scholarly journals Review of the Pathophysiology, Diagnosis, and Orthopedic Treatment Options for Juvenile Idiopathic Arthritis

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Phong Truong
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Treatment Options ◽  
Orthopedic Treatment

scholarly journals Beyond the guidelines management of juvenile idiopathic arthritis: a case report of a girl with polyarticular disease refractory to multiple treatment options and Leri Weill syndrome

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vana Vukić ◽  
Ana Smajo ◽  
Mandica Vidović ◽  
Rudolf Vukojević ◽  
Miroslav Harjaček ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Case Report ◽  
Treatment Options ◽  
Janus Kinase ◽  
Musculoskeletal Symptoms ◽  
Multiple Treatment ◽  
Number Of Patients ◽  
Systemic Glucocorticoids ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract Background The last two decades brought new treatment options and high quality guidelines into the paediatric rheumatologic practice. Nevertheless, a number of patients still present a diagnostic and therapeutic challenge due to combination of vague symptoms and unresponsiveness to available treatment modalities. Case presentation We report a case of sixteen years old girl suffering from polyarticular type of juvenile idiopathic arthritis refractory to multiple treatment options. She first presented at the age of 4 with swelling and contractures of both knees. Her symptoms were initially unresponsive to nonsteroidal anti-inflammatory drugs and progressed despite treatment with intraarticular and systemic glucocorticoids and methotrexate. Throughout the years, she received several biologics together with continuous administration of nonsteroidal anti-inflammatory drugs and disease modifying anti-rheumatic drugs as well as intraarticular and systemic glucocorticoids in disease flares. However, none of this options  provided a permanent remission, so various other modalities, as well as other possible diagnoses were constantly being considered. Eventually she became dependent on a daily dose of systemic glucocorticoids. In 2018, the treatment with Janus kinase inhibitor tofacitinib was initiated, which led to gradual amelioration of musculoskeletal symptoms, improvement of inflammatory markers and overall well-being, as well as to the weaning of systemic glucocorticoids. As the swelling of the wrists subsided for the first time in many years, Madelung’s deformity was noticed, first clinically, and later radiographically as well. Genetic analysis revealed short-stature homeobox gene deficiency and confirmed the diagnosis of Leri Weill syndrome. Conclusions This case report emphasizes the need for reporting refractory, complicated cases from everyday clinical practice in order to build-up the overall knowledge and share experience which is complementary to available guidelines. Individual reports of difficult to treat cases, especially when additional diagnoses are involved, can be helpful for physicians treating patients with common rheumatological diseases such as juvenile idiopathic arthritis.

Treatment Options for Juvenile Idiopathic Arthritis (JIA) Associated Uveitis

2015 ◽  
Vol 24 (1) ◽  
pp. 81-90 ◽  
Author(s):  
Rowayda M. Amin ◽  
Elisabetta Miserocchi ◽  
Jennifer E. Thorne ◽  
Dana Hornbeak ◽  
Douglas A. Jabs ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Treatment Options

Surgery Insight: orthopedic treatment options in rheumatoid arthritis

2008 ◽  
Vol 4 (5) ◽  
pp. 266-273 ◽  
Author(s):  
Beat R Simmen ◽  
Earl R Bogoch ◽  
Jörg Goldhahn
Keyword(s):  
Rheumatoid Arthritis ◽  
Treatment Options ◽  
Orthopedic Treatment

scholarly journals Coincidence of juvenile idiopathic arthritis and type 1 diabetes: a case-based review

2022 ◽  
Author(s):  
Maciej Szabłowski ◽  
Michał Andrzej Okruszko ◽  
Katarzyna Pochodowicz ◽  
Paweł Abramowicz ◽  
Jerzy Konstantynowicz ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Juvenile Idiopathic Arthritis ◽  
Autoimmune Diseases ◽  
Metabolic Control ◽  
Pediatric Population ◽  
Treatment Options ◽  
Glucose Monitoring ◽  
Control Of Diabetes

