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Anti-tumor necrosis factor (aTNF) weaning strategy in juvenile idiopathic arthritis (JIA): does duration matter?
Teh, Kai Liang; Das, Lena; Book, Yun Xin; Hoh, Sook Fun; Gao, Xiaocong; Arkachaisri, Thaschawee.
Afiliación
  • Teh KL; Rheumatology and Immunology Service, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, 100 Bukit Timah Road, Children's Tower, Level 3, Zone B, Singapore, 229899, Singapore.
  • Das L; Duke-NUS Medical School, Singapore, Singapore.
  • Book YX; Rheumatology and Immunology Service, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, 100 Bukit Timah Road, Children's Tower, Level 3, Zone B, Singapore, 229899, Singapore.
  • Hoh SF; Rheumatology and Immunology Service, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, 100 Bukit Timah Road, Children's Tower, Level 3, Zone B, Singapore, 229899, Singapore.
  • Gao X; Division of Nursing, KK Women's and Children's Hospital, Singapore, Singapore.
  • Arkachaisri T; Division of Nursing, KK Women's and Children's Hospital, Singapore, Singapore.
Clin Rheumatol ; 43(5): 1723-1733, 2024 May.
Article en En | MEDLINE | ID: mdl-38443603
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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Juvenil / Antirreumáticos Límite: Female / Humans / Male Idioma: En Revista: Clin Rheumatol Año: 2024 Tipo del documento: Article País de afiliación: Singapur Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artritis Juvenil / Antirreumáticos Límite: Female / Humans / Male Idioma: En Revista: Clin Rheumatol Año: 2024 Tipo del documento: Article País de afiliación: Singapur Pais de publicación: Alemania