scholarly journals Effectiveness and Safety of Vaccination in Patients with Juvenile Idiopathic Arthritis

2021 ◽  
pp. 388-397
Author(s):  
I. V. Fridman ◽  
N. A. Lyubimova ◽  
M. M. Kostik ◽  
S. M. Kharit ◽  
Yu. E. Konstantinova
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Literature Analysis ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Live Vaccines ◽  
Medical Databases ◽  
Long Time ◽  
Antibody Titers ◽  
Rheumatological Diseases ◽  
Global Population

Background. Vaccination is the most effective method for reducing morbidity, disability, mortality from of various infections. However, there was a view for a long time that vaccines are ineffective and unsafe to use in people with rheumatological diseases, including juvenile idiopathic arthritis (JIA). Objective.The aim of the study is to analyze literature data on safety and efficacy of vaccination for JIA patients with live and non-live vaccines.Methods: literature analysis was based on data from medical databases PubMed and Google Scholar.Results. Both live and non-live vaccines are safe and immunogenic enough for children with JIA. Most studies confirm vaccination efficacy in patients with JIA when using glucocorticosteroids (GCS) and methotrexate, while therapy with disease-modifying antirheumatic drugs (DMARD) can reduce antibody titers over time. In general, antibodies levels preservation in previously vaccinated children with JIA is less than in global population. This indicates the need to administer booster doses for such patients. No adverse effects on the course of primary disease after vaccination and no post-vaccine complications were revealed.Conclusion. Vaccination of patients with JIA should be performed with reference to the therapy that the patient already receives, under the control of antibodies level. Booster doses should be implemented in case of titers decrease below the protective levels.

Current therapeutic options for the treatment of juvenile idiopathic arthritis

2020 ◽  
Vol 16 ◽  
Author(s):  
Ioanna G. Saougou ◽  
Theodora E. Markatseli ◽  
Paraskevi V. Voulgari ◽  
Alexandros A. Drosos
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
International Institutions ◽  
Relevant Literature ◽  
Joint Damage ◽  
Chronic Inflammatory Disease ◽  
Biologic Therapies ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
The Past ◽  
American College Of Rheumatology

: Juvenile idiopathic arthritis [JIA] is a chronic inflammatory disease and an exclusion diagnosis that includes all forms of arthritis that persist more than 6 weeks under the age of 16. Although there is not yet a cure for JIA, recent advances in the therapeutic field have created a more hopeful present and future for the patients. In the past, therapies for JIA have depended on non-steroidal medication, conventional synthetic disease modifying antirheumatic drugs and corticosteroids. However, over the last decades, the advent of biologic therapies in JIA contributed to the preservation of functional activity, control of pain, avoidance of joint damage and extra-articular manifestations. Furthermore, over the last years, international institutions such as the American College of Rheumatology have released recommendations and guidelines for rheumatologists for optimal JIA management. All the above, have revolutionized the treatment of JIA with promising outcomes. To this end, we review and discuss appropriately the relevant literature.

Drug monitoring in long-term treatment with adalimumab for juvenile idiopathic arthritis-associated uveitis

2018 ◽  
Vol 104 (3) ◽  
pp. 246-250 ◽  
Author(s):  
Andrea Skrabl-Baumgartner ◽  
Gerald Seidel ◽  
Beate Langner-Wegscheider ◽  
Axel Schlagenhauf ◽  
Jörg Jahnel
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Prospective Observational Study ◽  
Term Treatment ◽  
Disease Modifying Antirheumatic Drugs ◽  
Single Centre ◽  
Antirheumatic Drugs ◽  
Long Term Treatment ◽  
Serum Trough ◽  
Trough Levels

ObjectivesAssessing influence of anti-adalimumab (ADA) antibodies (AAA) on serum trough ADA levels and uveitis activity in long-term ADA treatment of juvenile idiopathic arthritis (JIA)-associated uveitis.Patients and interventionsThis prospective observational study included 20 patients from a single centre treated with ADA for active uveitis refractory to conventional disease-modifying antirheumatic drugs. AAA, serum ADA trough levels and uveitis activity were evaluated at regular intervals up to 6 years.ResultsAAA were detected in nine patients (45%). Permanent AAA in seven were associated with undetectable ADA trough levels and loss of response (LOR). Transient AAA were detected in four with measurable ADA trough levels and response of uveitis to treatment, followed in two by permanent AAA associated with LOR. Use of concomitant immunosuppression was significantly higher in patients without AAA (p<0.05).ConclusionsAAA-associated LOR frequently occurs in long-term treatment with ADA for JIA-associated uveitis. Concomitant immunosuppressive therapy significantly reduces the risk of LOR due to AAA.

scholarly journals Prevalence of temporomandibular disorder in children and adolescents with juvenile idiopathic arthritis – a Norwegian cross- sectional multicentre study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
J. Fischer ◽  
M. S. Skeie ◽  
K. Rosendahl ◽  
K. Tylleskär ◽  
S. Lie ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Children And Adolescents ◽  
Temporomandibular Disorder ◽  
Clinical Signs ◽  
Masticatory Muscles ◽  
Healthy Controls ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Cross Sectional ◽  
Disease Modifying

