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Withdrawing biologics in non-systemic JIA: what matters to pediatric rheumatologists?

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اقرأ على الانترنت اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • Corporate Authors:
      UCAN CAN-DU, UCAN CURE consortia
    • المصدر:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101248897 Publication Model: Electronic Cited Medium: Internet ISSN: 1546-0096 (Electronic) Linking ISSN: 15460096 NLM ISO Abbreviation: Pediatr Rheumatol Online J Subsets: MEDLINE
    • بيانات النشر:
      Publication: 2007- : [London] : BioMed Central
      Original Publication: [Chicago, Ill. : University of Chicago, 2003]-
    • الموضوع:
      Biological Products*/therapeutic use ; Arthritis, Juvenile*/therapy ; Withholding Treatment*; Child ; Humans ; Canada ; Duration of Therapy ; Netherlands ; Rheumatologists
    • نبذة مختصرة :
      Objective: Approximately one third of children with JIA receive biologic therapy, but evidence on biologic therapy withdrawal is lacking. This study aims to increase our understanding of whether and when pediatric rheumatologists postpone a decision to withdraw biologic therapy in children with clinically inactive non-systemic JIA.
      Methods: A survey containing questions about background characteristics, treatment patterns, minimum treatment time with biologic therapy, and 16 different patient vignettes, was distributed among 83 pediatric rheumatologists in Canada and the Netherlands. For each vignette, respondents were asked whether they would withdraw biologic therapy at their minimum treatment time, and if not, how long they would continue biologic therapy. Statistical analysis included descriptive statistics, logistic and interval regression analysis.
      Results: Thirty-three pediatric rheumatologists completed the survey (40% response rate). Pediatric rheumatologists are most likely to postpone the decision to withdraw biologic therapy when the child and/or parents express a preference for continuation (OR 6.3; p < 0.001), in case of a flare in the current treatment period (OR 3.9; p = 0.001), and in case of uveitis in the current treatment period (OR 3.9; p < 0.001). On average, biologic therapy withdrawal is initiated 6.7 months later when the child or parent prefer to continue treatment.
      Conclusion: Patient's and parents' preferences were the strongest driver of a decision to postpone biologic therapy withdrawal in children with clinically inactive non-systemic JIA and prolongs treatment duration. These findings highlight the potential benefit of a tool to support pediatric rheumatologists, patients and parents in decision making, and can help inform its design.
      (© 2023. The Author(s).)
    • References:
      Curr Opin Rheumatol. 2020 Sep;32(5):403-413. (PMID: 32657803)
      Rheumatol Ther. 2021 Sep;8(3):1303-1322. (PMID: 34275124)
      Best Pract Res Clin Rheumatol. 2017 Aug;31(4):476-487. (PMID: 29773268)
      BMC Rheumatol. 2019 Jun 13;3:2. (PMID: 31225429)
      Rheumatology (Oxford). 2023 Feb 23;62(SI2):SI170-SI180. (PMID: 35583252)
      Ann Rheum Dis. 2018 Jun;77(6):819-828. (PMID: 29643108)
      Pediatr Rheumatol Online J. 2022 Dec 5;20(1):109. (PMID: 36471348)
      J Rheumatol. 2004 Feb;31(2):390-2. (PMID: 14760812)
      Front Surg. 2021 Aug 12;8:690680. (PMID: 34458314)
      Int J Clin Health Psychol. 2015 May-Aug;15(2):160-170. (PMID: 30487833)
      Acta Reumatol Port. 2020 Jul-Sep;45(3):229-232. (PMID: 33139687)
      Arthritis Care Res (Hoboken). 2019 Jun;71(6):717-734. (PMID: 31021516)
      Semin Arthritis Rheum. 2017 Apr;46(5):584-593. (PMID: 27914689)
      Ann Rheum Dis. 2022 Jul;81(7):990-997. (PMID: 35260388)
      Patient. 2022 Sep;15(5):599-609. (PMID: 35322390)
      BMC Med Res Methodol. 2015 Apr 09;15:32. (PMID: 25888346)
      J Rheumatol. 2012 Sep;39(9):1875-9. (PMID: 22859344)
      Expert Rev Pharmacoecon Outcomes Res. 2021 Oct;21(5):975-984. (PMID: 33243033)
      Open Access Rheumatol. 2019 Nov 01;11:237-252. (PMID: 31807093)
      Ann Rheum Dis. 2016 Jun;75(6):1092-8. (PMID: 25985972)
      Arthritis Care Res (Hoboken). 2018 Jul;70(7):1046-1051. (PMID: 28973842)
      Arthritis Rheumatol. 2022 Apr;74(4):553-569. (PMID: 35233993)
      Clin Rheumatol. 2023 May 19;:. (PMID: 37202606)
      Paediatr Drugs. 2019 Dec;21(6):469-492. (PMID: 31673960)
      Autoimmun Rev. 2011 Jun;10(8):482-9. (PMID: 21320644)
      Pediatr Rheumatol Online J. 2022 Apr 11;20(1):25. (PMID: 35410419)
      J Rheumatol. 2017 Mar;44(3):352-360. (PMID: 28148696)
      Patient Educ Couns. 2015 Oct;98(10):1172-9. (PMID: 26215573)
    • Grant Information:
      EP-D-18-001 United States EPA EPA; 848006001 Netherlands ZONMW_ ZonMw
    • Contributed Indexing:
      Keywords: Biologicals; Clinical vignette study; Decision support tool; Juvenile Idiopathic Arthritis; Treatment withdrawal
    • الرقم المعرف:
      0 (Biological Products)
    • الموضوع:
      Date Created: 20230711 Date Completed: 20230719 Latest Revision: 20230719
    • الموضوع:
      20260130
    • الرقم المعرف:
      PMC10337208
    • الرقم المعرف:
      10.1186/s12969-023-00845-4
    • الرقم المعرف:
      37434157