Evidence map›Paper›PMID 35260388›Full record

ArticleAnnals of the rheumatic diseases2022

Prevention of disease flares by risk-adapted stratification of therapy withdrawal in juvenile idiopathic arthritis: results from the PREVENT-JIA trial.

Joachim Gerss, Monika Tedy, Ariane Klein, Gerd Horneff, Maria Miranda-Garcia, Christoph Kessel, Dirk Holzinger, Valda Stanevica, Joost F Swart, David A Cabral and 2 more

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of the rheumatic diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
6.6field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 41 citations in OpenAlex.

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  12. Treatment of systemic juvenile idiopathic arthritis.Nature reviews. Rheumatology · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 8 institutions in 5 countries.

Joachim GerssInterdisciplinary Center of Clinical Research, University of Münster, Munster, Germany.ORCID http://orcid.org/0000-0003-3489-683X
Monika TedyDepartment of Pediatric Rheumatology and Immunology, University Hospital Munster, Munster, Germany.
Ariane KleinAsklepios Children's Hospital, Sankt Augustin, Germany.
Gerd HorneffPediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin, Germany.
Maria Miranda-GarciaDepartment of Pediatric Rheumatology and Immunology, University Hospital Munster, Munster, Germany.
Christoph KesselDepartment of Pediatric Rheumatology and Immunology, University Hospital Munster, Munster, Germany.ORCID http://orcid.org/0000-0002-0638-2949
Dirk HolzingerDepartment of Pediatric Hematology-Oncology, University of Duisburg-Essen, Essen, Germany.ORCID http://orcid.org/0000-0002-8062-8820
Valda StanevicaDepartment of Pediatrics, Riga Stradins University, Riga, Latvia.
Joost F SwartPediatric Immunology, Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands.ORCID http://orcid.org/0000-0002-2759-2822
David A CabralPediatric Rheumatology, BC Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
Hermine I BrunnerDivision of Rheumatology, University of Cincinnati, Cincinnati Children's Hospital Medical Center, PRCSG Coordinating Center, Cincinnati, Ohio, USA.ORCID http://orcid.org/0000-0001-9478-2987
Dirk FoellInterdisciplinary Center of Clinical Research, University of Münster, Munster, Germany dfoell@uni-muenster.de.ORCID http://orcid.org/0000-0002-1946-3916
University Hospital Münster · DEAsklepios Klinik Sankt Augustin · DEUniversity of Münster · DECincinnati Children's Hospital Medical Center · USRiga Stradiņš University · LVUniversity Medical Center Utrecht · NLUniversity of British Columbia · CAUniversity of Duisburg-Essen · DE

Funding

Pediatric musculOskeletal & RheumaTology Innovation COre center (PORTICO)P30AR076316 · NIAMS · CINCINNATI CHILDRENS HOSP MED CTR · PI BRUNNER, HERMINE I · 2019 to 2023
$3.4M
6 · The paper itself

Abstract

objectivesTo investigate the ability of high-sensitivity C-reactive protein (hsCRP) and S100A12 to serve as predictive biomarkers of successful drug withdrawal in children with clinical remission of juvenile idiopathic arthritis (JIA).

methodsThis multicentre trial (PREVENT-JIA) enrolled 119 patients with JIA in clinical remission, and 100 patients reached the intervention phase in which the decision whether to continue or stop treatment was based on S100A12 and hsCRP levels. Patients were monitored for 12 months after stopping medication for flares of disease. Results were compared with withdrawal of therapy without biomarker-based stratification in patients from the German Biologika in der Kinderrheumatologie (BiKeR) pharmacovigilance registry.

resultsIn the PREVENT-JIA group, 49 patients had a flare, and 45% of patients stopping medication showed flares within the following 12 months. All patients (n=8) continuing therapy due to permanently elevated S100A12/hsCRP at more than one visit flared during the observation phase. In the BiKeR control group, the total flare rate was 62%, with 60% flaring after stopping medication. The primary outcome, time from therapy withdrawal to first flare (cumulative flare rate after therapy withdrawal), showed a significant difference in favour of the PREVENT-JIA group (p=0.046; HR 0.62, 95% CI 0.38 to 0.99). As additional finding, patients in the PREVENT-JIA trial stopped therapy significantly earlier.

conclusionBiomarker-guided strategies of therapy withdrawal are feasible in clinical practice. This study demonstrates that using predictive markers of subclinical inflammation is a promising tool in the decision-making process of therapy withdrawal, which translates into direct benefit for patients. TRIAL REGISTRATION NUMBER: ISRCTN69963079.

Indexed as

Antirheumatic AgentsArthritis, JuvenileBiomarkersChildC-Reactive ProteinHumansS100A12 ProteinSymptom Flare UpTreatment OutcomeAntirheumatic AgentsBiomarkersC-Reactive ProteinS100A12 Proteinbiomarkerimmunological remissionJuvenile idiopathic arthritis (JIA)relapse preventionsubclinical inflammationtherapy withdrawal

Identifiers

PMID35260388
PMCPMC9209679
OpenAlexW4221064814

What OpenQuestion holds

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Registered trials

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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.