Real‐World Effectiveness of Common Treatment Strategies for Juvenile Idiopathic Arthritis: Results From a Canadian Cohort
| Autor: | Amieleena, Chhabra, Kiem, Oen, Adam M, Huber, Natalie J, Shiff, Gilles, Boire, Susanne M, Benseler, Roberta A, Berard, Rosie, Scuccimarri, Brian M, Feldman, Lily Siok Hoon, Lim, Julie, Barsalou, Alessandra, Bruns, David A, Cabral, Gaëlle, Chédeville, Janet, Ellsworth, Kristin, Houghton, Bianca, Lang, Kimberly, Morishita, Dax G, Rumsey, Alan M, Rosenberg, Shirley M, Tse, Karen, Watanabe Duffy, Ciaran M, Duffy, Jaime, Guzman, Paul, Dancey |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Canada medicine.medical_specialty Intra-Articular Anti-Inflammatory Agents Juvenile Arthritis Logistic regression Pediatrics Injections Injections Intra-Articular Cohort Studies 03 medical and health sciences 0302 clinical medicine Rheumatology Joint injection Internal medicine Humans Medicine Child Preschool Glucocorticoids 030203 arthritis & rheumatology business.industry Anti-Inflammatory Agents Non-Steroidal Odds ratio medicine.disease Arthritis Juvenile Confidence interval 3. Good health Methotrexate Child Preschool Cohort Female Non-Steroidal business Immunosuppressive Agents medicine.drug Cohort study |
| Zdroj: | Paediatrics Publications |
| ISSN: | 2151-4658 2151-464X |
| Popis: | OBJECTIVE Undervaluing the effectiveness of conventional treatments may lead to overtreatment with biologic medications in children with juvenile idiopathic arthritis (JIA). Using data from a nationwide inception cohort and strict methods to control bias, the aim of our study was to estimate the real-world effectiveness of simple JIA treatment strategies recommended in current guidelines. METHODS Children with JIA who were recruited at 16 Canadian centers from 2005 to 2010 were followed for up to 5 years. For each child, all observed treatment changes over time were assessed by independent physicians using prospectively collected data and published response criteria. Success was defined as attainment of inactive disease or maintenance of this state when stepping down treatment; minimally active disease was deemed acceptable for children with polyarticular JIA. Success rates were calculated for treatments tried ≥25 times, and logistic regression analysis identified features associated with success. RESULTS A total of 4,429 treatment episodes were observed in 1,352 children. Nonsteroidal antiinflammatory drug (NSAID) monotherapy was attempted 697 times, mostly as initial treatment when |
| Databáze: | OpenAIRE |
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