scholarly journals A13: The Research in Arthritis in Canadian Children Emphasizing Outcomes (ReACCh Out) Cohort: Prospective Determination of the Incidence of New Onset Uveitis in Juvenile Idiopathic Arthritis

2014 ◽  
Vol 66 ◽  
pp. S21-S22 ◽  
Author(s):  
Karen N Watanabe Duffy ◽  
Jennifer Lee ◽  
Jaime Guzman ◽  
Nick Barrowman ◽  
Kimberly Morishita ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
New Onset

Prospective Determination of the Incidence and Risk Factors of New‐Onset Uveitis in Juvenile Idiopathic Arthritis: The Research in Arthritis in Canadian Children Emphasizing Outcomes Cohort

2019 ◽  
Vol 71 (11) ◽  
pp. 1436-1443 ◽  
Author(s):  
Jennifer J. Y. Lee ◽  
Ciarán M. Duffy ◽  
Jaime Guzman ◽  
Kiem Oen ◽  
Nick Barrowman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Juvenile Idiopathic Arthritis ◽  
New Onset

scholarly journals Effect of first-line biologic initiation on glucocorticoid exposure in children hospitalized with new-onset systemic juvenile idiopathic arthritis: emulation of a pragmatic trial using observational data

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Rosemary G. Peterson ◽  
Rui Xiao ◽  
Hannah Katcoff ◽  
Brian T. Fisher ◽  
Pamela F. Weiss
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Biologic Therapy ◽  
Tertiary Care ◽  
Pragmatic Trial ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Source Population ◽  
First Line ◽  
Eligibility Criteria ◽  
Over Time ◽  
New Onset

Abstract Background Glucocorticoid exposure is a significant driver of morbidity in children with systemic juvenile idiopathic arthritis (sJIA). We determined the effect of early initiation of biologic therapy (IL-1 or IL-6 inhibition) on glucocorticoid exposure in hospitalized patients with new-onset sJIA. Methods We emulated a pragmatic sequence of trials (“pseudo-trials”) of biologic initiation in children (≤ 18 years) hospitalized with new-onset sJIA utilizing retrospective data from an administrative database from 52 tertiary care children’s hospitals from 2008 to 2019. Eligibility window, treatment assignment and start of follow-up between biologic and non-biologic study arms were aligned for each pseudo-trial. Patients in the source population could meet eligibility criteria at several timepoints. Mixed-effects logistic regression was used to determine the effect of biologic initiation on in-hospital glucocorticoid exposure. Results Four hundred sixty-eight children met eligibility criteria, of which 19% received biologic therapy without preceding or concomitant initiation of immunomodulatory medications. This proportion significantly increased over time during the study period (p <  0.01). 1451 trial subjects were included across 4 pseudo-trials with 71 assigned to the biologic arm and 1380 assigned to the non-biologic arm. After adjustment, there was a trend toward decreased odds of glucocorticoid initiation in the biologic arm compared to the non-biologic arm (OR 0.39, 95% CI [0.13, 1.15]). Conclusion Biologic initiation in children hospitalized with new-onset sJIA significantly increased over time and may be associated with reduced glucocorticoid exposure. The increasing use of first-line biologic therapy may lead to clinically relevant reductions in treatment-related adverse effects of glucocorticoid-reliant therapeutic approaches.

scholarly journals Automated determination of bone age and bone mineral density in patients with juvenile idiopathic arthritis: a feasibility study

2014 ◽  
Vol 16 (4) ◽  
Author(s):  
Janneke Anink ◽  
Charlotte M Nusman ◽  
Lisette WA van Suijlekom-Smit ◽  
Rick R van Rijn ◽  
Mario Maas ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Juvenile Idiopathic Arthritis ◽  
Feasibility Study ◽  
Bone Mineral ◽  
Bone Age ◽  
Mineral Density ◽  
Automated Determination

scholarly journals Red Cell Distribution Width: a Novel Predictive Biomarker for Stroke Risk After Transient Ischemic Attack

2021 ◽  
Author(s):  
Ke-Hang Xie ◽  
Ling-Ling Liu ◽  
Yun-Ru Liang ◽  
Chu-Yin Su ◽  
Run-Ni Liu ◽  
...  
Keyword(s):  
Transient Ischemic Attack ◽  
Complete Blood Count ◽  
Predictive Biomarker ◽  
Cell Distribution ◽  
Distribution Width ◽  
The Mean ◽  
Stroke Center ◽  
Ischemic Attack ◽  
New Onset

