A comparison of treatments for children and young people with systemic JIA
Short-term outcomes in patients with systemic juvenile idiopathic arthritis treated with either tocilizumab or anakinra in a real-world cohort study in the United Kingdom.
Lianne Kearsley-Fleet, Michael W. Beresford, Rebecca Davies, Diederik De Cock, Eileen Baildam, Helen E. Foster, Taunton R. Southwood, Wendy Thomson, Kimme L. Hyrich
Response was similar for tocilizumab and anakinra, the two main therapies, although more patients stopped anakinra, mostly for injection-related problems.
Anakinra and tocilizumab are the most common biologic drugs used in children with systemic juvenile idiopathic arthritis (sJIA). The aim of this study was to investigate whether responses to these therapies differ in children and young people with sJIA treated in routine care.
The Biologics for Children with Rheumatic Diseases (BCRD) study follows children with JIA starting biologic drugs to investigate how well they respond to these therapies. Between 2010 and 2016, 54 sJIA patients started tocilizumab and 22 started anakinra.
After one year, 51% of patients achieved minimal disease activity. There were no differences in response between patients on tocilizumab versus anakinra. However, significantly more patients remained on tocilizumab therapy at one year (89%) versus anakinra (59%), with many anakinra patients reporting injection-related problems as the reason for stopping. Anakinra is given as a daily injection, whereas tocilizumab is an IV drip given fortnightly or monthly.
This is the first study in the UK to show that approximately half of the patients with systemic JIA treated with tocilizumab or anakinra have a very good response, although tolerability of these two therapies may be different.
- Anakinra and tocilizumab are the most common biologic drugs used currently in systemic JIA.
- Tocilizumab and anakinra were effective treatments for systemic JIA; half achieved a very good treatment response.
- Treatment response appeared to be similar between systemic JIA patients treated with tocilizumab and anakinra.
- Tolerability over the first year was better with tocilizumab versus anakinra, which may relate to how the drugs are administered.
- Institute of Translational Medicine, University of Liverpool
- BMI Healthcare
- Institute of Cellular Medicine, Newcastle University
- Institute of Clinical Sciences, University of Birmingham
The recruiting centres were supported by the National Institute for Health Research Clinical Research Network in England. BCRD is funded by Versus Arthritis Grant 20747. This research was supported by the National Institute for Health Research Manchester Biomedical Research Centre.