Impact of biologic disease-modifying therapy on Quality of Life in Patients with juvenile idiopathic arthritis

Abstract

Background: Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of childhood, and biologic disease-modifying antirheumatic drugs targeting tumor necrosis factor, interleukin-1, interleukin-6, and T-cell costimulation have transformed disease control across its subtypes since the late 1990s.

Objective: This review synthesizes the published evidence on how biologic therapy affects health-related quality of life in JIA, beyond the joint-count and laboratory endpoints reported in most pivotal trials.

Methods: We synthesized randomized controlled trials, long-term registry cohorts, and validation studies of disability and quality of life instruments in children treated with biologic disease-modifying therapy for JIA.

Findings: Biologic therapy produces durable improvement in disability indices and patient-reported quality of life across subtypes, with the largest relative gains in systemic disease and the smallest, most variable gains in fatigue, pain interference, and family-reported burden; sustained disease control through treat-to-target strategies tracks closely with preserved quality of life over long-term follow-up.

Conclusions: Biologic disease-modifying therapy meaningfully improves quality of life in JIA primarily through sustained control of disease activity and reduced corticosteroid burden, but psychosocial and family-level domains require attention alongside joint-focused treatment targets to fully realize the benefit of modern therapy.