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. 2024 Sep 1;63(SI2):SI173-SI179.
doi: 10.1093/rheumatology/kead560.

A decade of progress in juvenile idiopathic arthritis treatments and outcomes in Canada: results from ReACCh-Out and the CAPRI registry

Kelly Nguyen  1 , Julie Barsalou  2 , Daniah Basodan  3 , Michelle Batthish  4 , Susanne M Benseler  5 , Roberta A Berard  6 , Nicholas Blanchette  7 , Gilles Boire  8 , Roxana Bolaria  1 , Alessandra Bruns  8 , David A Cabral  1 , Bonnie Cameron  9 , Sarah Campillo  10 , Tania Cellucci  4 , Mercedes Chan  1 , Gaëlle Chédeville  10 , Anne-Laure Chetaille  11 , Amieleena Chhabra  1 , Julie Couture  2 , Paul Dancey  12 , Jean-Jacques De Bruycker  2 , Erkan Demirkaya  6 , Muhammed Dhalla  5 , Ciarán M Duffy  13 , Brian M Feldman  9 , Debbie E Feldman  2 , Tommy Gerschman  1 , Elie Haddad  2 , Liane Heale  4 , Julie Herrington  4 , Kristin Houghton  1 , Adam M Huber  14 , Andrea Human  1 , Nicole Johnson  5 , Roman Jurencak  13 , Bianca Lang  14 , Maggie Larché  4 , Ronald M Laxer  9 , Claire M LeBlanc  10 , Jennifer J Y Lee  9 , Deborah M Levy  9 , Lillian Lim  3 , Lily S H Lim  15 , Nadia Luca  13 , Tara McGrath  3 , Tamara McMillan  15 , Paivi M Miettunen  5 , Kimberly A Morishita  1 , Hon Yan Ng  16 , Kiem Oen  15 , Jonathan Park  6 , Ross E Petty  1 , Jean-Philippe Proulx-Gauthier  11 , Suzanne Ramsey  14 , Johannes Roth  13 , Alan M Rosenberg  16 , Evelyn Rozenblyum  9 , Dax G Rumsey  3 , Heinrike Schmeling  5 , Rayfel Schneider  9 , Rosie Scuccimarri  10 , Natalie J Shiff  16 , Earl Silverman  9 , Gordon Soon  7   17 , Lynn Spiegel  9 , Elizabeth Stringer  14 , Herman Tam  1 , Shirley M Tse  9 , Lori B Tucker  1 , Stuart Turvey  1 , Marinka Twilt  5 , Karen Watanabe Duffy  13 , Rae S M Yeung  9 , Jaime Guzman  1
Affiliations

A decade of progress in juvenile idiopathic arthritis treatments and outcomes in Canada: results from ReACCh-Out and the CAPRI registry

Kelly Nguyen et al. Rheumatology (Oxford). .

Erratum in

Abstract

Objective: To assess changes in juvenile idiopathic arthritis (JIA) treatments and outcomes in Canada, comparing 2005-2010 and 2017-2021 inception cohorts.

Methods: Patients enrolled within three months of diagnosis in the Research in Arthritis in Canadian Children Emphasizing Outcomes (ReACCh-Out) and the Canadian Alliance of Pediatric Rheumatology Investigators Registry (CAPRI) cohorts were included. Cumulative incidences of drug starts and outcome attainment within 70 weeks of diagnosis were compared with Kaplan-Meier survival analysis and multivariable Cox regression.

Results: The 2005-2010 and 2017-2021 cohorts included 1128 and 721 patients, respectively. JIA category distribution and baseline clinical juvenile idiopathic arthritis disease activity (cJADAS10) scores at enrolment were comparable. By 70 weeks, 6% of patients (95% CI 5, 7) in the 2005-2010 and 26% (23, 30) in the 2017-2021 cohort had started a biologic DMARD (bDMARD), and 43% (40, 47) and 60% (56, 64) had started a conventional DMARD (cDMARD), respectively. Outcome attainment was 64% (61, 67) and 83% (80, 86) for inactive disease (Wallace criteria), 69% (66, 72) and 84% (81, 87) for minimally active disease (cJADAS10 criteria), 57% (54, 61) and 63% (59, 68) for pain control (<1/10), and 52% (47, 56) and 54% (48, 60) for good health-related quality of life (≥9/10).

Conclusion: Although baseline disease characteristics were comparable in the 2005-2010 and 2017-2021 cohorts, cDMARD and bDMARD use increased with a concurrent increase in minimally active and inactive disease. Improvements in parent and patient-reported outcomes were smaller than improvements in disease activity.

Keywords: juvenile arthritis; outcomes; prognosis; treatment.

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Figures

Figure 1.
Figure 1.
Cumulative incidence curves for treatments and outcomes in two Canadian JIA cohorts. Shown are Kaplan–Meier curves for the three years after diagnosis for patients diagnosed in 2005–2010 and patients diagnosed in 2017–2021. The serrated appearance of outcome curves for the 2005–2010 cohort is due to the use of fixed intervals for data collection every 6 months. This does not apply to treatment curves or to the outcome curves from the 2017–2021 cohort because that data was collected at every visit to the clinic. The numbers in brackets indicate the number of observed events during each time period
Figure 2.
Figure 2.
Treatments and outcomes across JIA categories in two Canadian cohorts. Shown are Kaplan–Meier estimates of the cumulative incidence of events within 70 weeks after JIA diagnosis for patients diagnosed in 2005–2010 and for patients diagnosed in 2017–2021
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