Academic Journal
Physician practices for withdrawal of medications in inactive systemic juvenile arthritis, Childhood Arthritis and Rheumatology Research Alliance (CARRA) survey
| العنوان: | Physician practices for withdrawal of medications in inactive systemic juvenile arthritis, Childhood Arthritis and Rheumatology Research Alliance (CARRA) survey |
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| المؤلفون: | Susan Shenoi, Kabita Nanda, Grant S. Schulert, John F. Bohnsack, Ashley M. Cooper, Bridget Edghill, Miriah C. Gillispie-Taylor, Baruch Goldberg, Olha Halyabar, Thomas G. Mason, Tova Ronis, Rayfel Schneider, Richard K. Vehe, Karen Onel |
| المصدر: | Pediatric Rheumatology Online Journal, Vol 17, Iss 1, Pp 1-7 (2019) |
| بيانات النشر: | BMC |
| سنة النشر: | 2019 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | Systemic Juvenile Idiopathic Arthritis, Inactive disease, Withdrawal of medications, CARRA, Pediatrics, RJ1-570, Diseases of the musculoskeletal system, RC925-935 |
| الوصف: | Background We describe a Childhood Arthritis and Rheumatology Research Alliance (CARRA) survey of North American pediatric rheumatologists that assesses physician attitudes on withdrawal of medications in systemic juvenile idiopathic arthritis (SJIA). Methods A REDCap anonymous electronic survey was distributed to 100 random CARRA JIA workgroup physician-voting members. The survey had three broad sections including: A) demographic information; B) physicians’ opinions on clinical inactive disease (CID) in SJIA and C) existing practices for withdrawing medications in SJIA. Results The survey had an 86% response rate. 88 and 93% of participants agreed with the current criteria for CID and clinical remission on medications (CRM) respectively. 78% thought it necessary to meet CRM before tapering medications except steroids. 76% use CARRA SJIA consensus treatment plans always or the majority of the time. All participants weaned steroids first in SJIA patients on combination therapy, 47% waited > 6 months before tapering additional medications. 35% each tapered methotrexate over > 6 months and 2–6 months; however, 39% preferred tapering anakinra, canakinumab and tocilizumab more quickly over 2–6 months and favored spacing the dosing interval for canakinumab and tocilizumab. When patients are on combination therapy with methotrexate and biologics, 58% preferred tapering methotrexate first while others considered patient/family preference and adverse effects to guide their choice. Conclusion Most CARRA members surveyed use published consensus treatment plans for SJIA and agree with validated definitions of CID and CRM. There was agreement with tapering steroids first in SJIA. There was considerable variability with tapering decisions of all other medications. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1546-0096 |
| Relation: | http://link.springer.com/article/10.1186/s12969-019-0342-5; https://doaj.org/toc/1546-0096; https://doaj.org/article/e2a409554cd54458a69d7fc5514747f2 |
| DOI: | 10.1186/s12969-019-0342-5 |
| الاتاحة: | https://doi.org/10.1186/s12969-019-0342-5 https://doaj.org/article/e2a409554cd54458a69d7fc5514747f2 |
| رقم الانضمام: | edsbas.7362603D |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 15460096 |
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| DOI: | 10.1186/s12969-019-0342-5 |