دورية أكاديمية
أعرض في EDS

Anti-tumor necrosis factor (aTNF) weaning strategy in juvenile idiopathic arthritis (JIA): does duration matter?

التفاصيل البيبلوغرافية
العنوان: Anti-tumor necrosis factor (aTNF) weaning strategy in juvenile idiopathic arthritis (JIA): does duration matter?
المؤلفون: 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.; Duke-NUS Medical School, Singapore, Singapore., Das L; 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., 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; Division of Nursing, KK Women's and Children's Hospital, Singapore, Singapore., Gao X; Division of Nursing, KK Women's and Children's Hospital, Singapore, Singapore., Arkachaisri T; 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. tash.arkachaisri@duke-nus.edu.sg.; Duke-NUS Medical School, Singapore, Singapore. tash.arkachaisri@duke-nus.edu.sg.
المصدر: Clinical rheumatology [Clin Rheumatol] 2024 May; Vol. 43 (5), pp. 1723-1733. Date of Electronic Publication: 2024 Mar 05.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: Germany NLM ID: 8211469 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1434-9949 (Electronic) Linking ISSN: 07703198 NLM ISO Abbreviation: Clin Rheumatol Subsets: MEDLINE
أسماء مطبوعة: Publication: <2008->: Heidelberg : Springer
Original Publication: Brussels : Acta Medica Belgica, [1982-
مواضيع طبية MeSH: Antirheumatic Agents*/therapeutic use , Arthritis, Juvenile*/drug therapy, Female ; Humans ; Male ; Adalimumab/therapeutic use ; Prospective Studies ; Treatment Outcome ; Tumor Necrosis Factor-alpha/therapeutic use
مستخلص: 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.
(© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)
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فهرسة مساهمة: Keywords: Adalimumab; Anti-tumor necrosis factor; Juvenile idiopathic arthritis; Tapering; Weaning
المشرفين على المادة: FYS6T7F842 (Adalimumab)
0 (Antirheumatic Agents)
0 (Tumor Necrosis Factor-alpha)
تواريخ الأحداث: Date Created: 20240305 Date Completed: 20240416 Latest Revision: 20240513
رمز التحديث: 20240513
DOI: 10.1007/s10067-024-06928-1
PMID: 38443603
قاعدة البيانات: MEDLINE
الوصف
تدمد:1434-9949
DOI:10.1007/s10067-024-06928-1