If you stop biologic therapy for remission, are you likely to remain off treatment?

What is it about?

Juvenile idiopathic arthritis (JIA) is a painful debilitating inflammatory arthritis affecting children and young people. Biologic therapies are the main treatment for selected categories of children and young people with JIA where conventional therapies have not work. However, concerns about their safety in these individuals has prompted many doctors to consider reducing the dose or stopping these treatments in patients whose arthritis is well controlled. It is currently unclear whether this is an effective decision, and we don’t know how many children and young people who stop treatment will later need to restart again due to worsening arthritis. This research aimed to: 1.Calculate how many children stopped biologic therapy for remission. 2. Calculate how many need to restart therapy, and who was more likely. What was discovered? Out of the 1451 children and young people with JIA from the UK JIA Biologics Register that were included in this analysis, one-in-five (19%) stopped therapy for remission after approximately 2 years of being on treatment. Of those, just over half (55%) then restarted the same biologic therapy, usually after 4 months. Those less likely to need to re-start therapy were those who had started biologics earlier in their disease course. Those more likely to need to re-start biologic therapy were those who also had uveitis (which may have been the reason for needing to restart).

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Photo by Marcus Wallis on Unsplash

Photo by Marcus Wallis on Unsplash

Why is it important?

This research has found that many children and young people can stop biologic therapy for remission and remain off therapy. Those who have been treated with biologic therapy earlier following JIA diagnosis were less likely to need to restart therapy if they stopped for remission. Real-world studies and clinical trials with better JIA patient stratification are needed to investigate a broad spectrum of clinical and laboratory information to identify which patients will successfully be able to reduce the dose of their biologic therapy or stop treatment altogether in the future without being at risk of their disease becoming active again.