{
  "abstract": "Objectives: To describe the prescription patterns of second-line biological disease-modifying antirheumatic drugs (bDMARDs) in non-systemic juvenile idiopathic arthritis (JIA) and to assess the effectiveness of TNFα inhibitors (TNFi) versus non-TNFi as second-line bDMARDs.\n\nMethods: This retrospective cohort study included patients with non-systemic JIA treated with at least two bDMARDs. Multivariate analyses were performed using logistic generalised estimating equations (GEE) models with robust SEs to assess factors associated with the presence of clinically inactive disease (CID) during the second course of bDMARD treatment. Propensity scores, stratified into quintiles, were included in the analysis.\n\nResults: A total of 127 patients were recruited at two paediatric rheumatology tertiary centres. In 25% of cases, a non-TNFi was chosen as second-line bDMARD, with tocilizumab being the most common (66%). The choice of second-line bDMARD was influenced by the calendar year of prescription. In median, non-TNFi treatments were initiated in 2021 (IQR 2017–2023), compared with 2019 (IQR 2013–2022) for TNFi treatments (p=0.03). In the multivariate GEE model adjusted for propensity score quintiles, switching to a second TNFi over a non-TNFi was significantly associated with achieving CID (OR 4.19, 95% CI 1.66 to 10.61, p<0.001). Time on the first TNFi did not significantly impact the likelihood of achieving CID during the second TNFi (OR 0.98, CI 0.79 to 1.21, p=0.83).\n\nConclusion: Our findings suggest that TNFi remains a viable and effective option as second-line bDMARDs in non-systemic JIA, regardless of the duration of prior TNFi exposure.",
  "abstract_shown": true,
  "affiliations": [
    "Gaetano Pini-CTO, Milan, Italy",
    "University of Milan, Milan, Italy",
    "Pediatric Immuno-Rheumatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy",
    "UOC Clinica Reumatologica, Milano, Italy",
    "Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy",
    "Unit of Pediatric Rheumatology, ASST G. Pini-CTO, Milan, Italy",
    "Unit of Pediatric Rheumatology, Milan, Italy",
    "Gaetano Pini-CTO, Milan, Lombardy, Italy",
    "UOC Pediatria Media Intesità di Cure, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy",
    "Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 17,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Achille Marino",
      "orcid": "0000-0002-3027-8009"
    },
    {
      "affs": [
        1
      ],
      "name": "Maria R Pellico"
    },
    {
      "affs": [
        1
      ],
      "name": "Emilio A Conti"
    },
    {
      "affs": [
        2
      ],
      "name": "Martina Rossano"
    },
    {
      "affs": [
        2
      ],
      "name": "Stefano Lanni"
    },
    {
      "affs": [
        1
      ],
      "name": "Sabino Germinario"
    },
    {
      "affs": [
        1
      ],
      "name": "Andrea Amati"
    },
    {
      "affs": [
        1
      ],
      "name": "Marco Pandolfi"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Claudia Iannone",
      "orcid": "0009-0005-5686-0127"
    },
    {
      "affs": [
        5
      ],
      "name": "Stefania Costi"
    },
    {
      "affs": [
        6
      ],
      "name": "Francesco Baldo"
    },
    {
      "affs": [
        7
      ],
      "name": "Maurizio Virgilio Gattinara"
    },
    {
      "affs": [
        8
      ],
      "name": "Francesca Minoia",
      "orcid": "0000-0002-5093-8422"
    },
    {
      "affs": [
        9
      ],
      "name": "Giovanni Filocamo"
    },
    {
      "affs": [
        1
      ],
      "name": "Roberto Caporali",
      "orcid": "0000-0001-9300-6169"
    },
    {
      "affs": [
        4
      ],
      "name": "Cecilia Beatrice Chighizola",
      "orcid": "0000-0002-3787-9632"
    },
    {
      "name": "Pediatric Rheumatology Associated Group of the Milan Area (PRAGMA)"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/38d7m6am4j6xn.bib",
  "cited_by": 0,
  "doi": "10.1136/rmdopen-2026-007105",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13723922/",
  "id": "38d7m6am4j6xn",
  "issns": [
    "2056-5933"
  ],
  "landing_url": "https://doi.org/10.1136/rmdopen-2026-007105",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "1506"
    ],
    [
      "heading",
      "Original Research"
    ],
    [
      "heading",
      "Paediatric Rheumatology"
    ],
    [
      "openalex",
      "2720|Autoimmune and Inflammatory Disorders Research"
    ]
  ],
  "openalex": "W7223991025",
  "pdf_url": null,
  "pmcid": "PMC13723922",
  "pmid": "42946380",
  "published": "2026-10-27",
  "publisher": "BMJ Publishing Group",
  "ris": "https://research.draconitic.com/paper/38d7m6am4j6xn.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T12:22:28Z",
      "native_id": "PMC13723922",
      "source": "pmc",
      "url": "https://doi.org/10.1136/rmdopen-2026-007105"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2720|Autoimmune and Inflammatory Disorders Research",
      "subfield": "general"
    }
  ],
  "title": "Effectiveness of second-line biologics in juvenile idiopathic arthritis: the IIBIOJIA Study",
  "title_text": "Effectiveness of second-line biologics in juvenile idiopathic arthritis: the IIBIOJIA Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:39Z",
  "url": "https://research.draconitic.com/paper/38d7m6am4j6xn",
  "venue": "RMD Open",
  "versions": []
}