Impact of Medication Withdrawal Method on Flare-Free Survival in Patients with Juvenile Idiopathic Arthritis on Combination Therapy
| Autor: | Andreas Reiff, Caroline Y. Chang, Rika M. L. Meyer |
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| Rok vydání: | 2015 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty medicine.diagnostic_test Combination therapy business.industry Arthritis Retrospective cohort study medicine.disease Surgery Discontinuation Pharmacotherapy Rheumatology Internal medicine Erythrocyte sedimentation rate medicine Rheumatoid factor Methotrexate skin and connective tissue diseases business medicine.drug |
| Zdroj: | Arthritis Care & Research. 67:658-666 |
| ISSN: | 2151-464X |
| DOI: | 10.1002/acr.22477 |
| Popis: | Objective To determine whether order of medication withdrawal in children with juvenile idiopathic arthritis (JIA) taking methotrexate (MTX) and tumor necrosis factor inhibitor (TNFi) combination therapy (CBT) affects flare-free survival (FFS). Methods This retrospective observational study of 335 patients with polyarticular JIA or enthesitis-related arthritis analyzed FFS off medications in 4 withdrawal arms: 1) TNFi plus MTX, off MTX first, 2) TNFi plus MTX, off TNFi first, 3) MTX monotherapy, or 4) TNFi monotherapy. Outcomes were evaluated based on order of medication withdrawal, clinical presentation, serologic parameters, and duration of clinically inactive disease (CID) while taking medications. Results Sixty-four percent of all patients achieved CID. However, 89% of patients on CBT who withdrew TNFi first flared within 12 months despite continuing MTX, compared to 12% of those who withdrew MTX and continued TNFi (P |
| Databáze: | OpenAIRE |
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