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Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry.

Publication ,  Journal Article
Hahn, T; Daymont, C; Beukelman, T; Groh, B; Hays, K; Bingham, CA; Scalzi, L; CARRA Registry investigators,
Published in: Pediatr Rheumatol Online J
November 25, 2022

BACKGROUND: Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months. METHODS: We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed. RESULTS: We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05). CONCLUSION: While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.

Duke Scholars

Published In

Pediatr Rheumatol Online J

DOI

EISSN

1546-0096

Publication Date

November 25, 2022

Volume

20

Issue

1

Start / End Page

107

Location

England

Related Subject Headings

  • Steroids
  • Rheumatology
  • Registries
  • Humans
  • Child
  • Biological Products
  • Arthritis, Juvenile
  • Arthritis & Rheumatology
  • Antirheumatic Agents
  • 3213 Paediatrics
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hahn, T., Daymont, C., Beukelman, T., Groh, B., Hays, K., Bingham, C. A., … CARRA Registry investigators, . (2022). Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry. Pediatr Rheumatol Online J, 20(1), 107. https://doi.org/10.1186/s12969-022-00770-y
Hahn, Timothy, Carrie Daymont, Timothy Beukelman, Brandt Groh, Kimberly Hays, Catherine April Bingham, Lisabeth Scalzi, and Lisabeth CARRA Registry investigators. “Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry.Pediatr Rheumatol Online J 20, no. 1 (November 25, 2022): 107. https://doi.org/10.1186/s12969-022-00770-y.
Hahn T, Daymont C, Beukelman T, Groh B, Hays K, Bingham CA, et al. Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry. Pediatr Rheumatol Online J. 2022 Nov 25;20(1):107.
Hahn, Timothy, et al. “Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry.Pediatr Rheumatol Online J, vol. 20, no. 1, Nov. 2022, p. 107. Pubmed, doi:10.1186/s12969-022-00770-y.
Hahn T, Daymont C, Beukelman T, Groh B, Hays K, Bingham CA, Scalzi L, CARRA Registry investigators. Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry. Pediatr Rheumatol Online J. 2022 Nov 25;20(1):107.
Journal cover image

Published In

Pediatr Rheumatol Online J

DOI

EISSN

1546-0096

Publication Date

November 25, 2022

Volume

20

Issue

1

Start / End Page

107

Location

England

Related Subject Headings

  • Steroids
  • Rheumatology
  • Registries
  • Humans
  • Child
  • Biological Products
  • Arthritis, Juvenile
  • Arthritis & Rheumatology
  • Antirheumatic Agents
  • 3213 Paediatrics