Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, Leibniz Institute, Berlin, Germany.
RMD Open. 2022 Oct;8(2). doi: 10.1136/rmdopen-2022-002520.
To assess the medication and disease burden of young adults with juvenile idiopathic arthritis (JIA).
Young adults with JIA prospectively followed in the Juvenile Arthritis Methotrexate/Biologics long-term Observation reported on their health status and medication use. All medications taken (disease-modifying antirheumatic drugs (DMARDs)/prescription/over-the-counter drugs, but excluding most local therapies) classified according to the Anatomical Therapeutic Chemical Classification System were included in this analysis. Medication use at last follow-up was evaluated by sex, JIA category and time from symptom onset to the first biological DMARD (bDMARD) start.
A total of 1306 young adults (68% female) with JIA and a mean disease duration of 13.6±6 years were included in the study. Patients reported using on average 2.4±2.1 medicines and 1.5±1.7 non-DMARD medicines, respectively, at the last follow-up. Almost a quarter of the patients reported polypharmacy. The higher the number of medications used was, the higher the disease activity, pain and fatigue, and the lower the quality of life of patients. Medication usage differed significantly between sexes and JIA categories, being highest in patients with rheumatoid factor-positive polyarthritis and systemic JIA. The number of medications used was significantly associated with the time from symptom onset to bDMARD start. Patients taking opioids or antidepressants had a particularly high disease burden and had received bDMARDs an average of 2 years later than patients not taking these medications.
Medication use in adults with JIA varies depending on sex, JIA category, and the time between symptom onset and initiation of treatment with bDMARD.
评估青少年特发性关节炎（JIA）患者的药物使用和疾病负担。
前瞻性随访的青少年关节炎甲氨蝶呤/生物制剂长期观察报告中，JIA 成年患者报告了他们的健康状况和药物使用情况。所有服用的药物（疾病修正抗风湿药物（DMARDs）/处方/非处方药，但不包括大多数局部治疗）根据解剖治疗化学分类系统进行分类，都包含在这项分析中。根据性别、JIA 类别和从症状出现到开始使用首个生物 DMARD（bDMARD）的时间，评估最后一次随访时的药物使用情况。
共纳入 1306 名 JIA 成年患者（68%为女性），平均病程为 13.6±6 年。患者报告在最后一次随访时平均使用 2.4±2.1 种药物和 1.5±1.7 种非 DMARD 药物。近四分之一的患者报告使用了多种药物。使用的药物数量越多，患者的疾病活动度、疼痛和疲劳程度越高，生活质量越低。药物使用在性别和 JIA 类别之间存在显著差异，在类风湿因子阳性多关节炎和全身型 JIA 患者中最高。使用的药物数量与从症状出现到 bDMARD 开始使用的时间显著相关。使用阿片类药物或抗抑郁药的患者疾病负担特别高，并且比未使用这些药物的患者平均晚 2 年接受 bDMARD 治疗。
JIA 成年患者的药物使用因性别、JIA 类别以及从症状出现到开始使用 bDMARD 的时间而异。
