Comparative effectiveness of tumor necrosis factor agents and disease-modifying antirheumatic therapy in children with enthesitis-related arthritis: The first year after diagnosis

Pamela F. Weiss, Rui Xiao, Timothy G. Brandon, Ilaria Pagnini, Tracey B. Wright, Timothy Beukelman, Esi Morgan-DeWitt, Chris Feudtner

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Objective: To characterize the effect of anti-tumor necrosis factor (TNF) therapy compared to conventional synthetic disease-modifying antirheumatic drugs (csDMARD) in children with enthesitis-related arthritis (ERA) over the first year after diagnosis. Methods: We conducted a multicenter retrospective comparative effectiveness study of children diagnosed with ERA. We estimated the effect of anti-TNF therapy on clinical variables (active joint count, tender entheses count) and patient-reported pain and global assessment of disease activity over the first year after diagnosis using state-of-the-art comparative effectiveness analytic methods. Results: During the study period, 217 patients newly diagnosed with ERA had a total of 965 clinic visits the first year after disease diagnosis. Children [median age 11.6 yrs, interquartile range 10-14] were treated with anti-TNF monotherapy (n = 33, 15.2%), csDMARD monotherapy (n = 73, 33.6%), or both (n = 52, 23.9%) in the first year after disease diagnosis. There was a statistically significant improvement in the primary outcome, active joint count, over time in children who received an anti-TNF drug versus those who did not (p = 0.03). Additionally, use of anti-TNF therapy versus no anti-TNF therapy was associated with less patient-reported pain (p < 0.01) and improved disease activity over time as assessed by the clinical Juvenile Arthritis Disease Activity Score (p < 0.01). The magnitude of estimated effect on clinical outcomes was uniformly greater, with the exception of tender entheses count, in children treated with an anti-TNF drug versus a csDMARD. Conclusion: During the first year after diagnosis, anti-TNF exposure was associated with benefits for several clinically meaningful outcomes in children with enthesitis-related arthritis.

Original languageEnglish (US)
Pages (from-to)107-114
Number of pages8
JournalJournal of Rheumatology
Volume45
Issue number1
DOIs
StatePublished - Jan 1 2018

Keywords

  • Anti-tumor necrosis factor agents
  • Enthesitis-related arthritis conventional synthetic disease-modifying antirheumatic drugs

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Fingerprint Dive into the research topics of 'Comparative effectiveness of tumor necrosis factor agents and disease-modifying antirheumatic therapy in children with enthesitis-related arthritis: The first year after diagnosis'. Together they form a unique fingerprint.

Cite this