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Research by PhD student from our team, Dr. Luiza Grazziotin, featured in Arthritis Society Canada Top 10 Research Advances of 2022.
Every year, the Arthritis Society Canada spotlights publications in their annual Top 10 Research Advances. We are thrilled to share that one of Dr. Luiza Grazziotin’s thesis articles was included in this year’s list!
Dr. Grazziotin (supervisor Dr. Deborah A. Marshall) completed her PhD in 2022. Her thesis focused on personalized care for juvenile idiopathic arthritis (JIA) and examined health care costs, treatment patterns and health-related quality of life of children with JIA and their parents. This work was conducted as part of the Understanding Childhood Arthritis: Canada-Netherlands Personalized Medicine Network in Childhood Arthritis and Rheumatic Diseases (UCAN CAN-DU).
The Arthritis Society Canada is featuring the publication entitled “Real‑world data reveals the complexity of disease modifying anti‑rheumatic drug treatment patterns in juvenile idiopathic arthritis: an observational study”. It is the first study to assess treatment patterns for the different drug classes currently prescribed to JIA patients in Canada.
Juvenile Idiopathic Arthritis (JIA) is one of the most common chronic musculoskeletal disorder in children, and affects about one in 1,000 children in Canada. Conventional disease modifying anti-rheumatic drugs (c-DMARDs), and biologic DMARDs (b-DMARDs) are recommended by the 2019 American College of Rheumatology (ACR) JIA treatment guidelines: c-DMARDs as a first-line treatment and b-DMARDS as a secondary therapy for more severe JIA cases.
Despite guidelines, the current real-world prescription patterns of DMARDS, including treatment trajectories may differ based on setting, treatment approval and treatment accessibility. Using medical chart and administrative health data, Grazziotin and co-authors conducted a retrospective cohort study to gain a better understanding of DMARD treatment patterns in JIA.
Analyzing the prescriptions of c-DMARDs and b-DMARDs in 325 patients newly diagnosed with JIA between 2011 and 2019, the research team identified 112 unique treatment sequences.
Figure 2. b-DMARD switching over a median of 4.3 (IQR 2.8–6.1) years of observational time (n = 147).
Among patients taking b-DMARDs, the majority (95%) were initially prescribed tumor necrosis factor inhibitors (TNFis). Most of those patients were then switched to a second TNFi.
Although recommended by the ACR and providing important health benefits to patients, DMARDs are expensive. By shedding light on real-life treatment patterns, Grazziotin, et al laid the groundwork for future effectiveness and economic evaluation studies.
More information about Dr. Grazziotin’s thesis research:
Grazziotin LR, Currie G, Twilt M, IJzerman MJ, Kip MMA, Koffijberg H, Benseler SM, Swart JF, Vastert SJ, Wulffraat NM, Yeung RSM, Marshall DA. Real-world data reveals the complexity of disease modifying anti-rheumatic drug treatment patterns in juvenile idiopathic arthritis: an observational study. Pediatric Rheumatology, 20, 25 (2022) https://doi.org/10.1186/s12969-022-00682-x
Grazziotin LR, Currie G, Twilt M, IJzerman MJ, Kip MMA, Koffijberg H, Bonsel G, Benseler SM, Swart JF, Vastert SJ, Wulffraat NM, Yeung RSM, Armbrust W, van den Berg M, Marshall DA. Factors associated with care-and health-related quality of life of caregivers of children with juvenile idiopathic arthritis. Pediatric Rheumatology 2022;20:51. https://doi.org/10.1186/s12969-022-00713-7
Grazziotin LR, Currie G, Twilt M, Ijzerman MJ, Kip MMA, Koffijberg H, Benseler SM, Swart JF, Vastert SJ, Wulffraat NM, Yeung RSM, Johnson N, Luca NJ, Miettunen PM, Schmeling H, Marshall DA. Evaluation of real-world healthcare resource utilization and associated costs in children with Juvenile Idiopathic Arthritis: A Canadian retrospective cohort study. Rheumatology and Therapy. Sept 2021;8(3):1303-1322. https://doi.org/10.1007/s40744-021-00331-x
