Carol A Wallace1, Sarah Ringold2, John Bohnsack2, Steven J Spalding2, Hermine I Brunner2, Diana Milojevic2, Laura E Schanberg2, Gloria C Higgins2, Kathleen M O'Neil2, Beth S Gottlieb2, Joyce Hsu2, Marilynn G Punaro2, Yukiko Kimura2, Audrey Hendrickson2. 1. From the Seattle Children's Hospital and Research Institute, Seattle, Washington; University of Utah, Pediatrics, Salt Lake City, Utah; Cleveland Clinic, Cleveland, Ohio; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; University of California at San Francisco, San Francisco, California; Duke University Medical Center, Pediatrics, Durham, North Carolina; Ohio State University and Nationwide Children's Hospital, Pediatrics, Columbus, Ohio; University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; Steven and Alexandra Cohen Children's Medical Center of New York, New York; Stanford University School of Medicine, Palo Alto, California; Texas Scottish Rite Hospital, Dallas, Texas; Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center, Hackensack, New Jersey, USA.C.A. Wallace, MD; S. Ringold, MD, MS, Seattle Children's Hospital and Research Institute; J. Bohnsack, MD, University of Utah; S.J. Spalding, MD, Cleveland Clinic; H.I. Brunner, MD, MSc, Cincinnati Children's Hospital Medical Center; D. Milojevic, MD, University of California at San Francisco; L.E. Schanberg, MD, Duke University Medical Center; G.C. Higgins, PhD, MD, Ohio State University and Nationwide Children's Hospital; K.M. O'Neil, MD, Oklahoma University Health Science Center, now at Riley Hospital for Children, Indianapolis, Indiana; B.S. Gottlieb, MD, MS, Steven and Alexandra Cohen Children's Medical Center of New York; J. Hsu, MD, MS, Stanford University School of Medicine; M.G. Punaro, MD, Texas Scottish Rite Hospital; Y. Kimura, MD, Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center; A. Hendrickson, MPH, Seattle Children's Hospital and Research Institute. cwallace@u.washington.edu. 2. From the Seattle Children's Hospital and Research Institute, Seattle, Washington; University of Utah, Pediatrics, Salt Lake City, Utah; Cleveland Clinic, Cleveland, Ohio; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; University of California at San Francisco, San Francisco, California; Duke University Medical Center, Pediatrics, Durham, North Carolina; Ohio State University and Nationwide Children's Hospital, Pediatrics, Columbus, Ohio; University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; Steven and Alexandra Cohen Children's Medical Center of New York, New York; Stanford University School of Medicine, Palo Alto, California; Texas Scottish Rite Hospital, Dallas, Texas; Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center, Hackensack, New Jersey, USA.C.A. Wallace, MD; S. Ringold, MD, MS, Seattle Children's Hospital and Research Institute; J. Bohnsack, MD, University of Utah; S.J. Spalding, MD, Cleveland Clinic; H.I. Brunner, MD, MSc, Cincinnati Children's Hospital Medical Center; D. Milojevic, MD, University of California at San Francisco; L.E. Schanberg, MD, Duke University Medical Center; G.C. Higgins, PhD, MD, Ohio State University and Nationwide Children's Hospital; K.M. O'Neil, MD, Oklahoma University Health Science Center, now at Riley Hospital for Children, Indianapolis, Indiana; B.S. Gottlieb, MD, MS, Steven and Alexandra Cohen Children's Medical Center of New York; J. Hsu, MD, MS, Stanford University School of Medicine; M.G. Punaro, MD, Texas Scottish Rite Hospital; Y. Kimura, MD, Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center; A. Hendrickson, MPH, Seattle Children's Hospital and Research Institute.
Abstract
OBJECTIVE: To follow children with juvenile idiopathic arthritis (JIA) who had completed at least 6 months of the TRial of Early Aggressive Therapy (TREAT) clinical study for an additional 2 years, describing safety of early aggressive treatment, disease activity, function, and duration of clinical inactive disease (CID) during followup. METHODS: Children were treated as per provider's discretion. Physician, patient/parent, and laboratory measures of disease status as well as safety information were collected at clinic visits every 3 months for up to 2 years. RESULTS:Forty-eight children were followed for a mean of 28 months (range 12-42) beyond the end of the TREAT study. Half of patients were in CID for > 50% of their followup time. Overall, 88% of patients achieved CID at > 1 study visit and 54% achieved clinical remission while taking medication. Six patients were in CID for the duration of the study, and, of those, 2 achieved a full year of clinical remission while not taking medication. Active disease was mild: mean physician's global assessment 2.4, active joint count 3.5, parent global evaluation 2.4, Childhood Health Assessment Questionnaire 0.32, erythrocyte sedimentation rate 19 mm/h, and morning stiffness 23 min. There were no serious adverse events or adverse events reported at grade 3 or higher of Common Terminology Criteria for Adverse Events. CONCLUSION: Early aggressive therapy in this cohort of patients with polyarticular JIA who had high initial disease activity was associated with prolonged periods of CID in the majority of patients during followup. Those not in CID had low levels of disease activity.
