A Retrospective Cohort Study of biologic disease-modifying therapy in pediatric rheumatology patients with juvenile idiopathic arthritis
DOI:
https://doi.org/10.5281/zenodo.22814019Keywords:
juvenile idiopathic arthritis, biologic DMARD, pediatric rheumatology, disease activity, retrospective cohortAbstract
Background: Biologic disease-modifying antirheumatic drugs (bDMARDs) have transformed outcomes in juvenile idiopathic arthritis (JIA), but most efficacy data come from registration trials rather than everyday pediatric rheumatology practice.
Objective: This review synthesizes the retrospective cohort and registry evidence on biologic use, disease activity trajectory, and safety in children with JIA managed with bDMARDs.
Methods: We synthesized randomized trials and observational cohorts addressing etanercept, adalimumab, tocilizumab, abatacept, canakinumab, and anakinra in JIA, extracting response measures, corticosteroid exposure, and adverse events.
Findings: Real-world cohorts achieved disease activity reduction and steroid-sparing benefit broadly consistent with trial data; earlier biologic initiation and methotrexate co-therapy were associated with better response, and serious adverse events were infrequent though mild infections were common.
Conclusions: First-line bDMARD therapy for JIA produces disease activity improvement broadly consistent across trial and real-world settings, supporting earlier escalation after inadequate synthetic DMARD response and structured long-term safety surveillance.
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