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. 2025 Sep 2;35(5):909-915.
doi: 10.1093/mr/roaf032.

Verification of unmet medical needs in patients with juvenile idiopathic arthritis in Japan

Masaki Shimizu  1 , Eisuke Inoue  2   3 , Ryoko Sakai  2   4 , Yuzaburo Inoue  5 , Kanako Mitsunaga  6 , Takahiko Sugihara  7 , Toru Hirano  8 , Kazushi Izawa  9 , Dai Kishida  10 , Masakazu Matsushita  11 , Masaaki Mori  12   13 , Hidehiko Narazaki  14 , Ryuta Nishikomori  15 , Shuji Sumitomo  16 , Takayuki Tanaka  17 , Susumu Yamazaki  18 , Ken Yamaji  11 , Naoto Yokogawa  19 , Hajime Yoshifuji  20 , Takako Miyamae  2
Affiliations

Verification of unmet medical needs in patients with juvenile idiopathic arthritis in Japan

Masaki Shimizu et al. Mod Rheumatol. .

Abstract

Objectives: To identify unmet medical needs (UMNs) of medical practices and investigate the real-world prescribing practices of therapeutic medical treatments and test implementation for patients with juvenile idiopathic arthritis (JIA).

Methods: The possible UMNs were collected from eight paediatric and eight adult rheumatologists. To verify UMNs, the real-world prescribing practices of therapeutic medical treatments and test implementation for patients with JIA were described using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB).

Results: Fifty-eight possible UMNs collected from 16 experts and 35 UMNs were investigated using NDB. The highest priority UMNs was the expansion of indications for subcutaneous tocilizumab (TCZ sc) and subcutaneous abatacept- subcutaneous tocilizumab was administered to 12.8% systemic JIA and 5.5% JIA with polyarthritis or oligoarthritis. Comorbidities for systemic JIA and JIA with polyarthritis or oligoarthritis included hypertension (7.1%, 1.3%), osteoporosis (17%, 5.4%), depression (2.3%, 1.3%), diabetes (1.9% systemic JIA), and iritis and/or uveitis (6.5% JIA with polyarthritis or oligoarthritis).

Conclusions: The highest priority UMNs for JIA was the expansion of indications for abatacept sc and especially subcutaneous tocilizumab. This study reveals the real-world prescribing practices of therapeutic medical treatments and test implementation for patients with JIA in Japan.

Keywords: Abatacept; Japan; National Database; comorbidity; juvenile idiopathic arthritis; oligoarthritis; polyarthritis; rheumatology; tocilizumab; unmet medical need.

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