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Table 4 Cases of csDMARD withdrawal

From: Clinical remission rate and drug withdrawal status in articular juvenile idiopathic arthritis

 

RF + PJIA

(n = 4 [57%])

RF − PJIA (n = 8 [89%])

OJIA

(n = 27 [82%])

p-value

Concomitant use of bDMARDs at withdrawal of csDMARDs, n (%)

1 (25%)

3 (38%)

1 (4%)

 < 0.05 g

History of bDMARDs use at withdrawal of csDMARDs, n (%)

0 (0%)

0 (0%)

1 (4%)

0.80

Duration of csDMARD administration (months)

27 (12–118)

28 (2–76)

19 (4–128)

0.81

Reasons for withdrawal of csDMARDs

 Adverse eventa, n (%)

2 (50%)

4 (50%)

1 (4%)

 < 0.05 h

Flare after drug withdrawal of csDMARDs, n (%)

2 (50%)

2 (25%)

8 (30%)

0.67

Time to flare (months)

4.5 (0–9)

14 (14–14)

4 (1–30)

0.17

Introduction of bDMARDs after flare

2 (100%)

0 (0%)

1 (13%)

 < 0.05i

Disease activity at the end of observation

 Active disease

0

0

1 (4%)

0.8

 Inactive disease

0

0

1 (4%)

0.8

 Clinical remission on medication

3 (75%)b

3 (38%)d

3 (11%)f

 < 0.05j

 Clinical remission off medication

1 (25%)c

5 (63%)e

22 (81%)e

0.06

  1. Data are presented as the median (range) or n (%), unless otherwise indicated
  2. bDMARD biological disease-modifying antirheumatic drug, csDMARD conventional synthetic disease-modifying antirheumatic drug, OJIA oligoarticular juvenile idiopathic arthritis, PJIA polyarticular juvenile idiopathic arthritis, RF rheumatoid factor
  3. aAdverse events include MTX intolerance due to gastrointestinal symptoms such as vomiting and nausea, oral aphthae, and liver disorders
  4. bAll three patients were treated with bDMARDs monotherapy. Two were treated with TCZ, and one with ABA
  5. cThis patient had not previously received bDMARDs
  6. dAll three patients were treated with TCZ. Two were treated with TCZ monotherapy, and one with TCZ and sulfasalazine combination therapy after flare following discontinuation of MTX due to adverse effects
  7. eNone of the patients had received bDMARDs
  8. fIn three patients, all medications were discontinued; however, the criteria for CR were not achieved by the conclusion of the observation period. One patient initially discontinued TCZ and sustained CRM for one year on MTX monotherapy, after which MTX was also discontinued
  9. gRF + PJIA versus RF − PJIA, p-value 0.41. RF + PJIA versus OJIA, p-value 0.25. RF − PJIA versus OJIA, p-value < 0.05. h RF + PJIA versus RF − PJIA, p-value 1.0. RF + PJIA versus OJIA, p-value < 0.05. RF − PJIA versus OJIA, p-value < 0.05. RF − PJIA versus OJIA, p-value < 0.05. i RF + PJIA versus RF − PJIA, p-value < 0.09. RF + PJIA versus OJIA, p-value < 0.05. RF − PJIA versus OJIA, p-value 0.84. j RF + PJIA versus RF − PJIA, p-value 0.47. RF + PJIA versus OJIA, p-value < 0.01. RF − PJIA versus OJIA, p-value 0.20
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Pediatric Rheumatology

ISSN: 1546-0096