Grazziotin LR, Currie G, Kipp MMA, Ijzerman MJ, Twilt M, Lee R, Marshall DA. Health State Utility Values in Juvenile Idiopathic Arthritis: What is the Evidence? Pharmacoeconomics. May 2020; 28:913-926. http://doi.org/10.1007/s40273-020-00921-7
Other Marshall team health economics UCAN CAN-DU research:
Currie GR, Groothuis-Oudshoorn K, Twilt M, Kip MM, IJzerman MJ, Benseler SM, Swart JF, Vastert SJ, Wulffraat NM, Yeung RS, Marshall DA and on behalf of UCAN CAN-DU and UCAN CURE Consortium. What matters most to pediatric rheumatologists in deciding whether to withdraw biologics in a child with juvenile idiopathic arthritis: a best-worst scaling study. 28th European Paediatrics Rheumatology Congress, September 20-23 2022, Prague, Czech Republic. (Poster)
Grazziotin L, Currie GR, Cantarutti S, Benseler SM, Swart JF, Kip MM, IJzerman MJ, Twilt M, Vastert SJ, Wulffraat NM, Yeung RS, Marshall DA and on behalf of UCAN CAN-DU and UCAN CURE Consortium. Present and accounted for: the workplace productivity loss for parents of children with juvenile idiopathic arthritis. 28th European Paediatrics Rheumatology Congress, September 20-23 2022, Prague, Czech Republic. (Poster)
Van Til JA, Kip MMA, Twilt M, Schatorjé E, Groothuis-Oudshoorn K, Currie G, Marshall DA, Swart JF, Yeung RSM, Benseler SM, Vastert SJ, Wulffraat N, IJzerman MJ, and on behalf of UCAN CAN-DU and UCAN CURE Consortium. Preferences of pediatric rheumatologists for tapering biologic DMARDs in children with juvenile idiopathic arthritis (JIA) – results of a clinical vignette study. 28th European Paediatrics Rheumatology Congress, September 20-23 2022, Prague, Czech Republic. (Poster)
Florax AA, Doeleman MJH, de Roock S, Van der Linden N, Schatorje E, Currie G, Marshall DA, IJzerman MJ, Yeung RSM, Benseler SM, Vastert SJ, Wulffraat M, Swart JF, Kip MMA, and on behalf of UCAN CAN-DU and UCAN CURE Consortium. Quantifying cost impact of withdrawing biologic DMARDs in children with JIA. 28th European Paediatrics Rheumatology Congress, September 20-23 2022, Prague, Czech Republic. (Poster)
Kip MMA, de Roock S, Currie G, Marshall DA, Grazziotin LR, Twilt M, Yeung RSM, Benseler SM, Vastert SJ, Wulffraat N, Swart JF, IJzerman MJ. Pharmacological treatment patterns in patients with juvenile idiopathic arthritis in the Netherlands: a real-world data analysis. Rheumatology, 2022; keac299, https://doi.org/10.1093/rheumatology/keac299
Currie GR, Pham T, Twilt M, Ijzerman MJ, Hull PJ, Kip MMA, Benseler S, Hazlewood GS, Yeung R, Wulffraat N, Swart JF, Vastert SJ, Marshall DA Perspectives of Pediatric Rheumatologists on Initiating and Tapering Biologics in Patients with Juvenile Idiopathic Arthritis: A Formative Qualitative Study. Patient (2022). https://doi.org/10.1007/s40271-022-00575-x
Kip MMA, de Roock S, van den Berg I, Currie G, Marshall DA, Grazziotin LR, Twilt M, Yeung RSM, Benseler SM, Vastert SJ, Wulffraat N, Swart JF, IJzerman MJ. Costs of hospital-associated care for patients with juvenile idiopathic arthritis in the Dutch healthcare system. Arthritis Care and Research. 2021 May 02. https://doi.org/10.1002/acr.24621. E-pub ahead of print.
Kip MMA, Currie G, Marshall DA, Grazziotin Lago L, Twilt M, Vastert SJ, Sward JF, Wulffraat N, Yeung RSM, Benseler SM, Ijzerman M. Seeking the state of the art in standardized measurement of health care resource use and costs in juvenile idiopathic arthritis: A scoping review. Pediatric Rheumatology. May 2019;17:20 https://doi.org/10.1186/s12969-019-0321-x
Barber CE, Twilt M, Pham T, Currie GR, Benseler S, Yeung RSM, Batthish M, Blanchette N, Guzman J, Lang B, LeBlanc C, Levy DM, O’Brin C, Schmeling H, Soon G, Spiegel L, Whitney K, Marshall DA. A Canadian evaluation framework for quality improvement in childhood arthritis: key performance indicators of the process of care. Arthritis Research and Therapy, March 2020;22(1):53 https://doi.org/10.1186/s13075-020-02151-w
Highlights from 2023
Deborah Marshall is Leading Prestigious National Cohort Training Program