Uveitis as predictor of disease flare after the first anti-TNF withdrawal in oligoarticular and polyarticular juvenile idiopathic arthritis: a multicentric Italian experience
Authors' conclusion
Younger age at onset, uveitis, duration of tapering, and non-persistent oligoarticular JIA seem to be independent risk factors for earlier relapse after the first TNFi withdrawal.
Study context
- Population
- Patients with oligoarticular and polyarticular juvenile idiopathic arthritis (JIA) who stopped the first TNF inhibitors (TNFi) (adalimumab or etanercept) for persistent inactivity, Italy102 female
- Participants
- 136 patients
- Exposure
- Adalimumab vs Etanercept
- Outcome
- Disease relapse after first TNFi withdrawal and associated factors
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Relapse after TNFi withdrawal
- Patients relapsed
- 79.4%
- Median time to relapse, months (range 0.5-66)
- 5
- Uveitis, predictor of relapse
- 2.11 (HR, CI 1.34-3.31)
- Age at onset, predictor of relapse
- 0.909 (HR, CI 0.836-0.987)
- Duration of tapering, predictor of relapse
- 0.938 (HR, CI 0.893-0.985)
- Persistent oligoarticular JIA, predictor of relapse
- 0.597 (HR, CI 0.368-0.968)
- Overall model (Mantel-Cox χ² 34.23)
- p<0.001
Observational data: associations, not effects.
Further findings
Time to relapse by uveitis
- Patients with uveitis relapsed earlier (log rank χ² 16.4)
- P < 0.0001
Time to relapse by tapering by lengthening interval
- Patients who lengthened the interval showed a later relapse (log rank χ² 6.95)
- P = 0.008
Original publication
Uveitis as predictor of disease flare after the first anti-TNF withdrawal in oligoarticular and polyarticular juvenile idiopathic arthritis: a multicentric Italian experience. Clin Exp Rheumatol. Published 20 August 2023. doi:10.
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