Discontinuation of Canakinumab following Clinical Disease Remission Is Feasible in Patients with Systemic Juvenile Idiopathic Arthritis
Bibliographic record
Abstract
To the Editor: The optimal duration of treatment in patients with juvenile idiopathic arthritis, especially systemic JIA (sJIA), is a major concern for parents and physicians alike. Innovative medicines have managed to control this otherwise potentially life-threatening condition1. However, questions remain regarding the duration and the best timing for cessation of treatment. We report the results of a retrospective study describing the longterm outcome of children with sJIA treated with the antiinterleukin (IL)-1β monoclonal antibody canakinumab. In these children, treatment was discontinued following sustained clinical remission; we aim to identify potential relapse-associated risk factors. This was a single-center retrospective case study conducted from January 2008 to January 2017 and including patients with sJIA (based on International League of Associations for Rheumatology criteria)2 who had clinically inactive sJIA (clinical remission on medication/Wallace criteria)3 for at least 2 years with canakinumab. Patients were monitored for up to 4 years [median time 3.4 yrs, interquartile range (IQR) 2.4–3.7] following attempted canakinumab withdrawal (the study period began at the time of canakinumab withdrawal). Demographics, clinical, and laboratory variables were recorded at the study onset. We also collected data … Address correspondence to Dr. D. Maritsi, Infectious Diseases, Immunology and Rheumatology Unit, Second Department of Paediatrics, P. & A. Kyriakou Children’s Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. E-mail: dmaritsi{at}gmail.com
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".