Verification of unmet medical needs in patients with juvenile idiopathic arthritis in Japan

Objectives To identify unmet medical needs (UMNs) of medical practices and investigate the real-world prescribing practices of therapeutic medical treatments and test implementation for patients with juvenile idiopathic arthritis (JIA).Methods The possible UMNs were collected from eight paediatric and eight adult rheumatologists. To verify UMNs, the real-world prescribing practices of therapeutic medical treatments and test implementation for patients with JIA were described using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB).Results Fifty-eight possible UMNs collected from 16 experts and 35 UMNs were investigated using NDB. The highest priority UMNs was the expansion of indications for subcutaneous tocilizumab (TCZ sc) and subcutaneous abatacept- subcutaneous tocilizumab was administered to 12.8% systemic JIA and 5.5% JIA with polyarthritis or oligoarthritis. Comorbidities for systemic JIA and JIA with polyarthritis or oligoarthritis included hypertension (7.1%, 1.3%), osteoporosis (17%, 5.4%), depression (2.3%, 1.3%), diabetes (1.9% systemic JIA), and iritis and/or uveitis (6.5% JIA with polyarthritis or oligoarthritis).Conclusions The highest priority UMNs for JIA was the expansion of indications for abatacept sc and especially subcutaneous tocilizumab. This study reveals the real-world prescribing practices of therapeutic medical treatments and test implementation for patients with JIA in Japan.