scholarly journals Longterm Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis: 17 Years of Followup of a Nordic Juvenile Idiopathic Arthritis Cohort

2019 ◽  
Vol 47 (5) ◽  
pp. 730-738 ◽  
Author(s):  
Mia Glerup ◽  
Peter Stoustrup ◽  
Louise H. Matzen ◽  
Veronika Rypdal ◽  
Ellen Nordal ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Demographic Data ◽  
Disease Onset ◽  
Population Based ◽  
Cone Beam ◽  
Biologic Treatment ◽  
Temporomandibular Joints ◽  
Tmj Pain ◽  
The Mean ◽  
Full Face

Objective.To determine the prevalence of orofacial symptoms, dysfunctions, and deformities of the temporomandibular joint (TMJ) in juvenile idiopathic arthritis (JIA) 17 years after disease onset.Methods.Drawn from a prospective, population-based Nordic JIA cohort with disease onset from 1997 to 2000, 420 consecutive cases were eligible for orofacial evaluation of TMJ involvement. The followup visit included demographic data, a standardized clinical orofacial examination, and full-face cone-beam computed tomography (CBCT). For comparison, 200 age-matched healthy controls were used.Results.Of 420 eligible participants with JIA, 265 (63%) were included (mean age 23.5 ± 4.2 yrs) and completed a standardized clinical orofacial examination. Of these, 245 had a full-face CBCT performed. At least 1 orofacial symptom was reported by 33%. Compared to controls, the JIA group significantly more often reported TMJ pain, TMJ morning stiffness, and limitation on chewing. Further, among participants reporting complaints, the number of symptoms was also higher in JIA. The mean maximal incisal opening was lower in the JIA group (p < 0.001), and TMJ pain on palpation was more frequent. Condylar deformities and/or erosions were observed in 61% as assessed by CBCT, showing bilateral changes in about 70%. Risk factors of condylar deformities were orofacial dysfunction or biologic treatment; enthesitis-related arthritis was protective.Conclusion.This study of the longterm consequences of TMJ involvement in a population-based JIA cohort reports persistence of comprehensive symptoms, dysfunctions, and damage of the TMJ into adulthood. We suggest interdisciplinary followup of JIA patients also in adulthood.

P031 Adherence with Methotrexate in Tunisian Juvenile Idiopathic Arthritis Patients

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Hiba Bettaieb ◽  
Wafa Triki ◽  
Kaouther Maatallah ◽  
Hanene Ferjani ◽  
Dorra Ben Nessib ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Rheumatoid Factor ◽  
Disease Duration ◽  
Pediatric Population ◽  
Demographic Data ◽  
Disease Onset ◽  
Weekly Dose ◽  
Cross Sectional ◽  
High Adherence ◽  
The Mean

Abstract Background Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in the pediatric population. Methotrexate (MTX) has been considered as the cornerstone of treatment of poly and oligoarticular subtypes of JIA. However, this treatment is supposed to be for long term, which may involve an obstacle for adherence. The aims of the study were to evaluate adherence of Tunisian JIA patients to MTX and to identify factors associated with high adherence to MTX. Methods A cross-sectional study including patients with confirmed JIA diagnosis, according to the International League of Associations for Rheumatology (ILAR) criteria, was performed. Demographic data as well as disease characteristics were obtained from medical records. Laboratory markers including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected. Adherence was measured, for patients under MTX for &gt;3 months, using the 5-item Compliance Questionnaire Rheumatology (CQR5) (1). Patients were divided into two groups: group 1: High adherence (HA) for patients having a CQR5 ≥ 80% and group 2: low adherence (LA) for patients having CQR5 &lt; 80%. A p inferior to 0.05 was considered statistically significant. Results The study included 29 patients (10 males and 19 females) with a mean age at disease onset of 9.1 ± 3.4 years. The mean disease duration was 61 ± 79 months [7–336]. JIA subtypes were in decreasing order of frequency as follows: enthesitis-related arthritis (n = 13), oligoarticular (n = 8), Polyarticular without rheumatoid factor (n = 4), Polyarticular with rheumatoid factor (n = 2), systemic (n = 1) and, psoriatic arthritis (n = 1). A biologic inflammatory syndrome was found in 48.3% (n = 14) of cases. The mean ESR and CRP were 20 mm/h ± 11.3 [3–98] and 5 ± 17.8 mg/l [0–56] respectively. Nineteen (65.5%) patients had coxitis. Overall, 55.17% of patients (n = 16) were treated with MTX with a mean weekly dose of 9.2 ± 3.2 mg [5–15]. MTX was orally administrated in all patients. NSAIDs and prednisone were prescribed in 51.7% (n = 15) and 17.2% (n = 5) of cases respectively. The MTX was associated with biological DMARDs in five patients (17.2%). It was about Etanercept in 4 patients and Tocilizumab in 1 patient. Mean CQR5 score was 70.8% ± 18 [25–100]. Only seven patients (43.8%) showed high adherence to MTX. The statistical study revealed no difference between HA and LA in term of gender (P = 0.84), age at disease onset (P = 0.39), disease duration (P = 0.9), prednisone use (P = 0.22), the occurrence of coxitis (P = 0.2), ESR (P = 0.83) and CRP (P = 0.033) rates. Conclusion In this study, less than one half of JIA patients were highly adherent to MTX according to CQR5. Low adherence should be considered before declaring MTX treatment failure.

