Skip to content
DraconiticResearch
Search Sources API
203,203 studies31 sourcesUpdated 55 min ago
Peer-reviewedCC BY-NC 4.0RMD Open

Effectiveness of second-line biologics in juvenile idiopathic arthritis: the IIBIOJIA Study

  • Achille Marino1
  • Maria R Pellico2
  • Emilio A Conti2
  • Martina Rossano3
  • Stefano Lanni3
  • Sabino Germinario2
  • Andrea Amati2
  • Marco Pandolfi2
  • Claudia Iannone4,5
  • Stefania Costi6
  • Francesco Baldo7
  • Maurizio Virgilio Gattinara8
5 more authors
  • Francesca Minoia9
  • Giovanni Filocamo10
  • Roberto Caporali2
  • Cecilia Beatrice Chighizola5
  • Pediatric Rheumatology Associated Group of the Milan Area (PRAGMA)
10 affiliations
  1. 1Gaetano Pini-CTO, Milan, Italy
  2. 2University of Milan, Milan, Italy
  3. 3Pediatric Immuno-Rheumatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
  4. 4UOC Clinica Reumatologica, Milano, Italy
  5. 5Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
  6. 6Unit of Pediatric Rheumatology, ASST G. Pini-CTO, Milan, Italy
  7. 7Unit of Pediatric Rheumatology, Milan, Italy
  8. 8Gaetano Pini-CTO, Milan, Lombardy, Italy
  9. 9UOC Pediatria Media Intesità di Cure, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
  10. 10Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
Read full textDOICite

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.

Methods: 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.

Results: 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).

Conclusion: 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.

Related

  1. Lipid and immune profiles in children with systemic juvenile idiopathic arthritis: a case-control study with paired longitudinal comparison of disease activity
    Translational pediatricsPeer-reviewedCC BY-NC-NDFull textGeneral medicineEurope PMC
  2. Sex-stratified autosomal association analysis reveals dimorphic genetic risk factors in non-systemic juvenile idiopathic arthritis.
    M. Tordoff, S. L. Smith, S. Lawson-Tovey +16
    medRxivPreprintAll rights reservedFull textGeneral medicinemedRxiv
  3. Advanced drug delivery and PBPK modelling as translational tools for precision therapies in juvenile idiopathic arthritis
    Marina Cuquerella-Gilabert, Cristina Martin-Sabroso, Javier Zarzoso-Foj +5
    Frontiers in PharmacologyPeer-reviewedCC BY 4.0Full textObstetrics, gynaecology & paediatricsCrossrefEurope PMCPMC
  4. Identification and evaluation of 41 risk loci for juvenile idiopathic arthritis informs precision medicine: mechanistic implications of DNA topology and an HLA-A*02:01-ERAP2 interaction
    H. C. Ainsworth, E. S. Khvatkova, M. Sudman +25
    medRxivPreprintCC BY-NC-NDFull textHuman geneticsmedRxiv
  5. Parent-child (dis)agreement in patient-reported outcomes in juvenile idiopathic arthritis: the role of child depression and caregiver burden.
    Michelle Dey, Lisa Pedrotti, Federica Vanoni +4
    EULAR rheumatology openPeer-reviewedCC BYFull textGeneral medicineEurope PMC

Cite

BibTeXRIS
BibTeX
@article{marino2026effectiveness,
  title = {{Effectiveness of second-line biologics in juvenile idiopathic arthritis: the IIBIOJIA Study}},
  author = {Achille Marino and Maria R Pellico and Emilio A Conti and Martina Rossano and Stefano Lanni and Sabino Germinario and Andrea Amati and Marco Pandolfi and Claudia Iannone and Stefania Costi and Francesco Baldo and Maurizio Virgilio Gattinara and Francesca Minoia and Giovanni Filocamo and Roberto Caporali and Cecilia Beatrice Chighizola and Pediatric Rheumatology Associated Group of the Milan Area (PRAGMA)},
  journal = {RMD Open},
  year = {2026},
  month = oct,
  doi = {10.1136/rmdopen-2026-007105},
  url = {https://doi.org/10.1136/rmdopen-2026-007105},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Effectiveness of second-line biologics in juvenile idiopathic arthritis: the IIBIOJIA Study
AU  - Achille Marino
AU  - Maria R Pellico
AU  - Emilio A Conti
AU  - Martina Rossano
AU  - Stefano Lanni
AU  - Sabino Germinario
AU  - Andrea Amati
AU  - Marco Pandolfi
AU  - Claudia Iannone
AU  - Stefania Costi
AU  - Francesco Baldo
AU  - Maurizio Virgilio Gattinara
AU  - Francesca Minoia
AU  - Giovanni Filocamo
AU  - Roberto Caporali
AU  - Cecilia Beatrice Chighizola
AU  - Pediatric Rheumatology Associated Group of the Milan Area (PRAGMA)
PY  - 2026
DA  - 2026/10/27
JO  - RMD Open
DO  - 10.1136/rmdopen-2026-007105
UR  - https://doi.org/10.1136/rmdopen-2026-007105
AB  - 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.  Methods: 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.  Results: 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).  Conclusion: 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.
SN  - 2056-5933
ER  -