Researchers find patterns for when and why doctors switch biologic medications for the treatment of Juvenile Idiopathic Arthritis (JIA)



Biologics are a type of medication used to treat juvenile idiopathic arthritis (JIA). Treatment with biologics improves daily life and disease severity for many JIA patients. But little is known about when and why doctors choose to switch biologics. Doctors do not currently have formal guidelines about when and how they should change from one biologic to another. For this study, researchers looked at medication use in children who were enrolled in the CARRA Registry and were diagnosed with JIA after January 1, 2008. Researchers followed patients for at least one year and reviewed data in the Registry to find patterns.

Note: Children with systemic JIA were not included in this study. Most participants were white females.

Key Findings

Researchers found that doctors often prescribed a biologic to children newly diagnosed with JIA. The most prescribed biologic was etanercept. Etanercept is a tumor necrosis factor inhibitor (TNFi). These medications help stop inflammation.

Researchers noted the following patterns:

  • Doctors preferred etanercept over other biologics to treat JIA. Most doctors started with etanercept before switching to another TNFi biologic.
  • Doctors are switching to another biologic faster than in the past. In 2008, doctors waited about 55 months before trying a new medication. In 2016, doctors only waited an average of 7 months.
  • About one in four children with JIA switched to another biologic medication. Most children switched biologics within the first 6 months of taking it.
  • Doctors switched biologics if the first one didn't help with symptoms or flares. They also switched biologics if children had a bad reaction to the first one.

Researchers found several patterns for when and why doctors switch biologics. But researchers need more information to find patterns that can inform formal guidelines. Researchers, doctors, and families want to know if there is a better time to switch biologics. Another question is whether the order of biologics makes a difference. Future studies may help health care teams know if switching biologics in a certain way can improve the outlook for JIA patients.

Next Steps

Learn more about what other CARRA research projects are finding from their work.

View the full contents of this article to learn more about when and why doctors switch biologics for JIA patients.


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