Geno-engineering biological therapy of juvenile idiopathic arthritis in the republic of belarus

The purpose of this study is to characterize the genetic engineering biological therapy performed in children with juvenile idiopathic arthritis in the Republic of Belarus for the period 2020–2023. To achieve this goal, the prevalence of juvenile idiopathic arthritis among the child population  in the Republic of Belarus, the dynamics of the number and number of children being monitored for juvenile idiopathic arthritis, and the demographic characteristics of patients receiving or having received biological therapy were studied. The structure and frequency of prescribing biological therapy for patients with juvenile idiopathic arthritis depending on the region of residence was determined. Indications for biological therapy were clarified and analyzed.
As a result of the study, it was established that the prevalence of juvenile idiopathic arthritis in the republic is 45.0–46.9 per 100,000 children. There has been a steady annual increase in the frequency of use of biological therapy in the treatment of juvenile idiopathic arthritis. The leading reason for prescribing biological therapy to children (82.5 %) was the ineffectiveness of the previous use of the basic anti-inflammatory drug – Methotrexate, both in the form of monotherapy and in combination with glucocorticoids. The leading biological drug in the treatment of patients with the articular form of the disease was adalimumab. It was used in 87.4 % of patients with affected joints. In the treatment of the systemic form of the disease, tocilizumab was most often used (93.3 %). 
Considering the long period from the development of the disease to the prescription of biological therapy (up to 5–7 years), the development of side effects from the use of methotrexate and glucocorticoids (hormone dependence/hormone resistance, osteoporosis), earlier prescription of genetic engineering biological therapy in childhood is required.

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