Juvenile Psoriatic Arthritis Inception Cohort in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry: Characteristics and Early Disease Outcomes

Authors

Hemalatha Srinivasalu, H. Srinivasalu, MD, Division of Rheumatology, Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA.
Timothy Beukelman, T. Beukelman, MD, Childhood Arthritis and Rheumatology Research Alliance, Washington, DC, USA.
Anne Dennos, A. Dennos, MSPH, Duke Clinical Research Institute, Duke University, Durham, NC, USA.
Anqi Chen, A. Chen, MS, Duke Clinical Research Institute, Duke University, Durham, NC, USA.
Colleen Correll, C. Correll, MD, MPH, Department of Pediatrics, Division of Pediatric Rheumatology, Allergy & Immunology, University of Minnesota, Minneapolis, MN, USA.
Sarah Ringold, S. Ringold, MD, MS, Janssen Research & Development, LLC, Spring House, PA, USA.
Stephen Balevic, S. Balevic, MD, PhD, Duke Clinical Research Institute, Duke University, Durham, NC, USA; Department of Pediatrics, Duke University, Durham, NC, USA.

Document Type

Journal Article

Publication Date

7-1-2025

Journal

The Journal of rheumatology

DOI

10.3899/jrheum.2025-0066

Abstract

OBJECTIVE: To characterize the demographics, disease characteristics and treatment patterns of an inception cohort of children with psoriatic arthritis (jPsA) within the CARRA Registry. METHODS: Patients diagnosed with jPsA within 6 months of CARRA Registry enrollment were included and observed for up to 24-months. Baseline disease characteristics, treatment history, disease activity measures, and patient reported outcomes were captured at 6-month intervals (+/- 3 months) at usual-care visits during the 24-month period. RESULTS: 306 patients were included. Patients were predominantly female (62.4%) with a median (IQR) age of onset of 11.0 years (6.0-14.0). At Registry enrollment, 52.3% had polyarticular course, median active joint count was 3.0 (1.0-6.0), 20.1% had enthesitis, 34.3% had dactylitis, 9.5% had active sacroiliitis, and 58.8% had psoriasis. Tumor necrosis factor inhibitors (TNFi) were used in 61.1% and other biologic DMARDs in 13.4% of patients. 20.5% of patients received treatment with ≥2 biologic DMARDs or traditional synthetic DMARDs. cJADAS-10 improved from a median of 10.0 (5.5-15.0) at baseline to 1.0 (0.0-5.0) at 24 months. Improvements were also seen in active enthesitis and active sacroiliitis. CONCLUSION: In this inception cohort of jPsA in the CARRA Registry, one-half of patients had polyarticular presentation, and the majority of patients required advanced therapy. Regardless of the treatment used, most patients had improvements in disease activity measures and patient reported outcomes, with most achieving clinically inactive disease. However, escalation of treatment was common, highlighting the unmet need for precision medicine in identifying the optimal initial drug for each individual patient.

APA Citation

Srinivasalu, Hemalatha; Beukelman, Timothy; Dennos, Anne; Chen, Anqi; Correll, Colleen; Ringold, Sarah; and Balevic, Stephen, "Juvenile Psoriatic Arthritis Inception Cohort in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry: Characteristics and Early Disease Outcomes" (2025). GW Authored Works. Paper 7677.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/7677

Department

Pediatrics