P019 Adulthood of juvenile idiopathic arthritis patients: professional outcome

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
S Miladi ◽  
S Bouzid ◽  
A Fazaa ◽  
L Souabni ◽  
M Sellami ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
College Graduates ◽  
Disease Onset ◽  
Cross Sectional Study ◽  
Full Time ◽  
Family Status ◽  
Cross Sectional ◽  
Telephone Interviews ◽  
The Mean ◽  
Professional Outcome

Abstract Background Juvenile idiopathic arthritis (JIA) is a heterogeneous group of rheumatic diseases characterized by onset before the age of 16. Since the disease starts at an early age, it may lead to socio-professional difficulties in adulthood for JIA patients. This study aimed to describe the professional outcome of a series of 20 JIA patients. Methods A cross-sectional study including patients aged 20 years and more and fulfilling the ILAR criteria for the diagnosis of JIA was carried out. Telephone interviews were conducted. The responders answered questions about family status, current occupation, working h, eventual workplace adjustments, and sick leave frequency. Results Twenty patients answered the questionary; 14 males and 6 females. The mean age of the disease onset was 8 years. The mean age of patients at the time of the study was 24.27 years [20–36]. Polyarticular form was the most frequent (10 cases). Other subtypes diagnosed were systemic (4 cases), enthesitis-related arthritis (5 cases), oligoarticular (one case). Hip arthritis was observed in 8 patients and surgical intervention was needed in three. Eight patients were treated with csDMARDSs and 12 with bDMARDs. Three of our patients were married (aged 24, 34, and 36). Five were still studying: 4 had good grades without absenteeism. However, one patient needed special aid to go to school and had a higher absence rate. Five other patients were full-time college students without absenteeism. Four patients were college graduates. Among them, two were searching for a job for &gt;6 months. The other two were full-time administrative workers with no absenteeism. One patient did need workplace adjustments. Six patients could not work because of their physical disabilities. Conclusion According to our results, a quarter of our patients could not access professional life. Disease activity and hip destruction are the two main factors causing JIA patients to miss out on important personal and professional opportunities.

Predictors of Hip Disease in the Systemic Arthritis Subtype of Juvenile Idiopathic Arthritis

2011 ◽  
Vol 38 (5) ◽  
pp. 954-958 ◽  
Author(s):  
MICHELLE BATTHISH ◽  
BRIAN M. FELDMAN ◽  
PAUL S. BABYN ◽  
PASCAL N. TYRRELL ◽  
RAYFEL SCHNEIDER
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Median Time ◽  
Joint Destruction ◽  
Disease Onset ◽  
Systemic Jia ◽  
Kaplan Meier ◽  
Hip Disease ◽  
The Mean ◽  
Censored Observations ◽  
Aggressive Interventions