AbstractThe study was aimed to review a rare coexistence of type 1 diabetes (T1D) and juvenile idiopathic arthritis (JIA) regarding different clinical approaches to the management and treatment options. Medical complications of the two autoimmune disorders in children and adolescents have been evaluated, particularly in those treated with glucocorticosteroids (GCS) and insulin. A review of the literature regarding reports on concomitant T1D and JIA was conducted using resources available in Medline, Google Scholar, and Web of Science databases, with a specific focus on the combination of T1D and JIA in a pediatric population. The review was extended by our analysis of two patients treated in a single center for this comorbidity. Eligible reports of four cases were found, and including our two original records, a total of six pediatric patients (5 females) were analyzed, of which three had also other autoimmune diseases (thyroiditis, coeliac disease, autoimmune hepatitis), whereas four had been treated with a long-term GCS, and two were receiving biological therapy (etanercept or adalimumab). Only one of them had good metabolic control of diabetes. Diabetes in childhood may coexist with other autoimmune diseases, including rheumatologic conditions. Hyperglycemia can worsen JIA therapy by induction and maintaining inflammation. Using modern diabetes technologies (like personal insulin pumps and continuous glucose monitoring) helps to minimize the deteriorating effect of JIA exacerbations and the rheumatoid treatment on metabolic control of diabetes.

scholarly journals Juvenile idiopathic arthritis in Jordan: Single center experience

2021 ◽  
Author(s):  
Raed M. Alzyoud ◽  
Motasem O. Alsuweiti ◽  
Heba Q. Almaaitah ◽  
Bushra N. Aladaileh ◽  
Mohammad K. Alnoubani ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Treatment Options ◽  
Age At Onset ◽  
Laboratory Data ◽  
Population Based ◽  
Detailed Knowledge ◽  
Single Center ◽  
Rheumatology Clinic ◽  
Single Center Experience ◽  
Single Center Study

Abstract Background: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of disorders, including all forms of arthritis, which develops in children who are less than 16 years old. This study aimed to evaluate the clinical and laboratory features of JIA in a single center in Jordan.Methods: A retrospective analysis of the electronic medical records of pediatric patients diagnosed with JIA based on the International League of Associations for Rheumatology (ILAR) criteria during the period from 2015 to 2019 at the Pediatric Rheumatology Clinic in the Queen Rania Children’s Hospital. All patients were below the age of 14 years at the time of diagnosis and followed for at least six months. Collected data consisted of age, gender, age at initial presentation and diagnosis, JIA subtype, laboratory data, treatment options, and outcome.Results: A total of 210 patients were included in this cohort (94 males and 116 females) with the mean age at diagnosis and mean age at onset of 5.33 ± 3.40 years and 5.08 ± 3.40 years (range: 7 months – 14 years), respectively. Oligoarticular JIA was the commonest subtype (54.7%), followed by systemic arthritis (17.1%) and polyarticular arthritis (12.3%). ANA was positive in 70 patients (33.6%). Uveitis occurred in thirty (14.2%) patients.Conclusion: To the best of our knowledge, this study on this cohort is the first report on JIA in Jordan, in comparison with other regionally and internationally published reports. Oligoarticular JIA was found to be the most common subtype. For detailed knowledge on JIA characteristics and patterns, a population-based, rather than a single center study, should be conducted in Jordan.

scholarly journals Juvenile idiopathic arthritis: from aetiopathogenesis to therapeutic approaches

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Lina N. Zaripova ◽  
Angela Midgley ◽  
Stephen E. Christmas ◽  
Michael W. Beresford ◽  
Eileen M. Baildam ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Genetic Factors ◽  
Inflammatory Diseases ◽  
Treatment Options ◽  
Therapeutic Interventions ◽  
Therapeutic Approaches ◽  
Treatment Pathways ◽  
Number Of Patients ◽  
Systemic Symptoms ◽  
International League

