (7.4%) required a second and third drug, respectively. The persistence rate for biological therapy at 5 years was 64%, with no differences between the first and second lines. Adherence was high during the first year of treatment (MPR80: 96.3%) and also in the second and third years (MPR80: 85.2% and 91.8%, respectively). Persistence and adherence to biological therapy were remarkably high in our JIA cohort. Adherence to biological treatments could be related to a higher probability of fulfilling the Wallace remission criteria at 6 months, although this was not confirmed at 12 months.

Evaluation of clinical outcomes in systemic juvenile idiopathic arthritis patients treated with biological agents in Turkey: the TURSIS study

“…In a retrospective longitudinal observational study involving 68 JIA patients, 16.2% of them required a second and 7.4% required a third biologic drug. They also found the persistence rate for biological therapy for 5 years was 64% (22). In the UK cohort and the Dutch registry, the percentage of SJIA patients who required a biologic switch was similar (26%) (23,24).…”

Patterns and determinants of response to novel therapies in juvenile and adult-onset polyarthritis

“…The disparate effect of b/tsDMARDS therapies observed in RA may have several biological explanations, and these have been listed in Table 2 [ 4 , 13 , 22 , 40 , 55 , 58–94 ]. We will discuss in the following paragraphs pathophysiological, patient-specific, drug-specific and environmental factors modulating treatment response in RA.…”

“…By contrast, when considering relative/absolute improvement, higher baseline disease activity may be associated with greater measured change (the floor effect for low disease activity) [ 80 , 162 , 163 ]. Other factors associated with reduced therapeutic response include longer disease duration, and greater number of previously failed drugs (although data on the latter point lack good differentiation between primary and secondary non-response) [ 3 , 4 , 162 ]. The pattern of joint involvement was also found to influence response to therapies in JIA, with wrist/ankle involvement being associated with a more severe disease course [ 156 , 164 ].…”