Latent classes of early response trajectories to biologics initiation in juvenile idiopathic arthritis: an analysis of four trials
Abstract Aims 1) To delineate latent classes of treatment response to biologics in juvenile idiopathic arthritis (JIA) patients in the first 16 weeks after initiation. 2) To identify predictors of early disease response. Methods The study population was drawn from four biologics trials in polyarticu...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | Pediatric Rheumatology Online Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12969-022-00719-1 |
| _version_ | 1818163124592705536 |
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| author | Lily Siok Hoon Lim Shamsia Shobhan Armend Lokku Sarah Ringold Eleanor Pullenayegum |
| author_facet | Lily Siok Hoon Lim Shamsia Shobhan Armend Lokku Sarah Ringold Eleanor Pullenayegum |
| author_sort | Lily Siok Hoon Lim |
| collection | DOAJ |
| description | Abstract Aims 1) To delineate latent classes of treatment response to biologics in juvenile idiopathic arthritis (JIA) patients in the first 16 weeks after initiation. 2) To identify predictors of early disease response. Methods The study population was drawn from four biologics trials in polyarticular course JIA: Etanercept 2000, Abatacept 2008, TRial of Early Aggressive Therapy (TREAT) 2012 and Tocilizumab 2014. The outcome was active joint counts (AJC). Semiparametric latent class trajectory analysis was applied to identify latent classes of response to treatment; AJC was transformed for this modelling. We tested baseline disease and treatment characteristics for their abilities to predict class membership of response. Results There were 480 participants, 74% females. At baseline, 26% were rheumatoid factor positive. 67% were on methotrexate at enrollment. Three latent class solution provided the best fit. Baseline AJC was the sole best predictor of class membership. Participants classified by their highest membership probabilities into high baseline AJC (> 30) and slow response (26.5%), low baseline AJC (< 10), early and sustained response (29.7%), and moderate baseline AJC progressive response (43.8%). Participants were classified into the latent classes with a mean class membership posterior probability of 0.97. Those on methotrexate at baseline were less likely to belong to high baseline AJC class. Conclusions Three latent classes of responses were detectable in the first 16 weeks of biologics therapy. Those with the highest baseline AJC demonstrated very slow response in this window and were less likely to be on concomitant methotrexate. Trials registration TREAT 2012 (NCT NCT00443430 ) (Wallace et. al, Arthritis Rheum 64:2012–21, 2012), tocilizumab trial 2014 ( NCT00988221 ), abatacept trial 2008 ( NCT00095173 ). Etanercept 2000 from Amgen does not have a trial registration number. |
| first_indexed | 2024-12-11T16:44:34Z |
| format | Article |
| id | doaj.art-09bec815b2fb4ff295470546bdeb9de6 |
| institution | Directory Open Access Journal |
| issn | 1546-0096 |
| language | English |
| last_indexed | 2024-12-11T16:44:34Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Pediatric Rheumatology Online Journal |
| spelling | doaj.art-09bec815b2fb4ff295470546bdeb9de62022-12-22T00:58:15ZengBMCPediatric Rheumatology Online Journal1546-00962022-07-012011710.1186/s12969-022-00719-1Latent classes of early response trajectories to biologics initiation in juvenile idiopathic arthritis: an analysis of four trialsLily Siok Hoon Lim0Shamsia Shobhan1Armend Lokku2Sarah Ringold3Eleanor Pullenayegum4Department of Pediatrics, Children’s Hospital Research Institute of Manitoba, University of ManitobaDepartment of Community Health Sciences, University of ManitobaDalla Lana School of Public Health, University of TorontoSeattle Children’s HospitalDalla Lana School of Public Health, University of TorontoAbstract Aims 1) To delineate latent classes of treatment response to biologics in juvenile idiopathic arthritis (JIA) patients in the first 16 weeks after initiation. 2) To identify predictors of early disease response. Methods The study population was drawn from four biologics trials in polyarticular course JIA: Etanercept 2000, Abatacept 2008, TRial of Early Aggressive Therapy (TREAT) 2012 and Tocilizumab 2014. The outcome was active joint counts (AJC). Semiparametric latent class trajectory analysis was applied to identify latent classes of response to treatment; AJC was transformed for this modelling. We tested baseline disease and treatment characteristics for their abilities to predict class membership of response. Results There were 480 participants, 74% females. At baseline, 26% were rheumatoid factor positive. 67% were on methotrexate at enrollment. Three latent class solution provided the best fit. Baseline AJC was the sole best predictor of class membership. Participants classified by their highest membership probabilities into high baseline AJC (> 30) and slow response (26.5%), low baseline AJC (< 10), early and sustained response (29.7%), and moderate baseline AJC progressive response (43.8%). Participants were classified into the latent classes with a mean class membership posterior probability of 0.97. Those on methotrexate at baseline were less likely to belong to high baseline AJC class. Conclusions Three latent classes of responses were detectable in the first 16 weeks of biologics therapy. Those with the highest baseline AJC demonstrated very slow response in this window and were less likely to be on concomitant methotrexate. Trials registration TREAT 2012 (NCT NCT00443430 ) (Wallace et. al, Arthritis Rheum 64:2012–21, 2012), tocilizumab trial 2014 ( NCT00988221 ), abatacept trial 2008 ( NCT00095173 ). Etanercept 2000 from Amgen does not have a trial registration number.https://doi.org/10.1186/s12969-022-00719-1Juvenile idiopathic arthritisPolyarticular-courseBiologicsTreatmentResponseDisease activity trajectory |
| spellingShingle | Lily Siok Hoon Lim Shamsia Shobhan Armend Lokku Sarah Ringold Eleanor Pullenayegum Latent classes of early response trajectories to biologics initiation in juvenile idiopathic arthritis: an analysis of four trials Pediatric Rheumatology Online Journal Juvenile idiopathic arthritis Polyarticular-course Biologics Treatment Response Disease activity trajectory |
| title | Latent classes of early response trajectories to biologics initiation in juvenile idiopathic arthritis: an analysis of four trials |
| title_full | Latent classes of early response trajectories to biologics initiation in juvenile idiopathic arthritis: an analysis of four trials |
| title_fullStr | Latent classes of early response trajectories to biologics initiation in juvenile idiopathic arthritis: an analysis of four trials |
| title_full_unstemmed | Latent classes of early response trajectories to biologics initiation in juvenile idiopathic arthritis: an analysis of four trials |
| title_short | Latent classes of early response trajectories to biologics initiation in juvenile idiopathic arthritis: an analysis of four trials |
| title_sort | latent classes of early response trajectories to biologics initiation in juvenile idiopathic arthritis an analysis of four trials |
| topic | Juvenile idiopathic arthritis Polyarticular-course Biologics Treatment Response Disease activity trajectory |
| url | https://doi.org/10.1186/s12969-022-00719-1 |
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