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Hahn, Timothy; Daymont, Carrie; Beukelman, Timothy; Groh, Brandt; Hays, Kimberly; Bingham, Catherine April; Scalzi, Lisabeth; Abel, N.; Abulaban, K.; Adams, A.; Adams, M.; Agbayani, R.; Aiello, J.; Akoghlanian, S.; Alejandro, C.; Allenspach, E.; Alperin, R.; Alpizar, M.; Amarilyo, G.; Ambler, W.; Anderson, E.; Ardoin, S.; Armendariz, S.; Baker, E.; [...]

Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry

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  • Medientyp: E-Artikel
  • Titel: Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry
  • Beteiligte: Hahn, Timothy; Daymont, Carrie; Beukelman, Timothy; Groh, Brandt; Hays, Kimberly; Bingham, Catherine April; Scalzi, Lisabeth; Abel, N.; Abulaban, K.; Adams, A.; Adams, M.; Agbayani, R.; Aiello, J.; Akoghlanian, S.; Alejandro, C.; Allenspach, E.; Alperin, R.; Alpizar, M.; Amarilyo, G.; Ambler, W.; Anderson, E.; Ardoin, S.; Armendariz, S.; Baker, E.; [...]
  • Erschienen: Springer Science and Business Media LLC, 2022
  • Erschienen in: Pediatric Rheumatology
  • Sprache: Englisch
  • DOI: 10.1186/s12969-022-00770-y
  • ISSN: 1546-0096
  • Schlagwörter: Immunology and Allergy ; Rheumatology ; Pediatrics, Perinatology and Child Health
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, <jats:italic>p</jats:italic> &lt; 0.01) and 12 months (81% vs 33%, <jats:italic>p</jats:italic> &lt; 0.05).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.</jats:p> </jats:sec>
  • Zugangsstatus: Freier Zugang