Juvenile idiopathic arthritis (JIA) is one of the most common and disabling rheumatic diseases in children. Pharmaceutical therapy for JIA can prevent the progression of the disease, achieve long-term remission, and significantly improve the quality of life in most patients. In cases where the initial therapy for JIA is not effective enough, it is recommended to escalate it, and vice versa, when remission is achieved, the de-escalation of therapy may be discussed. The latter is necessary due to the high risk of developing infectious complications and certain oncological diseases against the background of continuous biological treatment of JIA, as well as the negative impact of regular injections and/or infusions of medications on the quality of life, the interruption of educational process, the psychological burden of “lifelong” treatment with medications, and the economic burden on families and healthcare system. Currently, optimal regimens for the discontinuation of biopharmaceuticals, including TNFalpha inhibitors, remain a matter of debate. In this regard, the search for potential predictors of JIA exacerbation after withdrawal of biopharmaceuticals is relevant. Key words: juvenile idiopathic arthritis, biologic-free remission of JIA, tumor necrosis factor, inhibitors, etanercept, adalimumab, withdrawal, exacerbation, predictors
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