Abstract Objective: Predicting the prognosis of transient ischemic attack (TIA) is difficult for many frontline clinicians. The purpose of this study was to determine whether subsequent stroke in TIA patients can be predicted via the red blood cell distribution width(RDW).Material and methods: A total of 309 consecutive age- and sex-matched patients with new onset TIA, in our stroke center, were enrolled over the period studied. The patients were divided into two groups :103 TIA patients and 206 patients who had a stroke within 7 days after TIA. Complete blood count, biochemical parameters and brain imaging were performed in all patients. Results: The mean RDW values of patients with stroke after TIA were significantly higher than patients with TIA (12.84 ±1.19, 13.35 ±1.59, p= 0.001). In a multivariate model, RDW was independently associated with stroke after TIA (OR=2.52, 95% CI 1.46 to 3.35, P= 0.002). We also found that the higher levels of RDW, the earlier the stroke onset (p=0.024). Compared to ABCD2 score, the diagnostic power of RDW in the differentiation of patients with stroke after TIA is better (AUCs:0.613vs0.731, p= 0.015). When an RDW cut-off value of 13.95% is accepted for differentiating patients with stroke after TIA from TIA, the sensitivity and specificity were 73.7% and 74.3%, respectively.Conclusions: The early determination of RDW is a promising, rapid, easy and inexpensive biomarker to predict the subsequent stroke in TIA patients.

scholarly journals THU0551 Treatment strategy study in new onset dmard naive juvenile idiopathic arthritis first results on 24 months clinical outcome

2018 ◽  
Author(s):  
P. Hissink Muller ◽  
D. Brinkman ◽  
D. Schonenberg-Meinema ◽  
W. van den Bosch ◽  
Y. Koopman-Keemink ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Clinical Outcome ◽  
Treatment Strategy ◽  
Strategy Study ◽  
First Results ◽  
New Onset

scholarly journals P75 Relation between polymorphism of folic acid cycle genes and effectiveness of methotrexate in children with juvenile idiopathic arthritis

2019 ◽  
Vol 104 (6) ◽  
pp. e48.1-e48
Author(s):  
N Panko
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Folic Acid ◽  
Acid Cycle ◽  
American College Of Rheumatology ◽  
Group I ◽  
Polymerase Chain ◽  
Folate Cycle ◽  
Rheumatology Pediatric ◽  
Homocysteine Methyltransferase

BackgroundMethotrexate (MTX) is the basic treatment of patient with Juvenile Idiopathic Arthritis (JIA), but effectiveness of this therapy is different. We aimed to study effectiveness of MTX in children with JIA with different genotypes of folic acid cycle genes.MethodsThe study included 8 patients with JIA. For determination of MTX effectiveness the American College of Rheumatology pediatric criteria (ACR-pedi) was used. Patients were divided into 2 groups according the effectiveness of MTX treatment. Group I included 4 patients, who were non-responders because ACR-pedi was less than 10%. Second group contained 4 patients, who had ACR-pedi more than 10%. The megerment of genotypes of genes of folate cycle, such as 5-methyltetrahydrofolate-homocysteine methyltransferase (MTR), 5-methyltetrahydrofolate-homocysteine methyltransferase reductase (MTRR), 5,10methylenetetrahydrofolate reductase C677T and A1298C variants (MTHFR-677 and MTHFR129) by polymerase chain reaction (PCR) was performed for all patients.ResultsIn II group effectiveness of therapy according ACR-pedi was from 30% to 70% in 75% of children and more then 70% - in 25% of patients. In general, MTR gene indicated AA-genotype in 50% of patients, AG and GG-genotypes - in 25%; MTRR gene was performed with AA-genotype in 25%, AC-genotype in 12.5% and CC-genotype in 62.5%. MTHFR1298 gene was presented in 50% of patients with AA-alleles, in 25% - with AC and CC-genotypes. 50% of children had CC-genotype of MTHFR677 gene and other 50% - AC-genotype of MTHFR677 gene. CC-genotype of MTHFR1298 gene more frequently was determined in II group (p< 0.01). In group of non-responders AA-genotype of MTR gene was found more frequent in comparison with patients from group II (p< 0.01).ConclusionResponse to standard therapy in patients with JIA depends on time of prescription of MTX and genotype of MTHFR1298 and MTR genes.Disclosure(s)Nothing to disclose

