{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:00:11Z","timestamp":1792083611466,"version":"4.4.0"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,4,24]],"date-time":"2018-04-24T00:00:00Z","timestamp":1524528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To assess the time in remission after discontinuing biologic therapy in patients with juvenile idiopathic arthritis (\n                      <jats:styled-content style=\"fixed-case\">JIA<\/jats:styled-content>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled 135 patients followed in 3 tertiary\u2010care centers. The primary outcome was to assess, once remission was achieved, the time in remission up to the first flare after discontinuing treatment. Mann\u2010Whitney U test, Wilcoxon's signed rank test for paired samples, chi\u2010square tests, and Fisher's exact test were used to compare data. Pearson's and Spearman's correlation tests were used to determine correlation coefficients for different variables. To identify predictors of outcome, Cox regression model and Kaplan\u2010Meier curves were constructed, each one at the mean of entered covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The majority of enrolled patients flared after stopping treatment with biologics (102 of 135, 75.6%) after a median followup time in remission off therapy of 6 months (range 3\u2013109 months). A higher probability of maintaining remission after discontinuing treatment was present in systemic\u2010onset disease compared to the rest of the\n                      <jats:styled-content style=\"fixed-case\">JIA<\/jats:styled-content>\n                      patients (Mantel\u2010Cox \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      = 8.31,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.004). In analysis limited to children with\n                      <jats:styled-content style=\"fixed-case\">JIA<\/jats:styled-content>\n                      with polyarticular and oligoarticular disease, patients who received biologics &gt;2 years after achieving remission had a higher probability of maintaining such remission off therapy (mean \u00b1\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      18.64 \u00b1 3.3 months versus 11.51 \u00b1 2.7 months [\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.009]; Mantel\u2010Cox \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      = 9.06,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.002). No other clinical variable was significantly associated with a long\u2010lasting remission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Children with oligoarticular and polyarticular\n                      <jats:styled-content style=\"fixed-case\">JIA<\/jats:styled-content>\n                      who stop treatment before 2 years from remission have a higher chance of relapsing after biologic withdrawal.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.23435","type":"journal-article","created":{"date-parts":[[2017,10,3]],"date-time":"2017-10-03T14:52:40Z","timestamp":1507042360000},"page":"1046-1051","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Flares After Withdrawal of Biologic Therapies in Juvenile Idiopathic Arthritis: Clinical and Laboratory Correlates of Remission Duration"],"prefix":"10.1002","volume":"70","author":[{"given":"Gabriele","family":"Simonini","sequence":"first","affiliation":[{"name":"Anna Meyer Children's Hospital and University of Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Ferrara","sequence":"additional","affiliation":[{"name":"University of Trieste Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Pontikaki","sequence":"additional","affiliation":[{"name":"Gaetano Pini Institute and University of Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Scoccimarro","sequence":"additional","affiliation":[{"name":"University of Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Giani","sequence":"additional","affiliation":[{"name":"Anna Meyer Children's Hospital Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Taddio","sequence":"additional","affiliation":[{"name":"University of Trieste and Institute of Maternal and Child Health\u2013IRCCS Burlo Garofolo Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Luigi","family":"Meroni","sequence":"additional","affiliation":[{"name":"Gaetano Pini Institute and University of Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolando","family":"Cimaz","sequence":"additional","affiliation":[{"name":"Anna Meyer Children's Hospital and University of Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60363-8"},{"key":"e_1_2_6_3_1","first-page":"390","article-title":"International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton 2001","volume":"31","author":"Petty RE","year":"2004","journal-title":"J Rheumatol"},{"key":"e_1_2_6_4_1","first-page":"2256","article-title":"Prognosis of patients with juvenile chronic arthritis and juvenile spondyloarthropathy","volume":"27","author":"Minden K","year":"2000","journal-title":"J Rheumatol"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.120602"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-205372"},{"key":"e_1_2_6_7_1","first-page":"2290","article-title":"Preliminary criteria for clinical remission for select categories of juvenile idiopathic arthritis","volume":"31","author":"Wallace CA","year":"2004","journal-title":"J Rheumatol"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20497"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.3758\/BF03203630"},{"key":"e_1_2_6_10_1","volume-title":"Statistical power analysis for the behavioural sciences","author":"Cohen J","year":"1988"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar4280"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.375"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-207164"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22477"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2016.07.004"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21774"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-013-2884-z"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-015-0723-1"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201329"}],"container-title":["Arthritis Care &amp; 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