Treatment of patients with juvenile idiopathic arthritis (JIA) in a population-based cohort

Jorge A. Zamora-Legoff, Megan L. Krause, Cynthia Crowson, Theresa Wampler Muskardin, Thomas Mason, Eric Lawrence Matteson

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

A population-based cohort was utilized to evaluate medications and intra-articular injection utilization for patients with juvenile idiopathic arthritis (JIA) to inform clinical practice and further research. In a geographically defined population, all incident cases of JIA cases were identified between January 1, 1994 and December 31, 2013 based first on diagnosis code followed by medical chart confirmation. Medications and intra-articular glucocorticoid injections were abstracted. Predictors of the first disease-modifying antirheumatic drug (DMARD)/biologic and injections were reported as a hazard ratio (HR) with 95 % confidence intervals (CIs) adjusted for age and sex. Kaplan-Meier methods evaluated therapy at 6 months and 1 year. Injections were reported per 100 person-years (py) with 95 % CI using the Poisson methods. Seventy-one incident cases were identified. Forty-two (59 %) were female with mean age (standard deviation) at diagnosis of 8.2 (5.3) years. Twenty-six (37 %) utilized at least one DMARD or biologic, in which 77 % of these were prescribed in the first 6 months. Subtype of JIA was significantly associated with DMARDs/biologics (p <0.001). Intra-articular injections were performed in 48 %. The rate of intra-articular injections was 20.7 per 100 py (95 % CI 16.5, 25.6). The rate of joint injections was higher in the first year after diagnosis (p <0.001) and more common in recent years (p <0.001). The majority of patients with JIA in a modern population-based cohort do not require DMARDs or biologics. In those who do, the majority receives these within the first 6 months. Intra-articular injections were utilized in almost half of patients with JIA and were increasingly used.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalClinical Rheumatology
DOIs
StateAccepted/In press - Jan 29 2016

Fingerprint

Intra-Articular Injections
Juvenile Arthritis
Antirheumatic Agents
Population
Confidence Intervals
Biological Products
Injections
Therapeutics
Glucocorticoids
Joints
Research

Keywords

  • Biologics
  • DMARD
  • Intra-articular Injections
  • Juvenile idiopathic arthritis
  • NSAIDS

ASJC Scopus subject areas

  • Rheumatology

Cite this

Treatment of patients with juvenile idiopathic arthritis (JIA) in a population-based cohort. / Zamora-Legoff, Jorge A.; Krause, Megan L.; Crowson, Cynthia; Muskardin, Theresa Wampler; Mason, Thomas; Matteson, Eric Lawrence.

In: Clinical Rheumatology, 29.01.2016, p. 1-7.

Research output: Contribution to journalArticle

@article{ed904f11137f4c26b633806aae6109a7,
title = "Treatment of patients with juvenile idiopathic arthritis (JIA) in a population-based cohort",
abstract = "A population-based cohort was utilized to evaluate medications and intra-articular injection utilization for patients with juvenile idiopathic arthritis (JIA) to inform clinical practice and further research. In a geographically defined population, all incident cases of JIA cases were identified between January 1, 1994 and December 31, 2013 based first on diagnosis code followed by medical chart confirmation. Medications and intra-articular glucocorticoid injections were abstracted. Predictors of the first disease-modifying antirheumatic drug (DMARD)/biologic and injections were reported as a hazard ratio (HR) with 95 {\%} confidence intervals (CIs) adjusted for age and sex. Kaplan-Meier methods evaluated therapy at 6 months and 1 year. Injections were reported per 100 person-years (py) with 95 {\%} CI using the Poisson methods. Seventy-one incident cases were identified. Forty-two (59 {\%}) were female with mean age (standard deviation) at diagnosis of 8.2 (5.3) years. Twenty-six (37 {\%}) utilized at least one DMARD or biologic, in which 77 {\%} of these were prescribed in the first 6 months. Subtype of JIA was significantly associated with DMARDs/biologics (p <0.001). Intra-articular injections were performed in 48 {\%}. The rate of intra-articular injections was 20.7 per 100 py (95 {\%} CI 16.5, 25.6). The rate of joint injections was higher in the first year after diagnosis (p <0.001) and more common in recent years (p <0.001). The majority of patients with JIA in a modern population-based cohort do not require DMARDs or biologics. In those who do, the majority receives these within the first 6 months. Intra-articular injections were utilized in almost half of patients with JIA and were increasingly used.",
keywords = "Biologics, DMARD, Intra-articular Injections, Juvenile idiopathic arthritis, NSAIDS",
author = "Zamora-Legoff, {Jorge A.} and Krause, {Megan L.} and Cynthia Crowson and Muskardin, {Theresa Wampler} and Thomas Mason and Matteson, {Eric Lawrence}",
year = "2016",
month = "1",
day = "29",
doi = "10.1007/s10067-016-3190-4",
language = "English (US)",
pages = "1--7",
journal = "Clinical Rheumatology",
issn = "0770-3198",
publisher = "Springer London",

}

TY - JOUR

T1 - Treatment of patients with juvenile idiopathic arthritis (JIA) in a population-based cohort

AU - Zamora-Legoff, Jorge A.

