Risk, Timing, and Predictors of Disease Flare After Discontinuation of Anti-Tumor Necrosis Factor Therapy in Children With Polyarticular Forms of Juvenile Idiopathic Arthritis With Clinically Inactive Disease.
Risk, Timing, and Predictors of Disease Flare After Discontinuation of Anti-Tumor Necrosis Factor Therapy in Children With Polyarticular Forms of Juvenile Idiopathic Arthritis With Clinically Inactive Disease.
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DOI：
10.1002/art.40509
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发表时间：
2018-09
期刊：
影响因子：
--
通讯作者：
Giannini EH
中科院分区：
文献类型：
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作者：
Lovell DJ;Johnson AL;Huang B;Gottlieb BS;Morris PW;Kimura Y;Onel K;Li SC;Grom AA;Taylor J;Brunner HI;Huggins JL;Nocton JJ;Haines KA;Edelheit BS;Shishov M;Jung LK;Williams CB;Tesher MS;Costanzo DM;Zemel LS;Dare JA;Passo MH;Ede KC;Olson JC;Cassidy EA;Griffin TA;Wagner-Weiner L;Weiss JE;Vogler LB;Rouster-Stevens KA;Beukelman T;Cron RQ;Kietz D;Schikler K;Schmidt KM;Mehta J;Wahezi DM;Ting TV;Verbsky JW;Eberhard BA;Spalding S;Chen C;Giannini EH
确定多关节型幼年特发性关节炎（PF-JIA）儿童在停止抗肿瘤坏死因子（TNF）治疗后疾病发作的频率、发作时间和预测因素，这些儿童表现出≥ 6个月的连续临床非活动性疾病（CID）。在16个中心，前瞻性随访了137例接受抗TNF治疗的CID PF-JIA患者（其中42%还接受甲氨蝶呤[MTX]）。如果CID在研究的最初6个月内维持不变，则停止抗TNF治疗，并在1、2、3、4、6和8个月时评估患者的发作。使用寿命表、t检验、卡方和考克斯回归分析来确定可显著预测8个月或至发作时间的发作的独立变量。106/137例（77%）在抗TNF治疗的最初6个月内维持CID，并被纳入停止抗TNF治疗的研究阶段。停用抗TNF导致39/106例（37%）患者在8个月时疾病发作。平均/中位至发作时间为212/250（SEM 9.77）天。发现入组时病程较短、发病和诊断时年龄较大、经历CID前病程较短以及从CID发病至入组时间较短的患者在8个月时发作可能性的风险比显著较低（p< 0.05）。超过三分之一的持续CID的PF-JIA患者在停止抗TNF治疗后8个月内会发作。确定了几个较低的耀斑可能性的预测因子。
Determine the frequency, time-to-flare, and predictors of disease flare upon withdrawal of anti-tumor necrosis factor (TNF) therapy in children with polyarticular forms of juvenile idiopathic arthritis (PF-JIA) who demonstrated ≥ 6 continuous months of clinical inactive disease (CID). In 16 centers 137 patients with PF-JIA in CID on anti-TNF therapy (42% of whom were also on methotrexate [MTX]) were prospectively followed. If CID was maintained for the initial 6 months on study anti-TNF was stopped and patients assessed for flare at 1, 2, 3, 4, 6, and 8 months. Life-table, t-tests, Chi square, and Cox regression analyses were used to identify independent variables that could significantly predict flare by 8 months or time-to-flare. 106/137 (77%) maintained CID on anti-TNF therapy for the initial 6 months and were included in the phase of the study in which anti-TNF therapy was stopped. Stopping anti-TNF resulted in disease flare in 39/106 (37%) patients by 8 months. The mean/median time-to-flare were 212/250 (SEM 9.77) days. Patients with shorter disease duration at enrollment, older age at onset and diagnosis, shorter disease duration prior to experiencing CID, and shorter time from onset of CID to enrollment were found to have significantly lower hazard ratios (p< 0.05) for likelihood of flare by 8 months. Over one-third of patients with PF-JIA in sustained CID will flare by 8 months following discontinuation of anti-TNF therapy. Several predictors of lower likelihood of flare were identified.
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MRP8/14血清水平是对青少年特发性关节炎中开始和停止抗TNF治疗的反应的预测指标。
影响因子：
4.9
作者：
Anink J;Van Suijlekom-Smit LW;Otten MH;Prince FH;van Rossum MA;Dolman KM;Hoppenreijs EP;ten Cate R;Ursu S;Wedderburn LR;Horneff G;Frosch M;Vogl T;Gohar F;Foell D;Roth J;Holzinger D
通讯作者：
Holzinger D
影响因子：
158.5
作者：
De Benedetti, Fabrizio;Brunner, Hermine I.;Martini, Alberto
通讯作者：
Martini, Alberto
影响因子：
3.9
作者：
Filocamo, Giovanni;Davi, Sergio;Ravelli, Angelo
通讯作者：
Ravelli, Angelo
影响因子：
--
作者：
Lovell, DJ;Giannini, EH;Burge, DJ
通讯作者：
Burge, DJ
影响因子：
--
作者：
Lovell, Daniel J.;Reiff, Andreas;Giannini, Edward H.
通讯作者：
Giannini, Edward H.