Early intra-articular corticosteroid injection is predictors of remission of juvenile idiopathic arthritis

Filosco, Federica; Giallongo, Alessandro; Leonardi, ﻿Salvatore; Tomaselli, Venera; Barone, Patrizia

doi:10.23736/s2724-5276.21.06343-6

Cited by 2 publications

(2 citation statements)

References 34 publications

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“…Treatment of JIA is adjusted according to the severity of the disease as combinations of non-steroidal anti-inflammatory drugs (NSAIDs), synthetic and/ or biological disease modifying anti-rheumatic drugs (DMARDs) ( 207 – 210 ). Intra-articular corticosteroid injections can also be used with great effectiveness ( 211 , 212 ). Systemic administration of corticosteroids can have a positive short-term effect, but its prolonged administration is associated with severe side effects such as osteoporosis, growth suppression or immunosuppression ( 213 – 215 ).…”

Section: Treatment and B Cell Targeted Therapies In Juvenile Idiopath...mentioning

confidence: 99%

B Cells on the Stage of Inflammation in Juvenile Idiopathic Arthritis: Leading or Supporting Actors in Disease Pathogenesis?

Moura

Fonseca

2022

Front. Med.

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Juvenile idiopathic arthritis (JIA) is a term that collectively refers to a group of chronic childhood arthritides, which together constitute the most common rheumatic condition in children. The International League of Associations for Rheumatology (ILAR) criteria define seven categories of JIA: oligoarticular, polyarticular rheumatoid factor (RF) negative (RF-), polyarticular RF positive (RF+), systemic, enthesitis-related arthritis, psoriatic arthritis, and undifferentiated arthritis. The ILAR classification includes persistent and extended oligoarthritis as subcategories of oligoarticular JIA, but not as distinct categories. JIA is characterized by a chronic inflammatory process affecting the synovia that begins before the age of 16 and persists at least 6 weeks. If not treated, JIA can cause significant disability and loss of quality of life. Treatment of JIA is adjusted according to the severity of the disease as combinations of non-steroidal anti-inflammatory drugs (NSAIDs), synthetic and/ or biological disease modifying anti-rheumatic drugs (DMARDs). Although the disease etiology is unknown, disturbances in innate and adaptive immune responses have been implicated in JIA development. B cells may have important roles in JIA pathogenesis through autoantibody production, antigen presentation, cytokine release and/ or T cell activation. The study of B cells has not been extensively explored in JIA, but evidence from the literature suggests that B cells might have indeed a relevant role in JIA pathophysiology. The detection of autoantibodies such as antinuclear antibodies (ANA), RF and anti-citrullinated protein antibodies (ACPA) in JIA patients supports a breakdown in B cell tolerance. Furthermore, alterations in B cell subpopulations have been documented in peripheral blood and synovial fluid from JIA patients. In fact, altered B cell homeostasis, B cell differentiation and B cell hyperactivity have been described in JIA. Of note, B cell depletion therapy with rituximab has been shown to be an effective and well-tolerated treatment in children with JIA, which further supports B cell intervention in disease development.

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Section: Treatment and B Cell Targeted Therapies In Juvenile Idiopath...mentioning

confidence: 99%

B Cells on the Stage of Inflammation in Juvenile Idiopathic Arthritis: Leading or Supporting Actors in Disease Pathogenesis?

Moura

Fonseca

2022

Front. Med.

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“…Although intra-articular injections are strongly recommended, their incidence in population studies is difficult to define, but appears to range between 20.7% and 48% [15,16]. An optimal age for the first intra-articular injection of corticosteroids has not been reported, although patients receiving their first injection before the age of 7 or as soon as symptoms appeared were in remission for longer [17,18]. This technique is considered safe and effective [19].…”

Section: Intra-articular Corticosteroid Injectionmentioning

confidence: 99%

Surgical Treatment of Juvenile Idiopathic Arthritis in the Era of Novel Drug Therapies

Klein

Barbier

Glorion

et al. 2023

JCM

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Juvenile idiopathic arthritis is the most common chronic rheumatic disease encountered in children under the age of sixteen and causes significant impairments in daily life. Over the last two decades, the introduction of new drug treatments (including disease-modifying antirheumatic drugs and biologics) has changed the course of this disease, thus reducing the indication for surgery. However, some patients fail to respond to drug therapy and thus require personalized surgical management, e.g., the local reduction of joint effusion or a synovial pannus (via intra-articular corticosteroid injections, synovectomy, or soft tissue release), and management of the sequelae of arthritis (such as growth disorders and joint degeneration). Here, we provide an overview of the surgical indications and outcomes of the following interventions: intra-articular corticosteroid injections, synovectomy, soft tissue release, surgery for growth disorders, and arthroplasty.

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Early intra-articular corticosteroid injection is predictors of remission of juvenile idiopathic arthritis

Cited by 2 publications

References 34 publications

B Cells on the Stage of Inflammation in Juvenile Idiopathic Arthritis: Leading or Supporting Actors in Disease Pathogenesis?

B Cells on the Stage of Inflammation in Juvenile Idiopathic Arthritis: Leading or Supporting Actors in Disease Pathogenesis?

Surgical Treatment of Juvenile Idiopathic Arthritis in the Era of Novel Drug Therapies

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