A decade of progress in juvenile idiopathic arthritis treatments and outcomes in Canada: results from ReACCh-Out and the CAPRI registry
Kelly Nguyen, Julie Barsalou, Daniah Basodan, Michelle Batthish, Susanne M Benseler, Roberta Berard, Nicholas Blanchette, Gilles Boire, Roxana Bolaria, Alessandra Bruns, David A. Cabral, Bonnie Cameron, Sarah Campillo, Tania Cellucci, Mercedes Chan, Gaëlle Chédeville, Anne-Laure Chetaille, Amieleena Chhabra, Julie Couture, Paul Dancey, Jean Jacques De Bruycker, Erkan Demirkaya, Muhammed Dhalla, Ciarán M. Duffy, Brian M. Feldman, Debbie Ehrmann Feldman, Tommy Gerschman, Élie Haddad, Liane Heale, J. Lynwood Herrington, Kristin Houghton, Adam M. Huber, Andrea Human, Nicole Johnson, Roman Juřenčák, Bianca Lang, Maggie Larché, Ronald M. Laxer, Claire LeBlanc, Jennifer J. Lee, Deborah M. Levy, Lillian Lim, Lily Siok Hoon Lim, Nadia Luca, Tara McGrath, Tara McMillan, Päivi Miettunen, Kimberly Morishita, Hon Yan Ng, Kiem Oen, Jonathan Park, Ross E. Petty, Jean‐Philippe Proulx‐Gauthier, Suzanne Ramsey, Johannes Roth, Alan Rosenberg, Evelyn Rozenblyum, Dax G. Rumsey, Heinrike Schmeling, Rayfel Schneider, Rosie Scuccimarri, Natalie J. Shiff, Earl D. Silverman, Gordon S. Soon, Lynn Spiegel, Elizabeth Stringer, Herman Tam, Shirley M. L. Tse, Lori B. Tucker, Stuart E. Turvey, Marinka Twilt, Karen Watanabe Duffy, Rae S. M. Yeung, Jaime Guzmán
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.