Table 2.
Outcomes in all patients with systemic JIA starting either tocilizumab or anakinra
| All patients n = 76 | Tocilizumab n = 54 | Anakinra n = 22 | P-value (tocilizumab vs anakinra) | First biologic n = 53 | Subsequent biologic n = 23 | P-value (first biologic vs subsequent) | ||
|---|---|---|---|---|---|---|---|---|
| Systemic features, % | One year | 20% | 17% | 27% | P = 0.3 | 21% | 20% | P = 0.9 |
| Active joint count | Baseline | 6.8 (1.1) | 6.7 (1.3) | 7.1 (2.1) | P = 0.9 | 5.3 (1.1) | 10.4 (2.3) | P = 0.03 |
| One year | 0.6 (0.2) | 0.5 (0.2) | 0.8 (0.4) | P = 0.6 | 0.5 (0.2) | 0.8 (0.4) | P = 0.4 | |
| Changea | −6.2 (1.0) P < 0.001 | −6.2 (1.2) P < 0.001 | −6.4 (2.0) P < 0.001 | P = 0.6 | −4.8 (1.1) P < 0.001 | −9.6 (2.2) P < 0.001 | P = 0.8 | |
| Limited joint count | Baseline | 5.5 (1.0) | 5.1 (1.1) | 6.3 (2.1) | P = 0.6 | 3.9 (1.0) | 9.1 (2.2) | P = 0.02 |
| One year | 1.0 (0.3) | 1.0 (0.3) | 1.1 (0.6) | P = 0.8 | 0.7 (0.3) | 1.9 (0.7) | P = 0.06 | |
| Changea | −4.4 (1.0) P < 0.001 | −4.1 (1.1) P < 0.001 | −5.2 (2.1) P < 0.001 | P = 0.9 | −3.2 (1.0) P < 0.001 | −7.2 (2.2) P < 0.001 | P = 0.2 | |
| PGA | Baseline | 3.7 (0.4) | 3.9 (0.4) | 3.2 (0.7) | P = 0.4 | 3.3 (0.5) | 4.6 (0.6) | P = 0.1 |
| One year | 1.0 (0.3) | 1.0 (0.3) | 1.1 (0.5) | P = 0.9 | 1.1 (0.4) | 1.0 (0.5) | P = 0.9 | |
| Changea | −2.7 (0.5) P < 0.001 | −2.9 (0.6) P < 0.001 | −2.1 (0.9) P = 0.002 | P = 0.9 | −2.3 (0.6) P < 0.001 | −3.6 (0.8) P = 0.002 | P = 0.9 | |
| PGE | Baseline | 4.3 (0.4) | 4.3 (0.5) | 4.1 (0.8) | P = 0.8 | 4.1 (0.5) | 4.6 (0.7) | P = 0.6 |
| One year | 1.9 (0.4) | 1.9 (0.4) | 2.0 (0.7) | P = 0.8 | 2.1 (0.4) | 1.5 (0.5) | P = 0.5 | |
| Changea | −2.4 (0.5) P < 0.001 | −2.5 (0.6) P < 0.001 | −2.1 (1.0) P = 0.005 | P = 0.8 | −2.1 (0.6) P < 0.001 | −3.1 (0.9) P < 0.001 | P = 0.4 | |
| CHAQ | Baseline | 1.1 (0.1) | 1.1 (0.2) | 1.1 (0.3) | P = 1.0 | 1.1 (0.2) | 1.1 (0.2) | P = 1.0 |
| One year | 0.6 (0.1) | 0.6 (0.1) | 0.7 (0.2) | P = 0.7 | 0.7 (0.1) | 0.5 (0.2) | P = 0.4 | |
| Changea | −0.5 (0.1) (P < 0.001) | −0.5 (0.2) (P < 0.001) | −0.4 (0.2) (P = 0.005) | P = 0.6 | −0.4 (0.2) (P < 0.001) | −0.6 (0.2) (P = 0.005) | P = 0.4 | |
| ESR | Baseline | 42 (5) | 37 (5) | 54 (10) | P = 0.1 | 39 (6) | 48 (8) | P = 0.4 |
| One year | 7 (1) | 5 (1) | 11 (2) | P = 0.02 | 7 (1) | 7 (2) | P = 0.9 | |
| Changea | −35 (5) P < 0.001 | −32 (5) P < 0.001 | −43 (11) P < 0.001 | P = 0.02 | −33 (6) P < 0.001 | −41 (8) P < 0.001 | P = 0.9 | |
| JADAS-71 | Baseline | 17 (1.5) | 17 (1.8) | 18 (2.9) | P = 0.8 | 15 (1.6) | 23 (3.1) | P = 0.03 |
| One year | 4 (0.6) | 4 (0.7) | 4 (1.3) | P = 0.7 | 4 (0.7) | 4 (1.0) | P = 0.09 | |
| Changea | −14 (1.6) (P < 0.001) | −14 (1.8) (P < 0.001) | −14 (3.1) (P < 0.001) | P = 0.8 | −11 (1.7) (P < 0.001) | −19 (3.2) (P < 0.001) | — | |
| Primary outcomes | ||||||||
| ACR Pedi 90, % | One year | 42% | 46% | 31% | — | 36% | 54% | — |
| Unadjusted, OR (95% CI) | — | — | 2.0 (0.6, 6.6) | Reference. | P = 0.3 | 0.5 (0.2, 1.5) | Reference. | P = 0.2 |
| Propensity adjustedb, OR (95% CI) | — | — | 1.9 (0.4, 7.8) | Reference. | P = 0.4 | — | — | — |
| Minimal disease activity, % | One year | 51% | 52% | 49% | — | 48% | 58% | — |
| Unadjusted, OR (95% CI) | — | — | 1.1 (0.4, 3.5) | Reference. | P = 0.8 | 0.7 (0.2, 2.0) | Reference. | P = 0.5 |
| Propensity adjustedb, OR (95% CI) | — | — | 1.1 (0.3, 4.3) | Reference. | P = 0.9 | — | — | — |
| Clinically inactive disease, % | One year | 39% | 45% | 25% | — | 34% | 52% | — |
| Unadjusted, OR (95% CI) | — | — | 2.5 (0.8, 8.2) | Reference. | P = 0.1 | 0.5 (0.2, 1.4) | Reference. | P = 0.2 |
| Propensity adjustedb, OR (95% CI) | — | — | 2.7 (0.6, 11.2) | Reference. | P = 0.2 | — | — | — |
Using imputed data. Results displayed as mean (standard error), unless otherwise stated.
a
Change in variable taking into account baseline variable (P-values indicates change from baseline to one year).
b
Propensity score included: first biologic, gender, age, disease duration, concomitant methotrexate, concomitant steroids, active joint count, limited joint count, physician global assessment of overall disease activity (PGA), patient (parent) assessment of overall well-being (PGE), Childhood HAQ (CHAQ), ESR, JADAS-71.
JADAS-71:71-joint Juvenile Arthritis Disease Activity Score; ACR Pedi 90: ACR Paediatric criteria for 90% improvement; OR: odds ratio.