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Observational Study
. 2025 Dec 16:16:1712103.
doi: 10.3389/fimmu.2025.1712103. eCollection 2025.

The epidemiology and biologics treatment patterns of juvenile idiopathic arthritis in Taiwan- an 8-year follow-up

Ya-Chiao Hu  1   2 , Yun-Lin Huang  3   4 , Szu-Yu Yiao  5 , Min-Ting Lin  5 , Fang-Ju Lin  3   4   6 , Yao-Hsu Yang  1   2
Affiliations
Observational Study

The epidemiology and biologics treatment patterns of juvenile idiopathic arthritis in Taiwan- an 8-year follow-up

Ya-Chiao Hu et al. Front Immunol. .

Abstract

Background: Juvenile Idiopathic Arthritis (JIA) is the most common chronic arthritis in children, causing significant joint inflammation and complications. This study evaluates the incidence, prevalence, and treatment patterns of JIA in Taiwan, focusing on biologic therapy.

Methods: A retrospective observational study utilized data from the National Health Insurance Research Database (NHIRD) for the period 2011-2020. Patients diagnosed with JIA were identified, and the annual incidence and prevalence rates were calculated. Treatment patterns, particularly regarding biologics, were assessed. Subgroup analysis compared patients diagnosed with spondyloarthritis (SpA) versus non-SpA within the JIA cohort.

Results: Two thousand and thirty-three JIA patients were included. The annual prevalence ranged from 18.0 to 24.2 per 100,000 populations under 16 years old, with an incidence of 5.22 to 6.57 per 100,000. A male predominance was noted (male-to-female ratio: 1.08-1.52:1). The JIA-SpA subgroup comprised 49.2% of the JIA cohort. Compared to Non-SpA patients, the JIA-SpA subgroup showed male predominance (70.7% vs. 44.4%, p<0.0001), later age of onset, and lower biologic use (15.2% vs. 23.1%, p<0.001). Tumor necrosis factor alpha inhibitors were the most used biologics, with a continuation rate of 49.1%. Switching occurred in 13.2% of patients, mostly without interruption within a treatment gap of 60 days. Discontinuation without subsequent biologic therapy was observed in 9.5% of patients, while 28.2% restarted therapy after a treatment interruption of more than 60 days.

Conclusion: This study highlights the epidemiological characteristics and treatment patterns for JIA in Taiwan, focusing on biologic therapies. Most patients maintained consistent biologics, with a small proportion able to discontinue them, emphasizing the need for region-specific management strategies.

Keywords: biologics; epidemiology; juvenile idiopathic arthritis (JIA); spondyloarthritis; treatment.

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Conflict of interest statement

Authors S-YY and M-TL were employed by Novartis Taiwan Co. Ltd. The remaining author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Prevalence (A) and incidence (B) of juvenile idiopathic arthritis (JIA) in Taiwan from 2012 to 2019. Bar plots display the ratios of three age categories at onset: under 6 years, 6 to 12 years, and 12 to 16 years.
Figure 2
Figure 2
Flow chart of biologics use in patients with juvenile idiopathic arthritis (JIA) and the treatment course of the 326 JIA patients receiving biologics. The data are expressed as patient numbers.
Figure 3
Figure 3
Kaplan-Meier curves illustrating drug survival for biologics utilized in juvenile idiopathic arthritis patients. Curves are presented for (A) all biologics, (B) etanercept, (C) adalimumab, and (D) tocilizumab.
See this image and copyright information in PMC

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