{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:52:15Z","timestamp":1787759535878,"version":"build-2784847793"},"reference-count":39,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T00:00:00Z","timestamp":1591574400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2020,6,1]]},"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec id=\"s1\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Long-term safety and efficacy of adalimumab among patients with juvenile idiopathic arthritis (JIA) was evaluated through 6\u00a0years of treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s2\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Children aged 4\u201317\u00a0years with polyarticular JIA were enrolled in a phase III, randomised-withdrawal, double-blind, placebo-controlled trial consisting of a 16-week open-label lead-in period, 32-week randomised double-blind period and 360-week long-term extension. Patients were stratified by baseline methotrexate use. Adverse events (AEs) were monitored, and efficacy assessments included JIA American College of Rheumatology (JIA ACR) 30%, 50%, 70% or 90% responses and the proportions of patients achieving 27-joint Juvenile Arthritis Disease Activity Score (JADAS27) low disease activity (LDA, \u22643.8) and inactive disease (ID, \u22641).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s3\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 171 patients enrolled, 62 (36%) completed the long-term extension. Twelve serious infections in 11 patients were reported through 592.8 patient-years of exposure. No cases of congestive heart failure-related AEs, demyelinating disease, lupus-like syndrome, malignancies, tuberculosis or deaths were reported. JIA ACR 30\/50\/70\/90 responses and JADAS27 LDA were achieved in 66% to 96% of patients at week 104, and 63 (37%) patients achieved clinical remission (JADAS27 ID sustained for \u22656 continuous months) during the study. Attainment of JIA ACR 50 or higher and JADAS27 LDA or ID in the initial weeks were the best predictors of clinical remission. Mean JADAS27 decreased from baseline, 22.5 (n=170), to 2.5 (n=30) at week 312 (observed analysis).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s4\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Through 6\u00a0years of exposure, adalimumab was well tolerated with significant clinical response (up to clinical remission) and a relatively low retention rate.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2020-001208","type":"journal-article","created":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T05:55:11Z","timestamp":1594706111000},"page":"e001208","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Long-term outcomes in patients with polyarticular juvenile idiopathic arthritis receiving adalimumab with or without methotrexate"],"prefix":"10.1136","volume":"6","clinical-trial-number":[{"clinical-trial-number":"nct00048542","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1604-0130","authenticated-orcid":false,"given":"Daniel J","family":"Lovell","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Rheumatology, University of Cincinnati, Cincinnati Children\u2019s Hospital Medical Center, PRCSG Coordinating Center, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9478-2987","authenticated-orcid":false,"given":"Hermine I","family":"Brunner","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Rheumatology, University of Cincinnati, Cincinnati Children\u2019s Hospital Medical Center, PRCSG Coordinating Center, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas O","family":"Reiff","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, California, USA"},{"name":"Division of Rheumatology, Children\u2019s Hospital of Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Children\u2019s National Medical Center for Cancer and Immunology Research, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Jarosova","sequence":"additional","affiliation":[{"name":"Institute of Rheumatology, Prague, Czech Republic"},{"name":"Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech 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