Abstract Background Children and adolescents with juvenile idiopathic arthritis (JIA) may suffer pain from temporomandibular disorder (TMD). Still, routines for the assessment of temporomandibular joint (TMJ) pain in health and dental care are lacking. The aims of this study were to examine the prevalence of TMD in children and adolescents with JIA compared to their healthy peers and to investigate potential associations between JIA and TMD. Methods This comparative cross-sectional study is part of a longitudinal multicentre study performed during 2015–2020, including 228 children and adolescents aged 4–16 years with a diagnosis of JIA according to the ILAR criteria. This particular substudy draws on a subset of data from the first study visit, including assessments of TMD as part of a broader oral health examination. Children and adolescents with JIA were matched with healthy controls according to gender, age, and centre site. Five calibrated examiners performed the clinical oral examinations according to a standardised protocol, including shortened versions of the diagnostic criteria for TMD (DC/TMD) and the TMJaw Recommendations for Clinical TMJ Assessment in Patients Diagnosed with JIA. Symptoms were recorded and followed by a clinical examination assessing the masticatory muscles and TMJs. Results In our cohort of 221 participants with JIA and 221 healthy controls, 88 (39.8%) participants with JIA and 25 (11.3%) healthy controls presented with TMD based on symptoms and clinical signs. Painful TMD during the last 30 days was reported in 59 (26.7%) participants with JIA vs. 10 (5.0%) of the healthy controls (p <  0.001). Vertical unassisted jaw movement was lower in participants with JIA than in controls, with means of 46.2 mm vs. 49.0 mm, respectively (p <  0.001). Among participants with JIA, a higher proportion of those using synthetic disease-modifying antirheumatic-drugs and biologic disease-modifying antirheumatic-drugs presented with painful masticatory muscles and TMJs at palpation. Conclusion Symptoms and clinical signs of TMD were seen in approximately half of the JIA patients compared to about one fourth of their healthy peers. Painful palpation to masticatory muscles and decreased vertical unassisted jaw movement were more frequent in participants with JIA than among healthy controls and should be part of both medical and dental routine examinations in patients with JIA.

scholarly journals Assessment and Management of Pain in Juvenile Idiopathic Arthritis

2012 ◽  
Vol 17 (6) ◽  
pp. 391-396 ◽  
Author(s):  
Jennifer N Stinson ◽  
Nadia JC Luca ◽  
Lindsay A Jibb
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Childhood Illness ◽  
Self Management ◽  
Social Emotional ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Pain Experience ◽  
Psychological Therapies ◽  
Clinically Significant ◽  
Chronic Childhood

Juvenile idiopathic arthritis (JIA) is a common chronic childhood illness. Pain is the most common and distressing symptom of JIA. Pain has been found to negatively impact all aspects of functioning, including physical, social, emotional and role functions. Children with arthritis continue to experience clinically significant pain despite adequate doses of disease-modifying antirheumatic drugs and anti-inflammatory agents. The present article reviews the prevalence and nature of pain in JIA, the biopsychosocial factors that contribute to the pain experience, current approaches to assessing pain in this population, and ways of managing both acute and persistent pain using pharmacological, physical and psychological therapies. Finally, new approaches to delivering disease self-management treatment for youth with JIA using the Internet will be outlined.

scholarly journals Juvenile idiopathic arthritis and risk of cancer before and after the introduction of biological therapies

RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e001055
Author(s):  
AnnaCarin Horne ◽  
Bénédicte Delcoigne ◽  
Karin Palmblad ◽  
Johan Askling
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Group Level ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Increased Risk ◽  
Before And After ◽  
Risk Of Cancer ◽  
Excess Incidence ◽  
Swedish Patient

BackgroundThe risk of cancer, including any secular trends in risk, in patients with juvenile idiopathic arthritis (JIA) is incompletely understood.MethodsWe performed a register-based cohort study of patients with JIA from 2001 until 2017, identified via the Swedish Patient Register. Patients with JIA were matched to five population reference subjects. Patients and referents were followed up for incident cancers (via linkage to the Swedish Cancer Register) until 18 years of age or 31 December 2016.ResultsAmong the 6721 patients with JIA, we observed 10 incident malignancies (5 lymphoproliferative cancers) during 34 951 person-years of follow-up, corresponding to an excess incidence of 0.09 cancers per 1000 person-years (one extra case per 11 000 patients per year), an HR for cancer (all sites) of 1.4 (95% CI 0.7 to 2.9) and an HR for lymphoproliferative malignancies of 3.6 (95% CI 1.1 to 11.2). The rates of cancer in JIA did not increase over the study period. We noted no differences in the excess risk comparing periods before and after the introduction of biologic disease-modifying antirheumatic drugs (bDMARDs).DiscussionChildren and adolescents with JIA are at a slightly increased risk of lymphoproliferative (but not of other) malignancies. At the group level, there is no sign that this risk has increased further after the introduction of bDMARDs.

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