Inoue Yuzaburo, Sakai Ryoko, Inoue Eisuke, Mitsunaga Kanako, Shimizu Masaki, Sugihara Takahiko, Matsushita Masakazu, Yamaji Ken, Mori Masaaki, Shimojo Naoki, Miyamae Takako
Department of General Medical Science, Graduate School of Medicine, Chiba University, Chiba, Japan.
Department of Allergy and Rheumatology, Chiba Children's Hospital, Chiba, Japan.
Mod Rheumatol. 2025 Feb 21;35(2):359-365. doi: 10.1093/mr/roae076.
We aimed to assess the unmet medical needs of young adult patients with juvenile idiopathic arthritis (JIA) by evaluating real-world treatment data.
We analysed data on JIA in the age group of 20-29 years from the National Database of Designated Incurable Diseases of Japan, which records severe cases or those requiring high-cost medical care registered between April 2018 and March 2020.
Overall, 322 patients with JIA transitioning to adulthood were included. A high frequency of methotrexate use was observed among all JIA subtypes. The frequency of methotrexate use at registration was significantly higher in patients with rheumatoid factor-positive polyarthritis and those with oligoarthritis or polyarthritis than in those with systemic arthritis. The historical use percentage of any biological disease-modifying antirheumatic drug was ≥85% for all JIA subtypes. The proportion of patients with ≥2 biological disease-modifying antirheumatic drug prescriptions was significantly higher in patients with rheumatoid factor-positive polyarthritis than in those with systemic arthritis.
High-cost drugs were necessary for many patients with JIA transitioning to young adulthood and registered in the database. Further studies on the medical interventions and support for these patients are needed.
我们旨在通过评估真实世界的治疗数据，来评估青少年特发性关节炎（JIA）青年患者未满足的医疗需求。
我们分析了日本指定不治之症国家数据库中20至29岁年龄组的JIA数据，该数据库记录了2018年4月至2020年3月期间登记的严重病例或需要高额医疗护理的病例。
总共纳入了322例向成年期过渡的JIA患者。在所有JIA亚型中均观察到甲氨蝶呤的高使用频率。类风湿因子阳性多关节炎患者以及寡关节炎或多关节炎患者在登记时使用甲氨蝶呤的频率显著高于全身型关节炎患者。所有JIA亚型中，任何生物性改善病情抗风湿药物的既往使用百分比均≥85%。类风湿因子阳性多关节炎患者中开具≥2种生物性改善病情抗风湿药物处方的患者比例显著高于全身型关节炎患者。
许多向青年期过渡且登记在该数据库中的JIA患者需要使用高成本药物。需要对这些患者的医疗干预措施和支持进行进一步研究。