AU - Krause, Megan L.

AU - Crowson, Cynthia

AU - Muskardin, Theresa Wampler

AU - Mason, Thomas

AU - Matteson, Eric Lawrence

PY - 2016/1/29

Y1 - 2016/1/29

N2 - A population-based cohort was utilized to evaluate medications and intra-articular injection utilization for patients with juvenile idiopathic arthritis (JIA) to inform clinical practice and further research. In a geographically defined population, all incident cases of JIA cases were identified between January 1, 1994 and December 31, 2013 based first on diagnosis code followed by medical chart confirmation. Medications and intra-articular glucocorticoid injections were abstracted. Predictors of the first disease-modifying antirheumatic drug (DMARD)/biologic and injections were reported as a hazard ratio (HR) with 95 % confidence intervals (CIs) adjusted for age and sex. Kaplan-Meier methods evaluated therapy at 6 months and 1 year. Injections were reported per 100 person-years (py) with 95 % CI using the Poisson methods. Seventy-one incident cases were identified. Forty-two (59 %) were female with mean age (standard deviation) at diagnosis of 8.2 (5.3) years. Twenty-six (37 %) utilized at least one DMARD or biologic, in which 77 % of these were prescribed in the first 6 months. Subtype of JIA was significantly associated with DMARDs/biologics (p <0.001). Intra-articular injections were performed in 48 %. The rate of intra-articular injections was 20.7 per 100 py (95 % CI 16.5, 25.6). The rate of joint injections was higher in the first year after diagnosis (p <0.001) and more common in recent years (p <0.001). The majority of patients with JIA in a modern population-based cohort do not require DMARDs or biologics. In those who do, the majority receives these within the first 6 months. Intra-articular injections were utilized in almost half of patients with JIA and were increasingly used.

AB - A population-based cohort was utilized to evaluate medications and intra-articular injection utilization for patients with juvenile idiopathic arthritis (JIA) to inform clinical practice and further research. In a geographically defined population, all incident cases of JIA cases were identified between January 1, 1994 and December 31, 2013 based first on diagnosis code followed by medical chart confirmation. Medications and intra-articular glucocorticoid injections were abstracted. Predictors of the first disease-modifying antirheumatic drug (DMARD)/biologic and injections were reported as a hazard ratio (HR) with 95 % confidence intervals (CIs) adjusted for age and sex. Kaplan-Meier methods evaluated therapy at 6 months and 1 year. Injections were reported per 100 person-years (py) with 95 % CI using the Poisson methods. Seventy-one incident cases were identified. Forty-two (59 %) were female with mean age (standard deviation) at diagnosis of 8.2 (5.3) years. Twenty-six (37 %) utilized at least one DMARD or biologic, in which 77 % of these were prescribed in the first 6 months. Subtype of JIA was significantly associated with DMARDs/biologics (p <0.001). Intra-articular injections were performed in 48 %. The rate of intra-articular injections was 20.7 per 100 py (95 % CI 16.5, 25.6). The rate of joint injections was higher in the first year after diagnosis (p <0.001) and more common in recent years (p <0.001). The majority of patients with JIA in a modern population-based cohort do not require DMARDs or biologics. In those who do, the majority receives these within the first 6 months. Intra-articular injections were utilized in almost half of patients with JIA and were increasingly used.

KW - Biologics

KW - DMARD

KW - Intra-articular Injections

KW - Juvenile idiopathic arthritis

KW - NSAIDS

UR - http://www.scopus.com/inward/record.url?scp=84955614121&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84955614121&partnerID=8YFLogxK

U2 - 10.1007/s10067-016-3190-4

DO - 10.1007/s10067-016-3190-4

M3 - Article

C2 - 26825065

AN - SCOPUS:84955614121

SP - 1

EP - 7

JO - Clinical Rheumatology

JF - Clinical Rheumatology

SN - 0770-3198

ER -