With respect to when to initiate withdrawal, Dr. Horton predicted biomarkers will become available in the not-too-distant future to help predict which patients would do well with treatment withdrawal. He concluded by advocating for patients and their families to be actively involved in all treatment withdrawal decisions.
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On the whole, the session focused on important issues in the management of JIA. As the field continues to evolve, new evidence may become available to help rheumatologists optimize treatment and guide tapering decisions.
Jason Liebowitz, MD, completed his fellowship in rheumatology at Johns Hopkins University, Baltimore, where he also earned his medical degree. He is currently in practice with Skylands Medical Group, N.J.
- Ringold S, Angeles-Han ST, Beukelman T, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the treatment of juvenile idiopathic arthritis: Therapeutic approaches for non-systemic polyarthritis, sacroiliitis and enthesitis. Arthritis Rheumatol. 2019 Jun;71(6):846–863. Epub 2019 Apr 25.
- Chang CY, Meyer RM, Reiff AO. Impact of medication withdrawal method on flare-free survival in patients with juvenile idiopathic arthritis on combination therapy. Arthritis Care Res (Hoboken). 2015 May;67(5):658–666.
- Horton DB, Onel KB, Beukelman T, et al. Attitudes and approaches for withdrawing drugs for children with clinically inactive nonsystemic JIA: A survey of the Childhood Arthritis and Rheumatology Research Alliance. J Rheumatol. 2017 Mar;44(3):352–360. Epub 2017 Feb 1.