THU0640 Pharmacological treatment among newly diagnosed patients with juvenile idiopathic arthritis in the united states
Authors: A. Marshall, K. Gupta, M. Pazirandeh, M. Bonafede, D. McMorrow
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Juvenile idiopathic arthritis (JIA) is a chronic condition affecting approximately 3 00 000 children and adolescents in the United States, yet little is documented about its real-world burden or treatment patterns.<sup>1</sup> <h3>Objectives</h3> To describe treatment patterns among JIA patients (pts) who initiated biologic and non-biologic DMARDs. <h3>Methods</h3> Truven Health Analytics MarketScan<sup>®</sup> Commercial Database was used to identify pts aged 2–17 years with a new JIA diagnosis (index date; 2008–2016) and 12 months of continuous enrolment pre- and post-diagnosis. Pts with other rheumatic or autoimmune conditions were excluded. Receipt of a biologic and/or non-biologic was evaluated on or after the new JIA diagnosis. JIA-related healthcare resource utilisation was defined as the presence of JIA diagnosis on a medical claim. <h3>Results</h3> A total of 3815 pts newly diagnosed with JIA met study selection criteria (mean [SD] age 10.0 [4.5] years, 69.0% female). Pts with 12 months of continuous enrolment post-treatment initiation (n=2014) were classified as non-biologic only (n=734), biologic only (n=873), and both biologic and non-biologic (n=407) users. Among all three cohorts, baseline corticosteroid use was 48.8%–60.4%, prescription NSAID use 69.6%–85.3% and opioid use 24.5%–29.0%. Mean (SD) number of JIA-related outpatient office visits was 4.9 (3.2) in non-biologic-only users, 6.0 (3.8) in biologic and non-biologic users, and 5.0 (4.4) in biologic-only users. The most commonly used non-biologic was MTX and biologic was etanercept (table 1). In the year following diagnosis, total JIA-related costs were highest among pts who used only biologics (mean $27,292; SD $32,833; median $20,782) vs biologic and non-biologic agents (mean $15,808; SD $16,086; median $11,925) and vs only non-biologics (mean $4094; SD $9292; median $1918) (all p&lt;0.001). Mean prescription costs in the year following biologic initiation were $17 985 (SD $11,188) for etanercept, $26 217 (SD $15,039) for adalimumab and $38 260 (SD $42,260) for infliximab. Of pts treated with a biologic only, TNF inhibitors (TNFi) comprised 87.1% of their treatment costs. <h3>Conclusions</h3> Initial JIA treatment is driven by etanercept, MTX and adalimumab, with the majority of biologic costs coming from TNFi. Receipt of other supportive medications (corticosteroids and NSAIDs) was common and JIA-related costs varied substantially by treatment cohort. <h3>Reference</h3> [1] Chang HJ, et al. JAMA2010;303:1328. <h3>Disclosure of Interest</h3> A. Marshall Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, K. Gupta Employee of: Bristol-Myers Squibb, M. Pazirandeh Employee of: Bristol-Myers Squibb, M. Bonafede Grant/research support from: Bristol-Myers Squibb, Employee of: Truven Health Analytics (IBM), D. McMorrow Grant/research support from: Bristol-Myers Squibb, Employee of: Truven Health Analytics (IBM)