Effectiveness and drug survival of biologic drugs in the treatment of juvenile idiopathic arthritis

Abstract

Data on treatment performance in real-life setting is needed to supplement the data gained in randomised clinical trials. Variety of registries are increasingly exploited to provide real-world data on effectiveness and long-term safety of the treatments, especially in the context of biological drugs. This Master’s Thesis aimed to evaluate the effectiveness, safety, and drug survival of biologic anti-rheumatic medication in the treatment of juvenile idiopathic arthritis in real-life setting in Finnish population. Using the registry data of the New Children’s Hospital of the Helsinki University Hospital, this retrospective cohort study observed child and adolescent patients diagnosed with juvenile idiopathic arthritis initiating biologic drug during 2015‒2018, for a two-year period.

Hundred six patients were included in the study. Patients were divided into two study groups based on therapeutic intervention and probability of the formation of anti-drug antibodies against the drug, resulting in 73 patients on etanercept, tocilizumab or abatacept (ETA/TOC/ABA-group) and 33 on adalimumab, infliximab or golimumab (ADA/IFX/GOL-group). Marked decrease in disease activity was seen already after 3 months of treatment. Percentages of patients reaching clinically inactive disease at 12 months, a primary outcome of the study, were comparable between the groups (66.7% in ETA/TOC/ABA versus 65.4% in ADA/IFX/GOL). Among 106 patients, 30 subjects (28.3%) discontinued the treatment during the follow-up, most often due to intolerance (10.4%). This study confirms biologic drugs as generally safe and effective with a need for careful vigilance, creating real-world evidence to support clinical decision-making.