Comparative analysis of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) systemic Juvenile Idiopathic Arthritis Consensus Treatment Plans

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SCIENCE
Comparative analysis of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) systemic Juvenile Idiopathic Arthritis Consensus Treatment Plans
Key Take-Away: 

Consensus treatment plans can be successfully implemented using the Childhood Arthritis and Rheumatology Research Alliance registry infrastructure. Juvenile arthritis is a disease in which there is inflammation(swelling) of the synovium that lines inside of the joints in children aged 16 or younger.

Juvenile arthritis is a disease in which cause inflammation(swelling) of the synovium that lines inside of the joints in aged 16 or younger. Juvenile arthritis is an autoimmune disease. 

ABSTRACT: 
Background: 

Juvenile arthritis is a disease in which cause inflammation(swelling) of the synovium that lines inside of the joints in aged 16 or younger. Juvenile arthritis is an autoimmune disease.

That means the immune system, which protects the body from foreign substances, attacks the body instead.  The presented study was aimed to assess the feasibility of studying the comparative effectiveness of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) consensus treatment plans (CTPs) for Systemic Juvenile Idiopathic Arthritis (JIA) using an observational registry.

Methods: 

Untreated systemic JIA patients enrolled in the CARRA Registry were begun on one of 4 CTPs chosen by the treating physician and patient/family (glucocorticoid [GC] alone; methotrexate [MTX] ± GC; IL1 inhibitor [IL1i] ± GC; IL6 inhibitor [IL6i] ± GC).

The primary outcome of clinical inactive disease (CID) without current GC use was assessed at 9 months.

Results: 

Total thirty patients were enrolled at 13 sites; eight patients were started on a non-biologic CTP (2 GC, 6 MTX) and 22 patients on a biologic CTP (12 I-L1i, 10 IL-6i) at disease onset.

Demographic and disease features were similar between CTP groups and CTP choice appeared to segregate by site preference. CID off GC was achieved by 37% (11 of 30) including 11/22 (50%) starting a biologic CTP compared to 0/8 starting a non-biologic CTP (p = 0.014). There were four serious adverse events: two infections, one appendicitis and one macrophage activation syndrome.

Conclusion: 

The CARRA systemic JIA CTP pilot study demonstrated a successful implementation of CTPs using the CARRA registry infrastructure.

Having demonstrated feasibility, a larger study using CTP response to better determine the relative effectiveness of treatments for new-onset systemic JIA is now underway.

Source:

Pediatric Rheumatology

Link to the source:

https://pedrheum.biomedcentral.com/articles/10.1186/s12969-017-0157-1

The original title of the article:

Pilot study comparing the Childhood Arthritis & Rheumatology Research Alliance (CARRA) systemic Juvenile Idiopathic Arthritis Consensus Treatment Plans

Authors:

Yukiko Kimura et al.

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