Retraction: Early Prediction for Over Two Years Efficacy of The First Biologic Agent for Polyarticular Juvenile Idiopathic Arthritis: A Multi-Institutional Study In Japan

Abstract

Objective: To determine early predictors of long-term efficacy of the first biologic agent used to treat polyarticular Juvenile Idiopathic Arthritis (JIA). Methods: Data from patients treated at six medical institutions in Japan were analyzed. Patients were divided into two groups: those maintaining clinical remission with the first biologic agent >2 years (continuous treatment group) and those eventually switching to other biologic agents within 2 years (switching group). Three markers were examined: matrix metalloproteinase-3, Erythrocyte Sedimentation Rate (ESR), and Disease Activity Score (DAS) 28- ESR. Their associations with the continuity of the first biologic agent were assessed by multiple linear regression analysis. Cut-off points were calculated to distinguish these groups. Results: Thirty-two polyarticular JIA patients (8 boys, 24 girls) with median disease duration of 12 months were included. Agents used were adalimumab in 9 (28%) patients, etanercept in 8 (25%), infliximab in 2 (6%), and tocilizumab in 13 (41%). Twenty-four patients (75%) maintained clinical remission with the first biologic agent for a median 40 months (range, 24–119); 8 patients (25%) switched to a second biologic agent at a median 9.5 months (range, 6–18). Markers [odds ratio (95% confidence interval)] at 3 months were matrix metalloproteinase-3 [1.02 (0.99-1.05), p=0.219], ESR [1.00 (0.78-1.30), p=0.998], and DAS28-ESR [13.9 (2.08-409.82), p=0.035]. The cut-off point for DAS28-ESR at 3 months to distinguish the two groups was 2.49 (sensitivity, 87.5%; specificity, 87.5%). Conclusion: DAS28-ESR <2.49 at 3 months after initiating the first biologic agent may predict sustained clinical remission in polyarticular JIA patients.