ANALYSIS OF THE SURVIVAL OF GENETICALLY ENGINEERED BIOLOGICAL THERAPY IN JUVENILE IDIOPATHIC ARTHRITIS
Authors:   I.M. Sechenov First Moscow State Medical University, Moscow, Russia, Sevostyanov V.K. ,   Scientific and Research Institute for Health Organization and Medical Management, Moscow, Russia, Lototskaya P.S. ,   I.M. Sechenov First Moscow State Medical University, Moscow, Russia, Babich N.V. ,   Rostov State Medical University, Rostov-on-Don, Russia, Rassoha D.D. ,   I.M. Sechenov First Moscow State Medical University, Moscow, Russia, Novikov A.S. ,   V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia, Balashov S.L. ,   I.M. Sechenov First Moscow State Medical University, Moscow, Russia, Zholobova E.S. ,   I.M. Sechenov First Moscow State Medical University, Moscow, Russia,   Moscow City Center for Pediatric Rheumatology with the Morozov Children’s City Clinical Hospital, Moscow, Russia
Published: July 2022

The problem of the survival of various genetically engineered biological drugs (GEBD) is of a current scientific interest. A clear analysis of the reasons for the withdrawal coupled with the GEBD switching algorithmizing would allow developing of the individual treatment plans and monitoring of the patients. The objective of the study was to analyze the survival of genetically engineered biological therapy in children with juvenile idiopathic arthritis (JIA) through identifying the frequency and structure of cases of switching/cancellation of GEBD. Materials and methods: based on the data obtained from the Moscow registry of children with rheumatic diseases, an observational analytical cross-sectional study was conducted, including patients with JIA aged 0 to 17 years old living in Moscow, who had a history of episodes of switching or cancellation of GEBD. The study was conducted from January, 2015 to December, 2021. Results: 1220 patients (35.8% male/64.2% female) with JIA were included in the study. The median age of patients was 11.0 (8.0; 15.0) years. The total number of prescribing of GEBD of the first and subsequent lines was 589 episodes in 531 patients, of which 46 patients had 64 episodes of switching or cancellation of GEBD, which accounted for 10.9% of all cases of prescribing of GEBD. In the structure of the reasons for the therapy change the secondary failure accounted for 57.8%, the primary failure - 12.5%, intolerance - 10.9%, de novo uveitis - 9.4%. Cancellation of the drug therapy due to the achievement of remission was noted in 6.2% of cases. There are statistically significant differences in the duration of therapy depending on the reason for discontinuation or replacement of therapy (p<0.001). More often, patients were transferred to adalimumab (29.3%), and when adalimumab was canceled, to tocilizumab and golimumab. In the event of tocilizumab discontinuation, the majority of patients were switched to canakinumab drug therapy. Conclusion: the presented analysis is one of a few studies of such kind that were ever conducted in Russia; it requires further accumulation and analysis of data, including cases of discontinuation of the drug therapy, switching between the drugs, as well as the duration of therapy before the event that caused the change or discontinuation of the drug therapy happened.