Abstract | OBJECTIVES: To investigate patients who flared after discontinuation of biological disease-modifying anti-rheumatic agents (bDMARDs) and identify risk factors associated with flare. METHODS: A multicenter study evaluating systemic and non-systemic juvenile idiopathic arthritis (sJIA and non-sJIA) patients whose bDMARDs were ceased after remission. RESULTS: A total of 101 patients whose bDMARDs were ceased after remission was evaluated. Children with sJIA had the lowest risk of flare and 11.1% of 36 sJIA patients experienced flare after a median of 9 (4-24) months of bDMARDs cessation with three of them flaring in the first year. High leukocyte counts in sJIA patients were associated with inactive disease at 1-year after the start of treatment (p = 0.004). In the non-sJIA group, 46.1% patients experienced flare after a median of 7 (1-32) months of biologic cessation, and of these, 25 flared in the first year. Antinuclear antibody positivity (p = 0.02), earlier disease onset (p = 0.03), long disease duration (p = 0.01), and follow-up (p = 0.02) and extended time from diagnosis to first biological onset (p = 0.03) were more common among patients with flare. CONCLUSIONS: When considering discontinuation of bDMARDs, it should be kept in mind that the risk of exacerbation requiring re-initiation therapy is quite significant within the first year after discontinuation of therapy.
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Authors | Ayşe Tanatar, Özlem Akgün, Şengül Çağlayan, Esra Bağlan, Gülçin Otar Yener, Kübra Öztürk, Mustafa Çakan, Hafize Emine Sönmez, Betül Sözeri, Nuray Aktay Ayaz |
Journal | Expert opinion on biological therapy
(Expert Opin Biol Ther)
Vol. 23
Issue 3
Pg. 305-313
(03 2023)
ISSN: 1744-7682 [Electronic] England |
PMID | 36825474
(Publication Type: Multicenter Study, Journal Article)
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Chemical References |
- Antirheumatic Agents
- Biological Factors
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Topics |
- Child
- Humans
- Arthritis, Juvenile
(drug therapy)
- Antirheumatic Agents
(therapeutic use)
- Risk Factors
- Biological Factors
(therapeutic use)
- Biological Therapy
- Treatment Outcome
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