Background: Both the steroid- and NSAID-sparing effects of biologics in juvenile idiopathic arthritis (JIA) treatment are key aspects of the dynamics of patient's condition. The proper selection of biologics enables maximum treatment effectiveness and reduction of the dosage of concomitant therapy. Our aim was to study the dynamics of concomitant therapy during etanercept (ETA) and methotrexate (MTX) treatment in patients with JIA.
Methods: This analysis included 215 JIA patients (63.3% females) showing sufficient response to main therapy. One hundred patients received MTX as main therapy, 24 received ETA monotherapy, and 91 received ETA þ MTX combination therapy. The dynamics of concomitant therapy were analyzed after 1 month, every 3 months during the first year, and every 6 months during the long-term follow-up (up to 5 years).
Results: At the baseline, 24 (11.2%) patients received concomitant oral glucocorticoids (orGCs) and NSAIDs; the remaining 191 (88.8%) patients were treated with concomitant NSAIDs only. Within 1-year treatment, NSAIDs were discontinued in 162 (75.3%) patients. There were no significant differences in the dynamics of withdrawal of NSAIDs in patients who received and did not receive concomitant MTX. However, the percentage of treatment discontinuation in the MTX group was significantly lower compared to the other two groups (p < 0.001). Oral GCs were discontinued completely in 4 children (16.7%), and the dose of oral GCs was reduced in another 4 patients (16.7%). By the end of the follow-up period, 44 of 115 patients (38.3%) treated with ETA in combination with any concomitant therapy could switch to ETA monotherapy.
Conclusion: Therapy with ETA makes it possible to reduce the dosage or completely discontinue most concomitant medications (orGCs, NSAIDs, MTX) in a significant percentage of patients. This reduces the risk of development of NSAID- and GC-induced pathological conditions, while the effectiveness of therapy of the underlying condition remains high.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.pedneo.2019.02.003 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
How I Manage Patients with Unexplained Cytopenia.
Blood
December 2024
University of Pavia, Pavia, Italy.
The term "unexplained cytopenia" is used to describe a condition characterized by peripheral blood (PB) cytopenia that cannot be attributed to identifiable causes using conventional tests or to any concomitant diseases. Unexplained cytopenia requires clinical attention and further investigation to identify individuals at risk of developing a hematologic neoplasm. The available evidence suggests that somatic mutation analysis may effectively complement the diagnostic work-up and clinical management of unexplained cytopenia.
View Article and Find Full Text PDFBackground: We present Phase 1 trial data using the Neuropsychiatric Inventory ("NPI") domains, NPI-delusions and NPI-hallucinations as symptoms of psychosis in participants with Alzheimer's ("AD") receiving IGC-AD1, a combination of low concentration delta 9-tetrahydrocannabinol ("THC") and melatonin. Cannabis use is considered an established risk factor for psychosis in young people. Psychosis is prevalent in AD patients, with around 50% experiencing it, generating safety concerns regarding the use of THC in these patients.
View Article and Find Full Text PDFDeveloping Topics.
Alzheimers Dement
December 2024
University College London, London, United Kingdom.
Background: Studies that report an association between anticholinergic medications and dementia often suffer from confounding by indication and rarely consider gender effects. We estimated the association between recurrent prescriptions for anticholinergic overactive bladder (OAB) medications and incident dementia, separately in men and women.
Method: We studied patients aged ≥50 years first prescribed an anticholinergic OAB drug (e.
Developing Topics.
Alzheimers Dement
December 2024
University of Pennsylvania, Philadelphia, PA, USA.
Background: Due to the lack of in vivo molecular biomarkers for Limbic-predominant age-related TDP-43 encephalopathy (LATE), which commonly co-occurs with Alzheimer's disease (AD), it is challenging to identify patients with mixed AD/LATE pathology. Autopsy studies have suggested that AD patients with greater hippocampal atrophy are disproportionately enriched in having concomitant LATE. Here we define the lower quartile of hippocampal volume as a biomarker of possible LATE with AD.
View Article and Find Full Text PDFAlzheimer's disease (AD) is a complex disease that is often accompanied by a range of comorbidities, such as cardiovascular disease, diabetes, and depression. These comorbidities can impact the progression of AD and can complicate treatment strategies. Targeting comorbidities in Alzheimer's disease and developing combination therapies are emerging areas of research.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!