ArticleArthritis & rheumatology (Hoboken, N.J.)2018
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.
Article in Arthritis & rheumatology (Hoboken, N.J.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Approaches and outcomes of adalimumab discontinuation in patients with well-controlled inflammatory arthritis: a systematic search and review.Pediatric rheumatology online journal · 2024Pooled it
- Treatment Withdrawal Following Remission in Juvenile Idiopathic Arthritis: A Systematic Review of the Literature.Paediatric drugs · 2019Pooled it
- Tapering Canakinumab Monotherapy in Patients With Systemic Juvenile Idiopathic Arthritis in Clinical Remission: Results From a Phase IIIb/IV Open-Label, Randomized Study.Arthritis & rheumatology (Hoboken, N.J.) · 2021Trial
- Clinical predictors of relapse and severe disease phenotype in children with non-systemic juvenile idiopathic arthritis.European journal of pediatrics · 2026Article
- Toward Optimal Treatment Outcomes in New-Onset Polyarticular-Course Juvenile Idiopathic Arthritis.Paediatric drugs · 2026Review
- Toward Personalized Withdrawal of TNF-α Inhibitors in Non-Systemic Juvenile Idiopathic Arthritis: Predictors of Biologic-Free Remission and Flare.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Predictors of relapse after withdrawing biotherapies in children with inactive juvenile idiopathic arthritis: a retrospective cohort study of the JIR cohort.Pediatric rheumatology online journal · 2025Article
- Risk of flare in juvenile idiopathic arthritis: Is it related to the methotrexate treatment strategy or patient characteristics?Archives of rheumatology · 2023Article
- Successful stopping of biologic therapy for remission in children and young people with juvenile idiopathic arthritis.Rheumatology (Oxford, England) · 2023Article
- Development and Validation of a Juvenile Spondyloarthritis Disease Flare Measure: Ascertaining Flare in Patients With Inactive Disease.Arthritis care & research · 2023Article
- Discontinuation of biologic DMARDs in non-systemic JIA patients: a scoping review of relapse rates and associated factors.Pediatric rheumatology online journal · 2022Article
- Evaluation of flare rate and reduction strategies for bDMARDs in juvenile idiopathic arthritis: real world data from a single-centre cohort.Rheumatology international · 2022Observational
- The value of the patient global health assessment in polyarticular juvenile idiopathic arthritis: a nested cohort study.Journal of patient-reported outcomes · 2021Article
- Re-treatment with etanercept is as effective as the initial firstline treatment in patients with juvenile idiopathic arthritis.Arthritis research & therapy · 2021Article
- Long-term outcomes in patients with polyarticular juvenile idiopathic arthritis receiving adalimumab with or without methotrexate.RMD open · 2020Article
- Biomarkers of Response to Biologic Therapy in Juvenile Idiopathic Arthritis.Frontiers in pharmacology · 2020Review
- Serum S100A8/A9 and S100A12 Levels in Children With Polyarticular Forms of Juvenile Idiopathic Arthritis: Relationship to Maintenance of Clinically Inactive Disease During Anti-Tumor Necrosis Factor Therapy and Occurrence of Disease Flare After Discontinuation of Therapy.Arthritis & rheumatology (Hoboken, N.J.) · 2019Observational
Corrections and comments
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Authors and funding
44 authors at 17 institutions in 1 country.
Funding
Abstract
objectiveTo determine the frequency, time to flare, and predictors of disease flare upon withdrawal of anti-tumor necrosis factor (anti-TNF) therapy in children with polyarticular forms of juvenile idiopathic arthritis (JIA) who demonstrated ≥6 months of continuous clinically inactive disease.
methodsIn 16 centers 137 patients with clinically inactive JIA who were receiving anti-TNF therapy (42% of whom were also receiving methotrexate [MTX]) were prospectively followed up. If the disease remained clinically inactive for the initial 6 months of the study, anti-TNF was stopped and patients were assessed for flare at 1, 2, 3, 4, 6, and 8 months. Life-table analysis, t-tests, chi-square test, and Cox regression analysis were used to identify independent variables that could significantly predict flare by 8 months or time to flare.
resultsOf 137 patients, 106 (77%) maintained clinically inactive disease while receiving 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 (37%) of 106 patients by 8 months. The mean/median ± SEM time to flare was 212/250 ± 9.77 days. Patients with shorter disease duration at enrollment, older age at onset and diagnosis, shorter disease duration prior to experiencing clinically inactive disease, and shorter time from onset of clinically inactive disease to enrollment were found to have significantly lower hazard ratios for likelihood of flare by 8 months (P < 0.05).
conclusionOver one-third of patients with polyarticular JIA with sustained clinically inactive disease will experience a flare by 8 months after discontinuation of anti-TNF therapy. Several predictors of lower likelihood of flare were identified.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.