AbstractJuvenile idiopathic arthritis (JIA) is the most common paediatric rheumatological disorder and is classified by subtype according to International League of Associations for Rheumatology criteria. Depending on the number of joints affected, presence of extra-articular manifestations, systemic symptoms, serology and genetic factors, JIA is divided into oligoarticular, polyarticular, systemic, psoriatic, enthesitis-related and undifferentiated arthritis. This review provides an overview of advances in understanding of JIA pathogenesis focusing on aetiology, histopathology, immunological changes associated with disease activity, and best treatment options. Greater understanding of JIA as a collective of complex inflammatory diseases is discussed within the context of therapeutic interventions, including traditional non-biologic and up-to-date biologic disease-modifying anti-rheumatic drugs. Whilst the advent of advanced therapeutics has improved clinical outcomes, a considerable number of patients remain unresponsive to treatment, emphasising the need for further understanding of disease progression and remission to support stratification of patients to treatment pathways.

Novel treatment options for juvenile idiopathic arthritis

2015 ◽  
Vol 8 (5) ◽  
pp. 559-573 ◽  
Author(s):  
Katherine A Steigerwald ◽  
Norman T Ilowite
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Treatment Options ◽  
Novel Treatment

Biologics for the Treatment of Juvenile Idiopathic Arthritis

2019 ◽  
Vol 25 (42) ◽  
pp. 5860-5893 ◽  
Author(s):  
Dimitri Poddighe ◽  
Micol Romano ◽  
Maurizio Gattinara ◽  
Valeria Gerloni
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Clinical Evidence ◽  
Treatment Options ◽  
Lymphocyte Activation ◽  
Biological Drugs ◽  
Immune Systems ◽  
Tnf Α ◽  
New Treatment ◽  
Biologic Drug ◽  
Comprehensive Discussion

Juvenile Idiopathic Arthritis (JIA) is one of the most common chronic diseases in children. Recently, the management of JIA has substantially changed, thanks to the availability of new treatment options, represented by biological drugs or biologics. These drugs modulate the specific mechanisms of the immune systems, such as TNF-α, IL-1 and IL-6 signaling, or lymphocyte activation and/or functioning. In this review, we provide a comprehensive discussion on the current recommendations and clinical evidence regarding the use of the available biologics in the treatment of JIA; moreover, the main pharmacokinetic and pharmacodynamic aspects of any specific biologic drug have been summarized.

scholarly journals The Effects of Celecoxib or Naproxen on Blood Pressure in Pediatric Patients with Juvenile Idiopathic Arthritis

2015 ◽  
Vol 9 ◽  
pp. CMPed.S20720
Author(s):  
B. Falkner ◽  
M. Berger ◽  
P. Bhadra Brown ◽  
D. Iorga ◽  
R.W. Nickeson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Juvenile Idiopathic Arthritis ◽  
Pediatric Patients ◽  
Treatment Options ◽  
Final Visit ◽  
Double Blind ◽  
Safety And Efficacy ◽  
Suitable Treatment ◽  
Inflammatory Drugs ◽  
Mean Differences

Background Selective and nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) are indicated for the treatment of juvenile idiopathic arthritis (JIA). However, the effect of NSAIDs on blood pressure (BP) in children has not been rigorously examined. Methods In this randomized, double-blind, multicenter, active-controlled, 6-week trial, the safety and efficacy of celecoxib (50 mg twice daily [bid] or 100 mg bid) or naproxen (7.5 mg/kg bid) was evaluated in patients aged 2–17 years with JIA. Results The least squares (LS) mean difference (celecoxib – naproxen) in change from baseline to week 6/final visit in systolic BP was 1.10 (90% confidence interval, -0.56, 2.76). No significant LS mean differences in diastolic BP relative to baseline were reported. Treatment-emergent adverse events occurred in 48% of patients in each treatment group. Conclusion Both celecoxib and naproxen had no impact on BP, and both treatments had comparable safety profiles. Celecoxib, or naproxen, could be seen as suitable treatment options for pediatric patients with JIA.

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