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CONSIDERATIONS ABOUT BIOLOGIC TREATMENT WITHDRAWAL IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS AFTER DISEASE REMISSION
The aim of this paper is to discuss the reasons and opportunities for tapering and discontinuing treatment with biological agents when the clinical remission of juvenile idiopathic arthritis (JIA) is achieved. Unfortunately, the few studies published recently on JIA focused almost exclusively on etanercept and had conflicting results. It appears that the relapse rates after termination of these medications is substantial. No predictors of the risk of flare were identified. Currently, the role of Doppler ultrasound in the assessment of the status of JIA (activity/remission) has not been fully established. The optimal timeline for withdrawal after documentation of remission, as much as the modality of discontinuation, also remain to be established. The lack of evidence-based data from randomized controlled clinical trials imposes a pressing need to create guidelines for treatment discontinuation.
Keywords: JIA, biological treatment, withdrawal