Physician practices for withdrawal of medications in inactive systemic juvenile arthritis, Childhood Arthritis and Rheumatology Research Alliance (CARRA) survey
Autor: | Susan Shenoi, Kabita Nanda, Grant S. Schulert, John F. Bohnsack, Ashley M. Cooper, Bridget Edghill, Miriah C. Gillispie-Taylor, Baruch Goldberg, Olha Halyabar, Thomas G. Mason, Tova Ronis, Rayfel Schneider, Richard K. Vehe, Karen Onel, for the Childhood Arthritis and Rheumatology Research Alliance Systemic Juvenile Idiopathic Arthritis Workgroup |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
lcsh:Diseases of the musculoskeletal system Childhood arthritis Attitude of Health Personnel Clinical Decision-Making CARRA Arthritis Antibodies Monoclonal Humanized 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Tocilizumab Deprescriptions Rheumatology Adrenal Cortex Hormones Internal medicine Surveys and Questionnaires medicine Immunology and Allergy Humans 030212 general & internal medicine Adverse effect 030203 arthritis & rheumatology Response rate (survey) Anakinra business.industry Inactive disease lcsh:RJ1-570 lcsh:Pediatrics Systemic Juvenile Idiopathic Arthritis 16. Peace & justice medicine.disease Arthritis Juvenile 3. Good health Canakinumab Interleukin 1 Receptor Antagonist Protein Methotrexate chemistry Withdrawal of medications Antirheumatic Agents Pediatrics Perinatology and Child Health lcsh:RC925-935 Rheumatologists business medicine.drug Research Article |
Zdroj: | Pediatric Rheumatology Online Journal Pediatric Rheumatology Online Journal, Vol 17, Iss 1, Pp 1-7 (2019) |
ISSN: | 1546-0096 |
Popis: | Background We describe a Childhood Arthritis and Rheumatology Research Alliance (CARRA) survey of North American pediatric rheumatologists that assesses physician attitudes on withdrawal of medications in systemic juvenile idiopathic arthritis (SJIA). Methods A REDCap anonymous electronic survey was distributed to 100 random CARRA JIA workgroup physician-voting members. The survey had three broad sections including: A) demographic information; B) physicians’ opinions on clinical inactive disease (CID) in SJIA and C) existing practices for withdrawing medications in SJIA. Results The survey had an 86% response rate. 88 and 93% of participants agreed with the current criteria for CID and clinical remission on medications (CRM) respectively. 78% thought it necessary to meet CRM before tapering medications except steroids. 76% use CARRA SJIA consensus treatment plans always or the majority of the time. All participants weaned steroids first in SJIA patients on combination therapy, 47% waited > 6 months before tapering additional medications. 35% each tapered methotrexate over > 6 months and 2–6 months; however, 39% preferred tapering anakinra, canakinumab and tocilizumab more quickly over 2–6 months and favored spacing the dosing interval for canakinumab and tocilizumab. When patients are on combination therapy with methotrexate and biologics, 58% preferred tapering methotrexate first while others considered patient/family preference and adverse effects to guide their choice. Conclusion Most CARRA members surveyed use published consensus treatment plans for SJIA and agree with validated definitions of CID and CRM. There was agreement with tapering steroids first in SJIA. There was considerable variability with tapering decisions of all other medications. Electronic supplementary material The online version of this article (10.1186/s12969-019-0342-5) contains supplementary material, which is available to authorized users. |
Databáze: | OpenAIRE |
Externí odkaz: |