Real-world use of biologics for systemic juvenile idiopathic arthritis: information from a Japanese hospital claims database

Objectives Limited information is available on patients with systemic juvenile idiopathic arthritis (sJIA) receiving biologics in Japan. The types of biologics, treatment duration, prior and concomitant treatments, administration route (intravenous [IV] or subcutaneous [SC] injection), treatment sequence, and characteristics of patients receiving biologics were investigated. Methods We used data from a Japanese hospital claims database (2008–2024). Results Of the 2000 sJIA patients in the database, 315 (15.8%) received one or more biologics. For the first biologic, the most common were anti-interleukin-6 (anti-IL-6) drugs (82.5%; tocilizumab, 82.2% [IV, 65.1%; SC, 17.1%]; others, <0.4%), followed by anti-tumour necrosis factor (anti-TNF) drugs (11.7%; adalimumab SC, 4.4%; infliximab IV, 4.1%; others, <1.6% each), canakinumab SC (3.8%), and abatacept IV or SC (1.9%). Over 53% of patients received anti-IL-6 drugs for ≥1 year. The most common csDMARDs administered prior to anti-IL-6 drugs were cyclosporine (11.9%), methotrexate (11.5%), and tacrolimus (6.2%), and those most commonly administered concomitantly with anti-IL-6 drugs were methotrexate (22.7%), cyclosporine (16.9%), and tacrolimus (11.5%). Fifty patients switched from tocilizumab IV to a second biologic (tocilizumab SC, 50.0%; canakinumab SC, 36.0%; others ≤4.0% each). Conclusions Our study described the real-world usage of biologics for sJIA in Japan.