RCT Entities:
OBJECTIVE: To follow children with juvenile idiopathic arthritis (JIA) who had completed at least 6 months of the TRial of Early Aggressive Therapy (TREAT) clinical study for an additional 2 years, describing safety of early aggressive treatment, disease activity, function, and duration of clinical inactive disease (CID) during followup. METHODS:Children were treated as per provider's discretion. Physician, patient/parent, and laboratory measures of disease status as well as safety information were collected at clinic visits every 3 months for up to 2 years. RESULTS: Forty-eight children were followed for a mean of 28 months (range 12-42) beyond the end of the TREAT study. Half of patients were in CID for > 50% of their followup time. Overall, 88% of patients achieved CID at > 1 study visit and 54% achieved clinical remission while taking medication. Six patients were in CID for the duration of the study, and, of those, 2 achieved a full year of clinical remission while not taking medication. Active disease was mild: mean physician's global assessment 2.4, active joint count 3.5, parent global evaluation 2.4, Childhood Health Assessment Questionnaire 0.32, erythrocyte sedimentation rate 19 mm/h, and morning stiffness 23 min. There were no serious adverse events or adverse events reported at grade 3 or higher of Common Terminology Criteria for Adverse Events. CONCLUSION: Early aggressive therapy in this cohort of patients with polyarticular JIA who had high initial disease activity was associated with prolonged periods of CID in the majority of patients during followup. Those not in CID had low levels of disease activity.
Entities:
Keywords:
CLINICAL INACTIVE DISEASE; EARLY AGGRESSIVE THERAPY; JUVENILE IDIOPATHIC ARTHRITIS
Authors: Ashley P Jones; Dannii Clayton; Gloria Nkhoma; Frances C Sherratt; Matthew Peak; Simon R Stones; Louise Roper; Bridget Young; Flora McErlane; Tracy Moitt; Athimalaipet V Ramanan; Helen E Foster; Paula R Williamson; Samundeeswari Deepak; Michael W Beresford; Eileen M Baildam Journal: Health Technol Assess Date: 2020-07 Impact factor: 4.014
Authors: Daniel J Lovell; Anne L Johnson; Bin Huang; Beth S Gottlieb; Paula W Morris; Yukiko Kimura; Karen Onel; Suzanne C Li; Alexei A Grom; Janalee Taylor; Hermine I Brunner; Jennifer L Huggins; James J Nocton; Kathleen A Haines; Barbara S Edelheit; Michael Shishov; Lawrence K Jung; Calvin B Williams; Melissa S Tesher; Denise M Costanzo; Lawrence S Zemel; Jason A Dare; Murray H Passo; Kaleo C Ede; Judyann C Olson; Elaine A Cassidy; Thomas A Griffin; Linda Wagner-Weiner; Jennifer E Weiss; Larry B Vogler; Kelly A Rouster-Stevens; Timothy Beukelman; Randy Q Cron; Daniel Kietz; Kenneth Schikler; Kara M Schmidt; Jay Mehta; Dawn M Wahezi; Tracy V Ting; James W Verbsky; B Anne Eberhard; Steven Spalding; Chen Chen; Edward H Giannini Journal: Arthritis Rheumatol Date: 2018-07-25 Impact factor: 10.995
Authors: Flora McErlane; Helen E Foster; Roberto Carrasco; Eileen M Baildam; S E Alice Chieng; Joyce E Davidson; Yiannis Ioannou; Lucy R Wedderburn; Wendy Thomson; Kimme L Hyrich Journal: Rheumatology (Oxford) Date: 2016-03-25 Impact factor: 7.580
Authors: Flora McErlane; Chris Anderson; Saskia Lawson-Tovey; Barbara Lee; Chris Lee; Laura Lunt; Janet E McDonagh; Andrew D Smith; Nicola Smith; Gavin Cleary Journal: Pediatr Rheumatol Online J Date: 2022-06-18 Impact factor: 3.413