Objective.Hip involvement occurs in 20%–40% of all cases of juvenile idiopathic arthritis (JIA). Patients with systemic JIA (sJIA) are affected most frequently. The aim of our study was to investigate the predictors of clinical hip disease and radiographic hip damage in sJIA.Methods.The medical records (1997–2007) of all children (n = 98) with sJIA were reviewed. Potential clinical and laboratory predictors were examined at presentation and at 3 and 6 months. To account for censored observations, we used survival analysis.Results.During the study period, 59 children met our inclusion criteria. The mean age at diagnosis was 7.8 years. Thirty patients (51%) developed clinical hip disease, with 12 (20%) developing radiographic evidence of hip damage. The median time to develop clinical hip disease was 24 months. Using Kaplan-Meier estimates, 25% of patients develop radiographically evident hip damage within 43 months. At presentation, patients in whom clinical hip disease later developed had polyarthritis (hazard ratio 2.51, p = 0.01), elevated IgG (HR 1.12, p = 0.01) and IgM (HR 2.71, p = 0.02), and higher CHAQ scores (HR 1.65, p = 0.02). At 3 months after disease onset, patients in whom radiographic hip damage later developed had fever (HR 4.78, p = 0.02), polyarthritis (HR 4.63, p = 0.02), and higher CHAQ scores (HR 3.20, p = 0.005). At 6 months, polyarthritis was the strongest predictor of both clinical hip disease and radiographic hip damage.Conclusion.Half of patients with sJIA develop clinical hip disease a median time of 24 months from diagnosis. Early identification of predictors of hip disease and damage in patients with sJIA may suggest earlier, more aggressive interventions to prevent joint destruction.

P036 Juvenile Idiopathic Arthritis in adulthood: outcomes of oligo and polyarticular forms?

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Miladi Saoussen ◽  
Makhlouf Yasmine ◽  
Fazaa Alia ◽  
Sellami Mariem ◽  
Ouenniche Kmar ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Transition To Adulthood ◽  
Disease Onset ◽  
Adult Life ◽  
Treatment Modalities ◽  
Disease Characteristics ◽  
Female Predominance ◽  
Tunnel Syndrome ◽  
The Mean ◽  
International League

Abstract Background Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory rheumatic disease of childhood that can cause major physical disability, impairing patients' ability to lead a normal adult life. The objective of this study was to assess the outcomes of oligo- and polyarticular JIA in adulthood as well as the progression to authentic rheumatoid arthritis (RA). Methods We conducted a retrospective study including adult patients with JIA (diagnosed according to the International League of Associations for Rheumatology [ILAR]). Data collected included age, gender, disease characteristics (JIA subtype, disease duration). The progression to an authentic RA was determined by checking the response to the ACR/EULAR 2010 classification criteria. Results Twenty-eight patients were included in this study. There was a female predominance with a sex ratio of 1.5. The mean age of disease onset was 6 years and 2 months [2–17]. The mean age at inclusion was 29.5 years [18–64]. The frequency of each JIA subtype was as follows: polyarticular with RF + (n = 14), polyarticular with RF- (n = 9), oligoarthritis (n = 5). The polyarticular forms: RF+ and RF- evolved into genuine seropositive and seronegative RA in 71.4% and 66.7% of cases, respectively. Among the oligoarticular JIA subtype, an extension of the disease to a seronegative RA was noted in one patient (20%). Hip involvement was noted in 20% of patients. Carpal tunnel syndrome and elbow arthritis were found in 28.5% and 14.3% of patients, respectively. Regarding treatment modalities and at the time of recruitment, 36.3% of RAs were treated with Methotrexate, and 33% were on biological treatment. Ten percent of the patients dropped out of school because of disease flares and deformities. Conclusion Our study showed oligo- and polyarticular JIA evolves in most of the cases towards an authentic RA causing deformities and handicaps. Earlier management is necessary to allow a better transition to adulthood.

Accuracy of Wallace Criteria for Clinical Remission in Juvenile Idiopathic Arthritis: a Cohort Study of 761 Consecutive Cases

2009 ◽  
Vol 36 (7) ◽  
pp. 1532-1535 ◽  
Author(s):  
ALFREDOMARIA LURATI ◽  
ALESSANDRA SALMASO ◽  
VALERIA GERLONI ◽  
MAURIZIO GATTINARA ◽  
FLAVIO FANTINI
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Clinical Laboratory ◽  
Survival Function ◽  
Disease Onset ◽  
Remission Status ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Laboratory Variables ◽  
The Mean ◽  
Seronegative Polyarthritis

