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Bethencourt Baute JJ, Sanchez-Piedra C, Ruiz-Montesinos D, Medrano San Ildefonso M, Rodriguez-Lozano C, Perez-Pampin E, Ortiz A, Manrique S, Roselló R, Hernandez V, Campos C, Sellas A, Sifuentes-Giraldo WA, García-González J, Sanchez-Alonso F, Díaz-González F, Gómez-Reino JJ, Bustabad Reyes S. Persistence and adverse events of biological treatment in adult patients with juvenile idiopathic arthritis: results from BIOBADASER. Arthritis Res Ther 2018; 20:227. [PMID: 30305158 PMCID: PMC6235210 DOI: 10.1186/s13075-018-1728-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 09/19/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Biologic therapy has changed the prognosis of patients with juvenile idiopathic arthritis (JIA). The aim of this study was to examine the pattern of use, drug survival, and adverse events of biologics in patients with JIA during the period from diagnosis to adulthood. METHODS All patients included in BIOBADASER (Spanish Registry for Adverse Events of Biological Therapy in Rheumatic Diseases), a multicenter prospective registry, diagnosed with JIA between 2000 and 2015 were analyzed. Proportions, means, and SDs were used to describe the population. Incidence rates and 95% CIs were calculated to assess adverse events. Kaplan-Meier analysis was used to compare the drug survival rates. RESULTS A total of 469 patients (46.1% women) were included. Their mean age at diagnosis was 9.4 ± 5.3 years. Their mean age at biologic treatment initiation was 23.9 ± 13.9 years. The pattern of use of biologics during their pediatric years showed a linear increase from 24% in 2000 to 65% in 2014. Biologic withdrawal for disease remission was higher in patients who initiated use biologics prior to 16 years of age than in those who were older (25.7% vs 7.9%, p < 0.0001). Serious adverse events had a total incidence rate of 41.4 (35.2-48.7) of 1000 patient-years. Patients younger than 16 years old showed significantly increased infections (p < 0.001). CONCLUSIONS Survival and suspension by remission of biologics were higher when these compounds were initiated in patients with JIA who had not yet reached 16 years of age. The incidence rate of serious adverse events in pediatric vs adult patients with JIA treated with biologics was similar; however, a significant increase of infection was observed in patients under 16 years old.
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Affiliation(s)
| | | | | | | | - Carlos Rodriguez-Lozano
- Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain
| | - Eva Perez-Pampin
- Servicio de Reumatología, Hospital Clínico Universitario de Santiago, A Coruña, Spain
| | - Ana Ortiz
- Servicio de Reumatología, Hospital de La Princesa, Madrid, Spain
| | - Sara Manrique
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
| | - Rosa Roselló
- Servicio de Reumatología, Hospital San Jorge, Huesca, Spain
| | - Victoria Hernandez
- Servicio de Reumatología, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Cristina Campos
- Servicio de Reumatología, Hospital General Universitario Valencia, Valencia, Spain
| | - Agustí Sellas
- Servicio de Reumatología, Hospital Vall d’Hebron, Barcelona, Spain
| | | | | | | | - Federico Díaz-González
- Servicio de Reumatología, Hospital Universitario de Canarias, c/Ofra s/n 38320, La Laguna, Santa Cruz de Tenerife, Spain
| | | | - Sagrario Bustabad Reyes
- Servicio de Reumatología, Hospital Universitario de Canarias, c/Ofra s/n 38320, La Laguna, Santa Cruz de Tenerife, Spain
| | - on behalf of the BIOBADASER study group
- Servicio de Reumatología, Hospital Universitario de Canarias, Tenerife, Spain
- Research Unit, Sociedad Española de Reumatología, Madrid, Spain
- Servicio de Reumatología, Hospital Universitario del Virgen Macarena, Sevilla, Spain
- Servicio de Reumatología Hospital Universitario Miguel Servet, Zaragoza, Spain
- Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain
- Servicio de Reumatología, Hospital Clínico Universitario de Santiago, A Coruña, Spain
- Servicio de Reumatología, Hospital de La Princesa, Madrid, Spain
- UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
- Servicio de Reumatología, Hospital San Jorge, Huesca, Spain
- Servicio de Reumatología, Hospital Clinic de Barcelona, Barcelona, Spain
- Servicio de Reumatología, Hospital General Universitario Valencia, Valencia, Spain
- Servicio de Reumatología, Hospital Vall d’Hebron, Barcelona, Spain
- Servicio Reumatología, Hospital Ramón y Cajal, Madrid, Spain
- Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain
- Servicio de Reumatología, Hospital Universitario de Canarias, c/Ofra s/n 38320, La Laguna, Santa Cruz de Tenerife, Spain
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