{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:30:34Z","timestamp":1787315434430,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,5,2]],"date-time":"2019-05-02T00:00:00Z","timestamp":1556755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002429","name":"Amgen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006436","name":"Celgene","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006436","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008897","name":"Janssen Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008373","name":"Takeda Pharmaceutical Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008373","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006259","name":"Teva Pharmaceutical Industries","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006259","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011110","name":"UCB","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011110","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009857","name":"Regeneron Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009857","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis & Rheumatology"],"published-print":{"date-parts":[[2019,6]]},"abstract":"\n Objective<\/jats:title>\n \n To investigate whether the discontinuation of tumor necrosis factor inhibitors (\n TNF<\/jats:styled-content>\n i) during pregnancy is associated with any changes of the disease course in women with rheumatoid arthritis (\n RA<\/jats:styled-content>\n ) and juvenile idiopathic arthritis (\n JIA<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Pregnant women with\n RA<\/jats:styled-content>\n and\n JIA<\/jats:styled-content>\n from the\n US<\/jats:styled-content>\n and Canada were enrolled in the Organization of Teratology Information Specialists (\n OTIS<\/jats:styled-content>\n ) Autoimmune Diseases in Pregnancy Project, a prospective cohort study. Information about medication and disease activity (patient\u2010reported outcome measures) was collected prior to gestational week 20 and at gestational week 32. Associations between patterns of\n TNF<\/jats:styled-content>\n i continuation or discontinuation and disease activity changes were tested in unadjusted and multivariate analyses.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 490 women (397 with\n RA<\/jats:styled-content>\n , 93 with\n JIA<\/jats:styled-content>\n ) enrolled between 2005 and 2017, 122 (24.9%) discontinued a\n TNF<\/jats:styled-content>\n i before gestational week 20, 201 (41.0%) received a\n TNF<\/jats:styled-content>\n i beyond week 20, and 167 (34.1%) did not receive a\n TNF<\/jats:styled-content>\n i during pregnancy. At the time of enrollment, disease activity was low to minimal in 72.9% of women.\n TNF<\/jats:styled-content>\n i discontinuation was not associated with a clinically important worsening of patient reported outcome measures at the third trimester. Univariate but not multivariate analysis showed that women receiving\n TNF<\/jats:styled-content>\n i beyond week 20 were more likely to experience improved disease activity scores at the third trimester.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Discontinuing\n TNF<\/jats:styled-content>\n i before gestational week 20 seems feasible in women with\n RA<\/jats:styled-content>\n and\n JIA<\/jats:styled-content>\n who enter pregnancy with well\u2010controlled disease.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/art.40821","type":"journal-article","created":{"date-parts":[[2019,1,21]],"date-time":"2019-01-21T06:26:20Z","timestamp":1548051980000},"page":"901-907","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["No Association of Discontinuing Tumor Necrosis Factor Inhibitors Before Gestational Week Twenty in Well\u2010Controlled Rheumatoid Arthritis and Juvenile Idiopathic Arthritis With a Disease Worsening in Late Pregnancy"],"prefix":"10.1002","volume":"71","author":[{"given":"Frauke","family":"F\u00f6rger","sequence":"first","affiliation":[{"name":"University Hospital and University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen","family":"Bandoli","sequence":"additional","affiliation":[{"name":"University of California San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunjun","family":"Luo","sequence":"additional","affiliation":[{"name":"University of California San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loan","family":"Robinson","sequence":"additional","affiliation":[{"name":"University of California San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana L.","family":"Johnson","sequence":"additional","affiliation":[{"name":"University of California San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina D.","family":"Chambers","sequence":"additional","affiliation":[{"name":"University of California San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.140583"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24914"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/key053"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24003"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.161410"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23434"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2016.11.004"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208840"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.151179"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-206435"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-017-1269-1"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27358"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2010.09899.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0148-9062(75)90418-0"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780230202"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2016-000308"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21649"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2011.11.013"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23143"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61811-X"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-017-1484-9"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210246"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2003.016881"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2004.033019"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22773"}],"container-title":["Arthritis & Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fart.40821","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.40821","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/art.40821","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.40821","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T20:04:35Z","timestamp":1759953875000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/art.40821"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,2]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1002\/art.40821"],"URL":"https:\/\/doi.org\/10.1002\/art.40821","archive":["Portico"],"relation":{},"ISSN":["2326-5191","2326-5205"],"issn-type":[{"value":"2326-5191","type":"print"},{"value":"2326-5205","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,2]]},"assertion":[{"value":"2018-07-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}