Objective.To evaluate disease course and clinical usefulness in some categories of juvenile idiopathic arthritis (JIA) by applying newly developed Wallace definitions of remission off drugs.Methods.In a retrospective study, charts of patients with chronic form of primary (idiopathic) arthritis followed from our center since 1970 were reviewed and clinical/laboratory variables were collected for further analysis.Results.The cohort included 761 eligible patients [516 (67.8%) female, 245 (32.2%) male] with JIA. Mean disease onset age (± standard deviation) was 6.25 ± 4.4 years (range 0.5–15.9). Disease mean duration to last visit was 10.02 ± 4.31 years. Followup mean period was 7.6 ± 6.4 years (range 1.5–35 yrs). A total of 247 (32.46%) patients achieved remission according to criteria [persistent oligoarthritis 153 (42.9%); extended oligoarthritis 15 (13.1%); seronegative polyarthritis 21 (22.4%); systemic arthritis 33 (33.7%); enthesitis related arthritis (ERA) plus juvenile psoriatic arthritis (JPsA) 25 (33.4%)]. No patients with seropositive polyarthritis achieved remission status (p < 0.001). In remitted patients the mean survival function (± standard error of the mean) before relapse calculated by Kaplan-Meier was of 20.9 (± 1.3) months overall: 21.7 (± 0.46) in persistent oligoarthritis, 25.0 (± 6.6) in extended oligoarthritis, 26.7 (± 13.2) in seronegative polyarthritis, and 17.6 (± 2.44) in ERA+JPsA (p > 0.1).Conclusion.In our cohort about one-third of cases obtained a remission episode in 4 decades of observation, with a significant difference between oligoarthritis and other categories (p < 0.001) using the Kaplan-Meier method; the remission status duration before a relapse has been about 20 months, without a significant difference between JIA categories.

scholarly journals AB0732 JUVENILE IDIOPATHIC ARTHRITIS IN ADULTHOOD

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1396.2-1396
Author(s):  
N. Ben Chekaya ◽  
S. Bouden ◽  
A. Ben Tekaya ◽  
O. Ben Saidane ◽  
R. Tekaya ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Disease Activity ◽  
Rheumatoid Factor ◽  
Joint Destruction ◽  
Disease Onset ◽  
Failure To Thrive ◽  
Overweight And Obesity ◽  
Physical Growth ◽  
The Mean ◽  
Active Disease

Background:Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of unknown aetiology in childhood. Approximately 40- 60% of patients with juvenile idiopathic arthritis (JIA) have continuous or recurrent disease activity extending into adulthood.Objectives:The aim of this study was to evaluate the clinical, biological and radiological course of JIA in adulthood.Methods:A retrospective study including 35 patients was conducted between 2010 and 2019. The patients enrolled met the ILAR criteria for the diagnosis of JIA. Patients with JIA older than 20 years were included. Data regarding sociodemographic features, Physical growth, disease activity, biological and radiological parameters were analysed.Results:Thirty one patients were recruited. The sex ratio was 0.53. The mean age at the time of the study was 38.9 years [20-69]. The mean age of the disease onset was 9 years [3-16]. These patients were assigned to discrete JIA categories: rheumatoid factor positive polyarthritis (47.7%), rheumatoid factor negative polyarthritis (23.9%), oligoarthritis (14.2%), enthesitis-related arthritis (9.5%), and psoriatic arthritis (4.7%).A failure to thrive was seen in 33.3% of patients. Overweight and obesity were found in 38% and 19% of patients, respectively. Biological inflammatory syndrome was noted in 52% of patients, and 65.2% had active disease. Hip involvement was noted in 43.5% of patients and 17.4% of them had a total hip replacement. Sixteen patients had neck pain and the imagining showed an atloid-axoid dislocation in 50% of them. Radiographs showed a joint destruction in 60.9% of patients and a wrist arthritis was the most frequent involvement.Conclusion:Most of our included patients maintain active disease and have functional impairment in adulthood.Disclosure of Interests:None declared

P017 Complications of Juvenile Idiopathic Arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
S Miladi ◽  
S Bouzid ◽  
A Fazaa ◽  
L Souabni ◽  
M Sellami ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Adverse Effects ◽  
Disease Onset ◽  
Clinical Signs ◽  
Membranous Glomerulonephritis ◽  
Cross Sectional Study ◽  
Chronic Inflammatory Disease ◽  
Cross Sectional ◽  
Renal Manifestation ◽  
The Mean

