{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T02:17:45Z","timestamp":1786241865715,"version":"build-2736575974"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T00:00:00Z","timestamp":1651190400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T00:00:00Z","timestamp":1651190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"UK National Institute for Health Research Biomedical Research Centre"},{"DOI":"10.13039\/501100000861","name":"Sparks","doi-asserted-by":"publisher","award":["17ICH02"],"award-info":[{"award-number":["17ICH02"]}],"id":[{"id":"10.13039\/501100000861","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UK Research and Innovation Medical Research Council","award":["MR\/R013926\/1"],"award-info":[{"award-number":["MR\/R013926\/1"]}]},{"name":"UK Research and Innovation Medical Research Council","award":["MC_UU_00002\/4"],"award-info":[{"award-number":["MC_UU_00002\/4"]}]},{"DOI":"10.13039\/501100012041","name":"Versus Arthritis","doi-asserted-by":"publisher","award":["22084"],"award-info":[{"award-number":["22084"]}],"id":[{"id":"10.13039\/501100012041","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012041","name":"Versus Arthritis","doi-asserted-by":"publisher","award":["21593"],"award-info":[{"award-number":["21593"]}],"id":[{"id":"10.13039\/501100012041","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001279","name":"Great Ormond Street Hospital Charity","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001279","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["WT107881"],"award-info":[{"award-number":["WT107881"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Rheumatol"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The objective of this study was to determine the effectiveness of MRP8\/14 as a predictor of disease flare in patients with juvenile idiopathic arthritis (JIA) following the withdrawal of methotrexate (MTX) in a routine clinical setting. All MRP8\/14 tests performed at a single centre in a 27-month period were considered for analysis. Patients were assessed against criteria for inactive disease and subsequent disease flare. Decisions on whether or not to stop treatment were recorded. MRP8\/14 results were assessed in conjunction with clinical information. Clinicians were also surveyed to investigate if MRP8\/14 influenced their decision to discontinue MTX where this was available at that time point. One hundred four cases met the inclusion criteria during the study period. Although there was no significant difference in flares between patients with an elevated or low MRP8\/14 value, in those who stopped MTX (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200922), no patients with a low MRP8\/14 (\u2264\u20094000\u00a0ng\/ml) result flared (follow-up time 12\u00a0months). Clinicians reported that for patients with clinically inactive disease and an elevated MRP8\/14 result (&gt;\u20094000\u00a0ng\/ml), none would advise withdrawal of MTX. Low MRP8\/14 was interpreted favourably when considering stopping MTX treatment in patients with JIA. Implementation of MRP8\/14 testing has changed clinical practice at this centre. However, the observation that some patients in our cohort who had an elevated MRP8\/14 value did not flare after stopping MTX for non-disease-related reasons highlights the need for further biomarkers to predict the risk of flare off medication in JIA and aid clinicians in treatment decisions.\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>Key Points<\/jats:bold>\n                              <jats:italic>\u2022 First study of serum MRP8\/14 measurement in clinical practice to inform treatment decisions in patients with JIA.<\/jats:italic>\n                              <jats:italic>\u2022 No patients with a low MRP8\/14 test result went on to suffer a disease flare in 12 months of follow follow-up.<\/jats:italic>\n                              <jats:italic>\u2022 Further biomarkers are needed to predict the risk of flare off medication in JIA and treatment decisions.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s10067-022-06165-4","type":"journal-article","created":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T02:04:55Z","timestamp":1651197895000},"page":"2825-2830","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Use of MRP8\/14 in clinical practice as a predictor of outcome after methotrexate withdrawal in patients with juvenile idiopathic arthritis"],"prefix":"10.1007","volume":"41","author":[{"given":"Emma J","family":"Welsh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverley","family":"Almeida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Palman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Heard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Holzinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Roth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Foell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Ursu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Wallace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Gilmour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy R.","family":"Wedderburn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Ralph","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,4,29]]},"reference":[{"key":"6165_CR1","first-page":"2290","volume":"31","author":"C Wallace","year":"2004","unstructured":"Wallace C, Ruperto N, Giannini EH (2004) Preliminary criteria for clinical remission for select categories of juvenile idiopathic arthritis. J Rheumatol 31:2290\u20132294","journal-title":"J Rheumatol"},{"key":"6165_CR2","doi-asserted-by":"publisher","first-page":"3554","DOI":"10.1002\/art.21389","volume":"52","author":"CA Wallace","year":"2005","unstructured":"Wallace CA, Huang B, Bandeira M et al (2005) Patterns of clinical remission in select categories of juvenile idiopathic arthritis. Arthritis Rheum 52:3554\u20133562","journal-title":"Arthritis Rheum"},{"issue":"2","key":"6165_CR3","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1136\/ard.2003.005686","volume":"63","author":"D Foell","year":"2004","unstructured":"Foell D, Frosch M, Schulze Z, Wiesch A, Vogl T, Sorg C, Roth J (2004) Methotrexate treatment in juvenile idiopathic arthritis when is the right time to stop. 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Sumner\" must be updated to \"Emma J. Welsh\" following marriage surname.","order":8,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 December 2025","order":9,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":10,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":11,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s10067-025-07845-7","URL":"https:\/\/doi.org\/10.1007\/s10067-025-07845-7","order":12,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the ethical standards laid down in the Declaration of Helsinki. The overall analysis was performed as a clinical audit and had local approval from Great Ormond Street Hospital Audit Committee. Some patient data from the CHARMS study were also included: CHARMS had full ethical approval from London Bloomsbury Research Ethics Committee approved the study (MREC 95RU04) and all participating families provided written informed consent prior to enrolment. This manuscript does not contain personal identifiable data from any individual.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The UKRI-funded CLUSTER consortium (PI LRW) has partnerships with industrial partners currently GSK, AbbVie, UCB, Sobi and Pfizer, and CW has received funding from GSK and Merck Sharp Dohme. None of these were directly involved in the data, analysis or interpretation of this work. The authors have full control of all primary data and that they agree to allow the journal to review their data if requested.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}