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AB1213 Anti TNF dosage reduction response in juvenile idiopathic arthritis associated to enthesitis patients who achieved clinical remission
  1. V. Torrente-Segarra1,2,
  2. X. Juanola2,
  3. R. Bou1,
  4. S. Ricart3,
  5. J. Antόn1,
  6. J.M. Nolla2
  1. 1Pediatric Rheumatology, Hospital Sant Joan Deu, Esplugues Llobregat
  2. 2Rheumatology, Hospital Universitari Bellvitge, Hospitalet Llobregat
  3. 3Pediatric Rheumaology, Hospital Sant Joan Deu, Esplugues Llobregat, Spain

Abstract

Background Juvenile Idiopathic Arthritis (JIA) related to Enthesitis (JIA-ERA) it means 10-15% of all JIA patients. Once NSAID, methotrexate and corticosteroids fail to control disease activity, the use of an anti-TNF alpha is recommended. Once clinical remission is reached, the amount of time recommended to mantain the anti-TNF is unknown.

Objectives To describe the response to the reduction of anti-TNF dosage in JIA-ERA patients who achieved clinical remission with medication.

Methods We describe 4 cases of JIA-ERA who received anti-TNF treatment and reached clinical remission. After, at least, 12 months of clinical remission, anti-TNF dosage was tappered by increasing the week interval of anti-TNF administration (50mg every 2 weeks in etanercept; 40mg every 4 weeks in adalimumab). We considered clinical remission with medication (Wallace criteria) those patients who had inactive disease for 6 months: no arthritis, no enthesitis, no inflammatory low back pain, normal CPR and ESR, and VAS Physician=0). We collected following data: clinical features, age of onset, clinical features, B27 presence, acute phase reactants at onset, initial treatment, first DMARD, anti-TNF, remission time prior to dosage reduction, total time in remission with tappered dosage. We tappered anti-TNF treatment to those patients who stayed at least 12 months in clinical remission.

Results The table shows patients’ features.

Conclusions The reduction of anti-TNF dosage seems a right decision in JIA-ERA patients who reached clinical remission. This condition implies a reduction in JIA-ERA treatment costs, maintaining same effectivity and higher efficiency.

Disclosure of Interest None Declared

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