Use of Biologic Therapies Surpasses Conventional Treatments in Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis (JIA), the most common childhood rheumatic disorder, is experiencing a significant shift in treatment approaches. Over the past two decades, biologic and targeted therapies have become more prevalent, surpassing traditional treatments. A Rutgers Health study, published in Arthritis & Rheumatology, analyzed treatment patterns among nearly 14,000 children with JIA, highlighting these evolving trends in the therapeutic landscape.

Biologic Therapies Take Center Stage

The study revealed a notable decrease in the use of conventional therapies, such as methotrexate, with initiations dropping by over 45%. In contrast, biologic and targeted therapies have gained traction as preferred treatment options. By 2022, adalimumab, a biologic first approved for rheumatoid arthritis in 2002, accounted for nearly 80% of initial biologic therapies prescribed for JIA. These newer treatments, while more costly, tend to be both more effective and better tolerated than older medications. The growing availability of disease-modifying antirheumatic drugs (DMARDs) has allowed clinicians to address the underlying mechanisms of the disease, improving outcomes for pediatric patients.

Why This Matters

JIA affects between 16 and 150 per 100,000 children in North America and is associated with chronic inflammation, joint pain, and stiffness that can significantly impair quality of life. According to Daniel Horton, senior author of the study and a researcher at Rutgers, "JIA can take a heavy toll on the lives of affected children and families. Fortunately, the therapeutic landscape has changed dramatically in recent years." Emerging therapies not only provide symptomatic relief but also reduce the risk of long-term complications, such as joint damage and vision loss, offering children better chances for improved health outcomes.

A Pioneering Study

This research is among the first to comprehensively explore real-world treatment practices for JIA, filling a notable gap in pediatric-focused rheumatology studies. Lead author Priyanka Yalamanchili, a Rutgers School of Public Health graduate, noted that the findings provide a foundation for future investigations. These studies could examine the comparative safety and effectiveness of different treatment strategies, further advancing care for children with JIA.

Supporting Research and Broader Impact

The study was supported by a range of organizations, including the National Institutes of Health, the Rheumatology Research Foundation, and the Juvenile Diabetes Research Foundation. Its findings will be presented at the upcoming American College of Rheumatology Convergence, a key event for the rheumatology community.