Article ; Online: Anti-tumor necrosis factor (aTNF) weaning strategy in juvenile idiopathic arthritis (JIA): does duration matter?
2024 Volume 43, Issue 5, Page(s) 1723–1733
Abstract: ... aTNF) in our prospective juvenile idiopathic arthritis (JIA) cohort.: Research design and methods ... JIA patients on subcutaneous adalimumab with at least 6 months of follow-up were recruited (May 2010 ... were flare rates, time to flare, and predictors.: Results: Of 110 JIA patients, 77 (83% male, 78 ...
Abstract | Background: To compare outcomes of a short and long weaning strategy of anti-tumor necrosis factor (aTNF) in our prospective juvenile idiopathic arthritis (JIA) cohort. Research design and methods: JIA patients on subcutaneous adalimumab with at least 6 months of follow-up were recruited (May 2010-Jan 2022). Once clinical remission on medication (CRM) was achieved, adalimumab was weaned according to two protocols-short (every 4-weekly for 6 months and stopped) and long (extending dosing interval by 2 weeks for three cycles until 12-weekly intervals and thereafter stopped) protocols. Outcomes assessed were flare rates, time to flare, and predictors. Results: Of 110 JIA patients, 77 (83% male, 78% Chinese; 82% enthesitis-related arthritis) underwent aTNF weaning with 53% on short and 47% on long weaning protocol. The total flare rate during and after stopping aTNF was not different between the two groups. The time to flare after stopping aTNF was not different (p = 0.639). Positive anti-nuclear antibody increased flare risk during weaning in long weaning group (OR 7.0, 95%CI: 1.2-40.8). Positive HLA-B27 (OR 6.5, 95%CI: 1.1-30.4) increased flare risks after stopping aTNF. Conclusion: Duration of weaning aTNF may not minimize flare rate or delay time to flare after stopping treatment in JIA patients. Recapture rates for inactive disease at 6 months remained high for patients who flared after weaning or discontinuing medication. |
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MeSH term(s) | Humans ; Male ; Female ; Arthritis, Juvenile/drug therapy ; Adalimumab/therapeutic use ; Antirheumatic Agents/therapeutic use ; Prospective Studies ; Weaning ; Tumor Necrosis Factor-alpha/therapeutic use ; Necrosis/drug therapy ; Treatment Outcome |
Chemical Substances | Adalimumab (FYS6T7F842) ; Antirheumatic Agents ; Tumor Necrosis Factor-alpha |
Language | English |
Publishing date | 2024-03-05 |
Publishing country | Germany |
Document type | Journal Article |
ZDB-ID | 604755-5 |
ISSN | 1434-9949 ; 0770-3198 |
ISSN (online) | 1434-9949 |
ISSN | 0770-3198 |
DOI | 10.1007/s10067-024-06928-1 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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