Therapeutic strategies for treating juvenile idiopathic arthritis

Mannion, Melissa L.; Cron, Randy Q

doi:10.1016/j.coph.2022.102226

Cited by 12 publications

(6 citation statements)

References 39 publications

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“…La artritis idiopática juvenil (AIJ) es la enfermedad reumática inflamatoria crónica más frecuente en la infancia, así como una causa importante de morbilidad e incapacidad a corto y largo plazo. El concepto de AIJ no hace referencia a una única enfermedad, sino que engloba un grupo heterogéneo de artritis crónicas de causa desconocida que aparecen antes de los 16 años, que persisten durante más de 6 semanas y que clínicamente se presentan con tumefacción o presencia de dos o más de los siguientes signos: 1) limitación funcional de la movilidad; 2) dolor; 3) aumento del calor local [1][2][3][4][5] .…”

Section: Introductionunclassified

Valores de referencia para el 1-minute sit-to-stand test en pacientes pediátricos con artritis idiopática juvenil

García,

Vaccaroni,

Abraham

et al. 2024

Rev. Argent. Reumatol.

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Introducción: los niños con artritis idiopática juvenil (AIJ) experimentan períodos de dolor e inmovilidad que afectan sus capacidades condicionales. Objetivos: describir los valores de referencia para el 1-minute Sit-to-Stand Test (1-STS; test de 1 minuto de sentarse y pararse) en niños con AIJ como evaluación de la capacidad aeróbico-funcional y de la fuerza muscular de los miembros inferiores (MMII). Materiales y métodos: se realizó un estudio observacional que incluyó a 15 niños con AIJ de entre 5 y 16 años. Se evaluó su rendimiento en el 1-STS. Resultados: se encontró una correlación positiva significativa entre el 1-STS y el test de la marcha de 6 minutos (r=0,56; p=0,03), como con el índice de capacidad funcional (CAPFUN) (r=0,54; p=0,03). No se observaron correlaciones significativas entre el Childhood Health Assessment Questionnaire (CHAQ) y el 1-STS (r=-0,21; p=0,44), tampoco con el Juvenile Arthritis Disease Activity Score (JADAS-10) (p=0,83). Conclusiones: el 1-STS parece prometedor para medir la capacidad aeróbico-funcional y la fuerza muscular de los miembros inferiores en niños con AIJ oligoarticular.

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Section: Introductionunclassified

Valores de referencia para el 1-minute sit-to-stand test en pacientes pediátricos con artritis idiopática juvenil

García,

Vaccaroni,

Abraham

et al. 2024

Rev. Argent. Reumatol.

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“…The landscape of therapies for juvenile idiopathic arthritis (JIA) has changed dramatically in recent decades, with increasing options to treat JIA and achieve better outcomes such as disease remission. 1 Nonetheless, choice of initial and subsequent treatments remains an empiric venture, guided by clinical experience, consensus-based approaches, and treat-to-target strategies informed by limited evidence. [2][3][4] Randomized trials for JIA have successfully led to label expansion and increasing options with regulatory approval, though these trials and corresponding label changes often lag for years beyond the initial approvals for adults with inflammatory arthritis.…”

Section: Introductionmentioning

confidence: 99%

Validation of new medication use algorithms as proxies for worsening disease activity in patients with juvenile idiopathic arthritis

Saito,

Gabbeta,

Mulvihill

et al. 2024

Pharmacoepidemiology and Drug

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PurposeTo facilitate claims‐based research on populations with juvenile idiopathic arthritis (JIA), we sought to validate an algorithm of new medication use as a proxy for worsening JIA disease activity.MethodsUsing electronic health record data from three pediatric centers, we defined new JIA medication use as (re)initiation of disease‐modifying antirheumatic drugs or glucocorticoids (oral or intra‐articular). Data were collected from 201 randomly selected subjects with (101) or without (100) new medication use. We assessed the positive predictive value (PPV) and negative predictive value (NPV) based on a reference standard of documented worsening of JIA disease activity. The algorithm was refined to optimize test characteristics.ResultsOverall, the medication‐based algorithm had suboptimal performance in representing worsening JIA disease activity (PPV 69.3%, NPV 77.1%). However, algorithm performance improved for definitions specifying longer times after JIA diagnosis (≥1‐year post‐diagnosis: PPV 82.9%, NPV 80.0%) or after initiation of prior JIA treatment (≥1‐year post‐treatment: PPV 89.7%, NPV 80.0%).ConclusionAn algorithm for new JIA medication use appears to be a reasonable proxy for worsening JIA disease activity, particularly when specifying new use ≥1 year since initiating a prior JIA medication. This algorithm will be valuable for conducting research on JIA populations within administrative claims databases.

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“…Many treatment choices exist across JIA subcategories, including non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologic DMARDs. Biologics include medications that are small molecule inhibitors or monoclonal antibody treatments, such as tofacitinib [ 6 - 8 ]. It is well-known in the literature that some biological DMARDs have many side effects that increase the risk of complications [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Safety and Effectiveness of Tofacitinib in Treating Polyarticular Course Juvenile Idiopathic Arthritis

Jones,

Keller,

Abadie

et al. 2023

Cureus

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Polyarticular course juvenile idiopathic arthritis (pcJIA) is a form of arthritis that affects at least five joints at a time and presents before the age of 16. Its most common symptoms are pain, swelling, redness, and a limited range of motion, making it incredibly difficult for patients diagnosed to function in daily life. Historically, the leading treatment options have consisted of non-steroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs) such as methotrexate. However, these drugs have serious toxic side effects associated with long-term use in addition to being ineffective in refractory cases. Recently, small molecule biologics have emerged as an alternate treatment to pcJIA. Tofacitinib is a small molecule JAK inhibitor that blocks the JAK/STAT cascade and decreases the transcription of genes responsible for immune function. We conducted a risk-benefit analysis to determine the viability of tofacitinib as a treatment for pcJIA. In our review, we found the side effect profile of tofacitinib to be relatively mild, with many of the serious adverse side effects occurring in those immunocompromised and those with impaired renal and hepatic metabolism. Overall, we have determined that tofacitinib has the potential to be effective in reducing flare-ups and lowering erythrocyte sedimentation rate (ESR) in immunocompetent patients with pcJIA. Additionally, our review has found that tofacitinib has the potential to be effective in patients who are refractory to traditional treatment. However, large-scale clinical trials are needed to determine if this effect holds true in younger pediatric populations, as limited data surrounds this demographic.

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Therapeutic strategies for treating juvenile idiopathic arthritis

Cited by 12 publications

References 39 publications

Valores de referencia para el 1-minute sit-to-stand test en pacientes pediátricos con artritis idiopática juvenil

Valores de referencia para el 1-minute sit-to-stand test en pacientes pediátricos con artritis idiopática juvenil

Validation of new medication use algorithms as proxies for worsening disease activity in patients with juvenile idiopathic arthritis

Safety and Effectiveness of Tofacitinib in Treating Polyarticular Course Juvenile Idiopathic Arthritis

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