scholarly journals POS1332 ETANERCEPT-ASSOCIATED NEW ONSET UVEITIS IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS UNDER BIOLOGICAL THERAPY: SINGLE CENTER EXPERIENCE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 948.2-948
Author(s):  
I. Nikishina ◽  
S. Arsenyeva ◽  
M. Kaleda ◽  
O. Kostareva ◽  
A. Shapovalenko ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Clinical Features ◽  
Biological Therapy ◽  
De Novo ◽  
Disease Onset ◽  
Activity Level ◽  
Current Therapy ◽  
Laboratory Activity ◽  
Paradoxical Phenomenon ◽  
New Onset

Background:Biological agents (BA), especially TNF inhibitors, are high efficacy options for current therapy for patients (pts) with juvenile idiopathic arthritis (JIA). They are successfully used not only for the arthritis but also for JIA-associated uveitis, however, development of uveitis de novo in pts treated with BA is a well-established paradoxical phenomenon.Objectives:to evaluate the frequency of new onset (no-) uveitis, occurring under BA therapy in JIA pts, to establish clinical features, which may be associated with development of such effects.Methods:retrospective cohort study involved all JIA pts (1136) who were treated with BA in our clinic from 2004 to 2020. All cases of no-uveitis were collected for the describing of their clinical features in disease onset and course, activity level, JIA category, exposure to Methotrexate (MTX) and BA, presence of ANA, HLA B27.Results:among of 1136 pts treated with different BA we identified 36 (3.3%) pts (19 female/17 male) with no-uveitis under BA. Mostly during etanercept (ETA) therapy (34 cases from 488 ETA courses, 7%), 1/166 - in abatacept (ABA) and 1/372 - in adalimumab (ADA). 30 pts (83%) with no-uveitis developed it on the 1st line of BA treatment (29 ETA vs 1 ADA). 4pts (11%) developed no-uveitis on 2 nd line (3 ETA vs 1 ABA). 2 pts (6%) on third line (all ETA, both pts had also psoriasis). There are no cases of no-uveitis under other BA. Frequency of no-uveitis was much higher in ETA group. ETA exposure was 26.8 ± 28.8 months (mo). It means there are no “safe” period of therapy from paradoxical phenomenon of no-uveitis. JIA subtypes were as follows: RF-neg polyarthritis 9 (25%), persistent oligoarthritis 3 (8%), extended oligoarthritis 21 (59%), enthesitis-related arthritis (ERA) - 3 (8%). Average age at JIA onset was 4.6 ± 3.9 yrs. 20/36 patients had high laboratory activity (CRP 54 ± 23 mg/l; ESR 41 ± 19 mm/h) and severe arthritis before BA initiation. However most of pts (25/36) achieved 90-100% ACRpedi-response by the uveitis development. 23/36 pts were ANA-positive, 17/36 pts had HLAB27, including 7 pts who had the both features. Uveitis was occurred earlier in ANA plus HLAB27 positive pts (mean exposure - 15.3 mo) than in only ANA-positive or HLAB27-positive pts (27.7 mo and 27.6 mo accordingly). 29/36 (81%) of pts received methotrexate (MTX) in mean dosage 11.5 mg/m2/week. There are no differences in time of uveitis development depending of MTX. In all cases of no-uveitis BA was switched.Conclusion:Our study suggested that new onset of uveitis is rare adverse event during BA therapy in JIA. Uveitis can develop despite the excellent effect of therapy on joint manifestation. The most typical development of no-uveitis is under ETA therapy, especially in the predisposed cases (certain variants of JIA, ANF positivity, HLAB27 presence) and in patients with very high disease activity at the time of the start of biological therapy.Disclosure of Interests:Irina Nikishina Speakers bureau: Novartis, MSD, Pfizer, Abbvie, Hofman la Roche, Svetlana Arsenyeva: None declared, Maria Kaleda Speakers bureau: Novartis, Roche, MSD, Olga Kostareva: None declared, Anna Shapovalenko: None declared, Ekaterina Denisova: None declared, Anna Panova: None declared

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