Disease-Modifying Antirheumatic Drugs in Children With Juvenile Idiopathic Arthritis
Meta-analysis of Discontinuation Trials of Biologic DMARDs
Randomized discontinuation trials include only patients who respond to a treatment during a run-in phase. These studies evaluate the sustainability of treatment effects.
Data from four discontinuation trials were combined in a meta-analysis to determine the risk of a disease flare for patients receiving biologic DMARDs when compared to those who discontinued treatment. The trials included only patients who failed to improve with methotrexate therapy. Study durations were 4 months to 2 years.
Result: The risk of a flare in patients who continued treatment was half that of those who discontinued treatment (relative risk = 0.48, 95% confidence interval = 0.36, 0.63).
Keywords: juvenile idiopathic arthritis | JIA | JRA | juvenile rheumatoid arthritis | JCA | DMARDs | disease-modifying | antirheumatic | anti-rheumatic | rheumatic | TNF-alpha blockers | biologic DMARD | nonbiologic DMARD | non-biologic DMARD | anti-inflammatory | polyarticular | pauciarticular | oligoarticular | systemic onset | etanercept | infliximab | abatacept | adalimumab | anakinra | tocilizumab | etanercept | IVIG | intravenous immunoglobulin | methotrexate | disease activity | health status | erythrocyte sedimentation rate | ESR | randomized discontinuation trial | discontinuation trial | flare | remission
- Kemper A, Coeytaux R, Sanders G, et al. Disease-Modifying Antirheumatic Drugs (DMARDs) in Children With Juvenile Idiopathic Arthritis (JIA). Comparative Effectiveness Review No. 28 (Prepared by the Duke Evidence-based Practice Center under Contract No. HHSA 290-2007-10066-I). Rockville, MD: Agency for Healthcare Research and Quality; September 2011. AHRQ Publication No. 11-EHC039-EF. Available at www.effectivehealthcare.ahrq.gov/dmardsjia.cfm.
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