OBJECTIVE: To characterize disease-modifying antirheumatic drug (DMARD) use for 
children with juvenile idiopathic arthritis (JIA) in the United States and to 
determine patient factors associated with medication use.
METHODS: We analyzed cross-sectional baseline enrollment data from the Childhood 
Arthritis and Rheumatology Research Alliance (CARRA) Registry from May 2010 
through May 2011 for children with JIA. Current and prior medication use was 
included. We used parsimonious backward stepwise logistic regression models to 
calculate OR to estimate associations between clinical patient factors and 
medication use.
RESULTS: We identified 2748 children with JIA with a median disease duration of 
3.9 years from 51 US clinical sites. Overall, 2023 (74%) had ever received a 
nonbiologic DMARD and 1246 (45%) had ever received a biologic DMARD. Among 
children without systemic arthritis, methotrexate use was most strongly 
associated with uveitis (OR 5.2, 95% CI 3.6-7.6), anticitrullinated protein 
antibodies (OR 4.5, 95% CI 1.7-12), and extended oligoarthritis (OR 4.1, 95% CI 
2.5-6.6). Among children without systemic arthritis, biologic DMARD use was most 
strongly associated with rheumatoid factor (RF)-positive polyarthritis (OR 4.3, 
95% CI 2.9-6.6), psoriatic arthritis (PsA; OR 3.0, 95% CI 2.0-4.4), and uveitis 
(OR 2.8, 95% CI 2.1-3.7). Among children with systemic arthritis, 160 (65%) ever 
received a biologic DMARD; tumor necrosis factor inhibitor use was associated 
with polyarthritis (OR 2.5, 95% CI 3.8-16), while interleukin 1 inhibitor use 
was not.
CONCLUSION: About three-quarters of all children with JIA in the CARRA Registry 
received nonbiologic DMARD. Nearly one-half received biologic DMARD, and their 
use was strongly associated with RF-positive polyarthritis, PsA, uveitis, and 
systemic arthritis.