Real-world comparison of the effects of etanercept and adalimumab on well-being in non-systemic juvenile idiopathic arthritis: a propensity score matched cohort study.

Autor: van Straalen JW; Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. box 85090, 3508 AB, Utrecht, The Netherlands. j.w.vanstraalen-2@umcutrecht.nl.; Faculty of Medicine, Utrecht University, Utrecht, the Netherlands. j.w.vanstraalen-2@umcutrecht.nl., de Roock S; Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. box 85090, 3508 AB, Utrecht, The Netherlands.; Faculty of Medicine, Utrecht University, Utrecht, the Netherlands., Giancane G; Clinica Pediatrica E Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy.; Dipartimento Di NeuroscienzeRiabilitazioneOftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università Degli Studi Di Genova, Genoa, Italy., Consolaro A; Clinica Pediatrica E Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy.; Dipartimento Di NeuroscienzeRiabilitazioneOftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università Degli Studi Di Genova, Genoa, Italy., Rygg M; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.; Department of Pediatrics, St. Olavs University Hospital of Trondheim, Trondheim, Norway., Nordal EB; Department of Pediatrics, University Hospital of North Norway, Tromsø, Norway.; Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway., Rubio-Pérez N; Departamento de Pediatria, Facultad de Medicina, Hospital Universitario 'Dr. J. E. González', Universidad Autónoma de Nuevo León, Monterrey, Mexico., Jelusic M; Department of Paediatrics, University of Zagreb School of Medicine, Zagreb, Croatia., De Inocencio J; Department of Pediatric Rheumatology, University Hospital 12 de Octubre, Madrid, Spain., Vojinovic J; Department of Pediatric Immunology and Rheumatology, Faculty of Medicine, University of Nis, Nis, Serbia.; Department of Pediatric Rheumatology, Clinic of Pediatrics, Clinical Center Nis, Nis, Serbia., Wulffraat NM; Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. box 85090, 3508 AB, Utrecht, The Netherlands.; Faculty of Medicine, Utrecht University, Utrecht, the Netherlands., Bruijning-Verhagen PCJ; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands., Ruperto N; UOSID Centro Trial, IRCCS Istituto Giannina Gaslini, Genoa, Italy., Swart JF; Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. box 85090, 3508 AB, Utrecht, The Netherlands.; Faculty of Medicine, Utrecht University, Utrecht, the Netherlands.
Jazyk: angličtina
Zdroj: Pediatric rheumatology online journal [Pediatr Rheumatol Online J] 2022 Nov 14; Vol. 20 (1), pp. 96. Date of Electronic Publication: 2022 Nov 14.
DOI: 10.1186/s12969-022-00763-x
Abstrakt: Background: Etanercept (ETN) and adalimumab (ADA) are considered equally effective biologicals in the treatment of arthritis in juvenile idiopathic arthritis (JIA) but no studies have compared their impact on patient-reported well-being. The objective of this study was to determine whether ETN and ADA have a differential effect on patient-reported well-being in non-systemic JIA using real-world data.
Methods: Biological-naive patients without a history of uveitis were selected from the international Pharmachild registry. Patients starting ETN were matched to patients starting ADA based on propensity score and outcomes were collected at time of therapy initiation and 3-12 months afterwards. Primary outcome at follow-up was the improvement in Juvenile Arthritis Multidimensional Assessment Report (JAMAR) visual analogue scale (VAS) well-being score from baseline. Secondary outcomes at follow-up were decrease in active joint count, adverse events and uveitis events. Outcomes were analyzed using linear and logistic mixed effects models.
Results: Out of 158 eligible patients, 45 ETN starters and 45 ADA starters could be propensity score matched resulting in similar VAS well-being scores at baseline. At follow-up, the median improvement in VAS well-being was 2 (interquartile range (IQR): 0.0 - 4.0) and scores were significantly better (P = 0.01) for ETN starters (median 0.0, IQR: 0.0 - 1.0) compared to ADA starters (median 1.0, IQR: 0.0 - 3.5). The estimated mean difference in VAS well-being improvement from baseline for ETN versus ADA was 0.89 (95% CI: -0.01 - 1.78; P = 0.06). The estimated mean difference in active joint count decrease was -0.36 (95% CI: -1.02 - 0.30; P = 0.28) and odds ratio for adverse events was 0.48 (95% CI: 0.16 -1.44; P = 0.19). One uveitis event was observed in the ETN group.
Conclusions: Both ETN and ADA improve well-being in non-systemic JIA. Our data might indicate a trend towards a slightly stronger effect for ETN, but larger studies are needed to confirm this given the lack of statistical significance.
(© 2022. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje