{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:12:43Z","timestamp":1792620763339,"version":"4.5.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["848"],"award-info":[{"award-number":["848"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["006"],"award-info":[{"award-number":["006"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008762","name":"Genome Canada","doi-asserted-by":"publisher","award":["OGI\u2010150"],"award-info":[{"award-number":["OGI\u2010150"]}],"id":[{"id":"10.13039\/100008762","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["381280"],"award-info":[{"award-number":["381280"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006315","name":"ReumaNederland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006315","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013061","name":"Ontario Genomics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010787","name":"Genome Alberta","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010787","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the effect of time from symptom onset to start of biologic treatment on achieving inactive arthritis within six months in a cohort of patients with juvenile idiopathic arthritis (JIA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The international UCAN CAN\u2010DU study prospectively enrolled patients with JIA across Canada and the Netherlands. A nested cohort study was performed and biologic\u2010naive patients with nonsystemic JIA were included at the start of biologic therapy. The primary outcome was inactive arthritis at six\u2009months. Demographics, disease\u2010related parameters, and treatment response were compared using (non)parametric tests among early (time symptom onset to biologic start: 0\u20136 months), intermediate (7\u201312 months), and late (13\u201324 months) treatment groups. A logistic regression model analyzed the effect of time to biologic start on the response at six months, adjusting for active joint count and physician global assessment. A graphical representation of the model was created.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and thirty children with JIA were included (early: n = 35; intermediate: n = 46; late: n = 49), 66% were female, and the median age at symptom onset was 11.0 years. The proportion of patients that reach inactive arthritis in the early starters (83%) was significantly higher than in late starters (57%). For each month of delay to the start of biologic treatment, the adjusted odds of having active arthritis after six months of therapy was 1.09 (interquartile range: 1.02\u20131.17,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early start of biologic therapies in patients with JIA was associated with a higher proportion of patients reaching inactive arthritis within six months, suggesting a window of opportunity to control disease activity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.43401","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T09:02:58Z","timestamp":1758531778000},"page":"743-751","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Effect of Time to Start of Biologic Therapy on Treatment Response in Childhood Arthritis: Results From the\n                    <scp>UCAN CAN<\/scp>\n                    \u2010\n                    <scp>DU<\/scp>\n                    Cohort"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6847-4409","authenticated-orcid":false,"given":"Jelleke B.","family":"de Jonge","sequence":"first","affiliation":[{"name":"Division of Pediatrics, Department of Pediatric Rheumatology Wilhelmina Children's Hospital, University Medical Center Utrecht  the Netherlands"},{"name":"Faculty of Medicine Utrecht University  the Netherlands"},{"name":"Center for Translational Immunology, University Medical Center Utrecht, Utrecht University  the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7281-1304","authenticated-orcid":false,"given":"Sytze","family":"de Roock","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, Department of Pediatric Rheumatology Wilhelmina Children's Hospital, University Medical Center Utrecht  the Netherlands"},{"name":"Faculty of Medicine Utrecht University  the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9416-6631","authenticated-orcid":false,"given":"Dieneke","family":"Schonenberg\u2010Meinema","sequence":"additional","affiliation":[{"name":"Department of Pediatric Immunology, Rheumatology and Infectious Diseases Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam  the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9431-5457","authenticated-orcid":false,"given":"J. Merlijn","family":"van den Berg","sequence":"additional","affiliation":[{"name":"Department of Pediatric Immunology, Rheumatology and Infectious Diseases Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam  the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8467-8008","authenticated-orcid":false,"given":"Deborah A.","family":"Marshall","sequence":"additional","affiliation":[{"name":"Departments of Community Health Services and Medicine McCaig Institute for Bone and Joint Health, O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary  Calgary Alberta Canada"},{"name":"Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4226-0949","authenticated-orcid":false,"given":"Sebastiaan J.","family":"Vastert","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, Department of Pediatric Rheumatology Wilhelmina Children's Hospital, University Medical Center Utrecht  the Netherlands"},{"name":"Faculty of Medicine Utrecht University  the Netherlands"},{"name":"Center for Translational Immunology, University Medical Center Utrecht, Utrecht University  the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2361-725X","authenticated-orcid":false,"given":"Rae S. M.","family":"Yeung","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Paediatrics Immunology and Institute of Medical Science, The Hospital for Sick Children, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2759-2822","authenticated-orcid":false,"given":"Joost F.","family":"Swart","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, Department of Pediatric Rheumatology Wilhelmina Children's Hospital, University Medical Center Utrecht  the Netherlands"},{"name":"Faculty of Medicine Utrecht University  the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5756-3638","authenticated-orcid":false,"given":"Susanne M.","family":"Benseler","sequence":"additional","affiliation":[{"name":"Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary  Calgary Alberta Canada"},{"name":"Division of Rheumatology, Department of Pediatrics Alberta Children's Hospital, Cumming School of Medicine, University of Calgary  Calgary Alberta Canada"},{"name":"Rheumatology, Paediatrics Children's Health Ireland  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the UCAN CAN\u2010DU and UCAN CURE consortia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60363-8"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa118"},{"issue":"2","key":"e_1_2_7_4_1","first-page":"390","article-title":"International League of Associations for Rheumatology. 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