Abstract Background Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease characterized by onset before the age of 16. This term encompasses several disease categories, each of which has distinct methods of presentation, clinical signs, and prognosis. The study aimed to determine JIA complications in 51 patients. Methods A cross-sectional study including patients diagnosed with JIA according to ILAR criteria was conducted for 26 years [1995– 2021]. Epidemiological, clinical, therapeutic, and evolutive aspects were noted. Results Twenty-nine males and 22 females were included. The mean age of the disease onset was 7.6 years [1,5–16]. The mean age of patients at the time of the study was 23.29 years [9–45]. Polyarticular and seronegative form was the most frequent (34.5%). Other subtypes diagnosed were systemic (25%), enthesitis-related arthritis (21.2%), oligoarticular (12.5%), and seropositive polyarticular (5.8%). Standard X-Ray imaging showed articular damage in 50% of the cases. Hip arthritis was observed in 32% and surgery was needed in 16.9%. One patient presented with atlantoaxial subluxation. Growth retardation was noted in 28.6%. Cardiac manifestations were seen in 3 patients (pericarditis = 2, myocarditis = 1), uveitis in 3 cases, renal manifestation (extra membranous glomerulonephritis) in one patient with polyarticular form. One patient was diagnosed with multiple sclerosis. Small doses of corticosteroids were prescribed in 71.7%. Methotrexate was prescribed in 70.5% (interrupted for adverse effects in 3 patients), sulfasalazine in 30.6%, hydroxychloroquine in 5.7%, leflunomide in 15.4%. bDMARDs were needed in 16 patients: 14 patients received TNF alpha inhibitors, rituximab was prescribed for one patient with a polyarticular form, and tocilizumab in a patient with a systemic form. A switch of bDMARDs was conducted in 10 patients: for inefficiency in 4 cases and adverse effects in other 4 cases. Three patients developed uveitis under Etanercept, septicemia under Adalimumab, an allergic reaction, and depression under Infliximab. One patient died from a convulsive seizure at the age of 9. Conclusion The presence of complications is an additional burden to JIA patients. A multidisciplinary approach is required for the management of these complications.

scholarly journals Persistence of biologic treatments in psoriatic arthritis: a population-based study in Sweden

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Kirk Geale ◽  
Ingrid Lindberg ◽  
Emma C Paulsson ◽  
E Christina M Wennerström ◽  
Anna Tjärnlund ◽  
...  
Keyword(s):  
Risk Factors ◽  
Real World ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Reference Group ◽  
Treatment Plan ◽  
Disease Onset ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Biologic Treatment

Abstract Objectives TNF inhibitors (TNFis) and IL inhibitors are effective treatments for PsA. Treatment non-persistence (drug survival, discontinuation) is a measure of effectiveness, tolerability and patient satisfaction or preferences in real-world clinical practice. Persistence on these treatments is not well understood in European PsA populations. The aim of this study was to compare time to non-persistence for either ustekinumab (IL-12/23 inhibitor) or secukinumab (IL-17 inhibitor) to a reference group of adalimumab (TNFi) treatment exposures in PsA patients and identify risk factors for non-persistence. Methods A total of 4649 exposures of adalimumab, ustekinumab, and secukinumab in 3918 PsA patients were identified in Swedish longitudinal population-based registry data. Kaplan–Meier curves were constructed to measure treatment-specific real-world risk of non-persistence and adjusted Cox proportional hazards models were estimated to identify risk factors associated with non-persistence. Results Ustekinumab was associated with a lower risk of non-persistence relative to adalimumab in biologic-naïve [hazard ratio (HR) 0.48 (95% CI 0.33, 0.69)] and biologic-experienced patients [HR 0.65 (95% CI 0.56, 0.76)], while secukinumab was associated with a lower risk in biologic-naïve patients [HR 0.65 (95% CI 0.49, 0.86)] but a higher risk of non-persistence in biologic-experienced patients [HR 1.20 (95% CI 1.03, 1.40)]. Biologic non-persistence was also associated with female sex, axial involvement, recent disease onset, biologic treatment experience and no psoriasis. Conclusion Ustekinumab exhibits a favourable treatment persistency profile relative to adalimumab overall and across lines of treatment. The performance of secukinumab is dependent on biologic experience. Persistence and risk factors for non-persistence should be accounted for when determining an optimal treatment plan for patients.

