Intra-articular injection in patients with juvenile idiopathic arthritis: factors associated with a good response

Cunha, Ana Luiza Garcia; Silva, Vanessa Bugni Miotto e; Osaku, Fabiane Mitie; Niemxeski, Luísa Brasil; Furtado, Rita Nely Vilar; Natour, Jamil; Terreri, Maria Teresa

doi:10.1016/j.rbre.2016.01.001

Cited by 7 publications

(2 citation statements)

References 18 publications

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“…Studies have shown that more than half of the joints showed a good response to IACIs, and those with uveitis responded well to IACIs during the disease. Knees, wrists, and elbows were the most effective joints for IACIs ( 45 ).…”

Section: Methodsmentioning

confidence: 99%

Application of Intra-articular Corticosteroid Injection in Juvenile Idiopathic Arthritis

Zhang

Yang

2022

Front. Pediatr.

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Juvenile idiopathic arthritis (JIA) is one of the common rheumatic diseases in pediatrics. Persistent synovitis and joint pain cause reduced range of motion, deformity and gait interruption, which are important reasons for children's disability and a decline in their quality of life. Rheumatology experts have explored good treatment strategies, among which intra-articular corticosteroid injections (IACIs) targeting joints can greatly reduce these systemic adverse reactions while still obtaining local anti-inflammatory effects. Local inhibition of synovitis by the use of steroid hormones in a joint cavity can avoid or reduce adverse reactions of systemic therapy, prevent or treat leg length variance and joint contracture, solve Baker's cyst, improve tenosynovitis, promote physical therapy and rehabilitation, make gait change smoothly, relieve pain, and restore joint function. Given the importance of IACIs in treating JIA, this paper reviewed the case selection, drug injection, dose selection, current anesthesia and injection techniques, the efficacy, recurrence, and influencing factors of IACIs, the management of physiotherapy intervention post-injection, the application of ultrasound guidance and the safety and complications of IACIs in children with JIA. This study aims to guide the use of IACIs for the best approach throughout the review.

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Section: Methodsmentioning

confidence: 99%

Application of Intra-articular Corticosteroid Injection in Juvenile Idiopathic Arthritis

Zhang

Yang

2022

Front. Pediatr.

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“…The mainstay of JIA therapy includes a combination of non-steroidal anti-inflammatory drugs, diseasemodifying antirheumatic drugs (DMARDs), biological agents, systemic corticosteroids, intra-articular corticosteroid injections (IACS), and physiotherapy. 2,3 The IACS can significantly reduce pain, improve joint function, as well as promote the repair of bone deformity and bone growth. [3][4][5] Of the limited studies on JIA in Indonesia, most are descriptive, and to our knowledge, none have examined JIA patients who received IACS.…”

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confidence: 99%

Outcome predictors in patients with juvenile idiopathic arthritis receiving intraarticular corticosteroid therapy

Diwasasri

Sumadiono²,

Mulatsih³

2019

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Background Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children. It can continue into adulthood and cause severe joint damage, resulting in disability and decreased quality of life. Objective To determine the predictors of clinical outcomes in JIA patients receiving intra-articular corticosteroid injections (IACS). Methods We conducted a retrospective cohort study of children with JIA receiving IACS therapy in Dr. Sardjito General Hospital from 1 January 2012 to 31 December 2017 by reviewing data from medical records. The dependent variables were disabilities and early remission time. Independent variables included age at diagnosis, JIA subtype, duration of disease at first diagnosis, timing of IACS, exposure to oral systemic therapy, as well as anti-nuclear antibodies (ANA), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) test results. External variables were gender and nutritional status. Results Of 36 patients who received intraarticular corticosteroid injections, 28 (77.8%) experienced remission, and 16 (50%) experienced disabilities. Female subjects (OR 5.296; 95%CI 1.143 to 24.548; P=0.027) and subjects with ESR >26 mm/h (OR 2; 95%CI 1.259 to 3.170; P=0.043) were more likely to have disabilities. Use of oral corticosteroids for ≤3 months and IACS treatment ≤ 3 months after diagnosis were predictors of early remission time (OR 6.897; 95%CI 1.869 to 25 and OR 3.290; 95%CI 1.195 to 9.091, respectively). However, only oral corticosteroid had a significant correlation in multivariate analysis. Conclusion Female gender and ESR > 26 mm/h predict disabilities in JIA patients receiving IACS. Duration of oral corticosteroid ≤3 months and early IACS within 3 months of diagnosis correlate to earlier remission time. Shorter duration of oral corticosteroid is the only significant predictor for earlier remission time in JIA patients receiving IACS therapy.

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Identification of potential peripheral blood diagnostic biomarkers for patients with juvenile idiopathic arthritis by bioinformatics analysis

Xue

Chen

et al. 2016

Rheumatol Int

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Juvenile idiopathic arthritis (JIA) is common childhood rheumatic disease harming children health. However, there is still lack of effective biomarkers for diagnosis JIA at early onset. We aim to construct a classification model to predict JIA disease. The peripheral blood gene expression profile data of JIA were downloaded from GEO database. We compared and analyzed differentially expressed genes (DEGs) between different JIA samples through Pearson's correlation coefficient method and unsupervised clustering analysis. Diagnostic model were constructed based on the deviation pathway through bioinformatics method. Eighteen specific correlated DEGs were obtained, but the correlations altered in different disease states. Although most JIA and control samples were clustered by unsupervised clustering analysis, respectively, a few JIA samples could not be clustered well. Four co-expression networks were next constructed with gene connections dynamically altered under variable conditions. Eight signaling pathways were significantly enriched including B/T cell receptor, ErbB and MAPK signaling pathways. The deviation scores of pathways were calculated. Applying these eight signaling pathways as feature to construct a classification model could predict JIA disease with high accuracies. Our data provide some light into pathogenic mechanism of JIA, the specific gene sets and the related signaling pathways may be potential biomarkers for diagnosis or therapeutic targets of JIA.

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Intra-articular injection in patients with juvenile idiopathic arthritis: factors associated with a good response

Abstract: In our study, more than half of the joints showed a good response to IIC. Younger patients at diagnosis and uveitis during the course of the disease had good response to IIC. Knees, wrists and elbows were the joints that best responded to IIC. IIC proved to be a safe procedure.

Cited by 7 publications

References 18 publications

Application of Intra-articular Corticosteroid Injection in Juvenile Idiopathic Arthritis

Application of Intra-articular Corticosteroid Injection in Juvenile Idiopathic Arthritis

Outcome predictors in patients with juvenile idiopathic arthritis receiving intraarticular corticosteroid therapy

Identification of potential peripheral blood diagnostic biomarkers for patients with juvenile idiopathic arthritis by bioinformatics analysis

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