{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:09:34Z","timestamp":1790831374464,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T00:00:00Z","timestamp":1553731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100011102","name":"Seventh Framework Programme","doi-asserted-by":"publisher","award":["260353"],"award-info":[{"award-number":["260353"]}],"id":[{"id":"10.13039\/100011102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2019,4]]},"abstract":"\n Objective<\/jats:title>\n \n To study juvenile idiopathic arthritis (\n JIA<\/jats:styled-content>\n ) long\u2010term outcomes in relation to the time of initiation of biologic disease\u2010modifying antirheumatic drug (\n bDMARD<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Outcomes of\n JIA<\/jats:styled-content>\n patients prospectively followed by the Biologika in der Kinderrheumatologie (BiKeR) and Juvenile Arthritis Methotrexate\/Biologics Long\u2010Term Observation (Ju\n MBO<\/jats:styled-content>\n ) registers were analyzed with regard to drug\u2010free remission and inactive disease, functional status and quality of life, and surgery. To analyze the influence of early\n bDMARD<\/jats:styled-content>\n therapy on outcomes, patients were assigned to 3 groups based on the time from symptom onset to\n bDMARD<\/jats:styled-content>\n start (G1: \u22642 years, G2: >2 to \u22645 years, and G3: >5 years). Propensity score\u2013adjusted outcome differences were analyzed by multinomial logistic regression analyses among the groups.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 701\n JIA<\/jats:styled-content>\n patients were observed for mean \u00b1\n SD<\/jats:styled-content>\n 9.1 \u00b1 3.7 years. At the last follow\u2010up (disease duration mean \u00b1\n SD<\/jats:styled-content>\n 14.3 \u00b1 6.1 years), 11.7% of patients were in drug\u2010free remission, and 40.0% had inactive disease. More than half of the patients reported no functional limitation, while 5% had undergone arthroplasty, and 3% had eye surgery. At the 10\u2010year time point, patients in G1 (n = 108) were significantly more likely to be in drug\u2010free remission than those patients who began treatment later (G2, n = 199; G3, n = 259), with 18.5%, 10.1%, and 4.9%, respectively. Patients in G1 had significantly lower disease activity (clinical Juvenile Arthritis Disease Activity Score in 10 joints = 4.9), a better overall well\u2010being (18.2% patient global assessment score = 0), and higher functional status (59.2% Health Assessment Questionnaire score = 0), compared to patients in G3 (7.1, 8.4%, and 43.7%, respectively). G1 patients required arthroplasty significantly less frequently than G3 patients and had significantly lower disease activity over time than patients in both G2 and G3.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Early\n DMARD<\/jats:styled-content>\n treatment is associated with better disease control and outcomes, which supports the concept of a \u201cwindow of opportunity\u201d for\n JIA<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/acr.23709","type":"journal-article","created":{"date-parts":[[2018,7,25]],"date-time":"2018-07-25T08:50:00Z","timestamp":1532508600000},"page":"471-481","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":79,"title":["Time of Disease\u2010Modifying Antirheumatic Drug Start in Juvenile Idiopathic Arthritis and the Likelihood of a Drug\u2010Free Remission in Young Adulthood"],"prefix":"10.1002","volume":"71","author":[{"given":"Kirsten","family":"Minden","sequence":"first","affiliation":[{"name":"German Rheumatism Research Center and Charit\u00e9\u2013University Medicine Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Horneff","sequence":"additional","affiliation":[{"name":"Asklepios Clinic Sankt Augustin GmbH, Sankt Augustin and University Hospital of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Niewerth","sequence":"additional","affiliation":[{"name":"German Rheumatism Research Center Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Seipelt","sequence":"additional","affiliation":[{"name":"Immanuel Krankenhaus Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Aringer","sequence":"additional","affiliation":[{"name":"University Medical Center Carl Gustav Carus at the Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peer","family":"Aries","sequence":"additional","affiliation":[{"name":"Rheumatologie im Struensee\u2010Haus Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Foeldvari","sequence":"additional","affiliation":[{"name":"Centre for Pediatric and Adolescent Rheumatology Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes\u2010Peter","family":"Haas","sequence":"additional","affiliation":[{"name":"German Centre for Pediatric and Adolescent Rheumatology Garmisch\u2010Partenkirchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariane","family":"Klein","sequence":"additional","affiliation":[{"name":"Asklepios Clinic Sankt Augustin GmbH Sankt Augustin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Tatsis","sequence":"additional","affiliation":[{"name":"Kath. 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