HLA-B27 Predicts a More Chronic Disease Course in an 8-year Followup Cohort of Patients with Juvenile Idiopathic Arthritis

2013 ◽  
Vol 40 (5) ◽  
pp. 725-731 ◽  
Author(s):  
Lillemor Berntson ◽  
Ellen Nordal ◽  
Kristiina Aalto ◽  
Suvi Peltoniemi ◽  
Troels Herlin ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Age At Onset ◽  
Disease Onset ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Population Based ◽  
Hla B27 ◽  
Disease Characteristics ◽  
Serological Data ◽  
Longterm Outcome

Objective.We investigated associations of HLA-B27 with clinical manifestations and longterm outcome in a near population-based setting among patients with juvenile idiopathic arthritis (JIA).Methods.We studied clinical and serological data from 410 patients with HLA-B27 results among 440 prospectively collected patients with JIA with 8-year followup data in a Nordic database. The study was structured to be as close to a population-based study as possible.Results.HLA-B27 was analyzed in 93% of patients, and was positive in 21% of the cohort, in 18.4% of the girls and in 25.9% of the boys. Boys who were HLA-B27-positive had significantly higher age at onset compared to HLA-B27-negative boys and compared to both HLA-B27-negative and positive girls. This difference in onset age in relation to HLA-B27 was not found in girls. HLA-B27 was associated with clinical signs of sacroiliitis, enthesitis, and tenosynovitis in boys, but not in girls. After 8 years of disease, 46 children (11.2%) were classified as having enthesitis-related arthritis (ERA). Boys with ERA had clinical signs of sacroiliitis more often than girls with ERA. HLA-B27-positive children, as well as children with clinical signs of sacroiliitis, enthesitis, and hip arthritis, had higher odds of not being in remission off medication after 8 years of disease.Conclusion.In this near population-based Nordic JIA cohort we found significant differences between HLA-B27-positive boys and girls in age at disease onset, clinical signs of sacroiliitis, and ERA classification. HLA-B27 was negatively associated with longterm remission status, possibly because of its association with clinical disease characteristics, such as sacroiliitis, rather than being a general marker of persistent disease.

scholarly journals Complement lectin pathway protein levels reflect disease activity in juvenile idiopathic arthritis: a longitudinal study of the Nordic JIA cohort

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Mia Glerup ◽  
◽  
Steffen Thiel ◽  
Veronika Rypdal ◽  
Ellen Dalen Arnstad ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Disease Activity ◽  
Disease Onset ◽  
Serum Levels ◽  
Population Based ◽  
Lectin Pathway ◽  
Protein Levels ◽  
Markers Of Inflammation ◽  
Remission Status

Abstract Background To determine the serum levels of the lectin pathway proteins early in the disease course and 17 years after disease onset and to correlate the protein levels to markers of disease activity in participants from a population-based Nordic juvenile idiopathic arthritis (JIA) cohort. Additionally, to assess the predictive value of lectin pathway proteins with respect to remission status. Methods A population-based cohort study of consecutive cases of JIA with a disease onset from 1997 to 2000 from defined geographical areas of Finland, Sweden, Norway and Denmark with 17 years of follow-up was performed. Clinical characteristics were registered and H-ficolin, M-ficolin, MASP-1, MASP-3, MBL and CL-K1 levels in serum were analyzed. Results In total, 293 patients with JIA were included (mean age 23.7 ± 4.4 years; mean follow-up 17.2 ± 1.7 years). Concentrations of the lectin protein levels in serum were higher at baseline compared to the levels 17 years after disease onset (p ≤ 0.006, n = 164). At baseline, the highest level of M-ficolin was observed in systemic JIA. Further, high M-ficolin levels at baseline and at 17-year follow-up were correlated to high levels of ESR. In contrast, high MASP-1 and MASP-3 tended to correlate to low ESR. CL-K1 showed a negative correlation to JADAS71 at baseline. None of the protein levels had prognostic abilities for remission status 17 years after disease onset. Conclusion We hypothesize that increased serum M-ficolin levels are associated with higher disease activity in JIA and further, the results indicate that MASP-1, MASP-3 and CL-K1 are markers of inflammation.

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