Is it time to re-think juvenile-onset Rheumatic and Musculoskeletal Diseases? – First steps towards individualised treatments to meet agreed targets

McCann, Liza; Hedrich, Christian M.

doi:10.1016/j.clim.2020.108647

Cited by 2 publications

(3 citation statements)

References 96 publications

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“…Personalised medicine (ie, choosing the right drug for the right patient at the right time) has historically been described as the holy grail of medical research, with increasing interest in this approach for paediatric rheumatic diseases. 6 Unsurprisingly, several of the general and disease-specific research priorities relate to aspects of personalised medicine, including predicting disease course (ie, flares, remission, and treatment response) for individual patients, identification of the best treatment for each individual patient, and the effects of genetics and environmental factors on the development and course of paediatric rheumatic diseases. Several personalised medicine initiatives are already [7][8][9] with increased focus in this area called for by several funders and charities.…”

Section: Discussionmentioning

confidence: 99%

Research priority setting for paediatric rheumatology in the UK

Smith¹,

Egbivwie²,

Cowan³

et al. 2022

The Lancet Rheumatology

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Section: Discussionmentioning

confidence: 99%

Research priority setting for paediatric rheumatology in the UK

Smith¹,

Egbivwie²,

Cowan³

et al. 2022

The Lancet Rheumatology

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“…Although the pathomechanisms of those diseases have not been fully understood, genetic, environmental, and immune-related mechanisms are believed to contribute to the pathogenesis. JRDs are originally associated mainly with arthritis, but the possibility of systemic involvement varies depending on the type of disease [ 6 , 60 ].…”

Section: Vitamin D: Chemistry Metabolism Optimal Serum Concentration ...mentioning

confidence: 99%

“…Management protocols for JRDs are disease-specific, and many therapies rely on classical or biological disease-modifying antirheumatic drugs (DMARDs). Given the chronic nature of those conditions, which affect children’s present and future health, managing JRDs typically involves long-term treatment strategies that require regular monitoring of therapeutic outcomes, advantages, and potential adverse reactions [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Can vitamin D be an adjuvant therapy for juvenile rheumatic diseases?

et al. 2023

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Vitamin D, known for its essential role in calcium and bone homeostasis, has multiple effects beyond the skeleton, including regulation of immunity and modulation of autoimmune processes. Several reports have shown suboptimal serum 25 hydroxyvitamin D [25(OH)D] levels in people with different inflammatory and autoimmune rheumatic conditions, and an association between 25(OH)D levels, disease activity and outcomes. Although most available data pertain to adults, insights often are extended to children. Juvenile rheumatic diseases (JRDs) are a significant health problem during growth because of their complex pathogenesis, chronic nature, multisystemic involvement, and long-term consequences. So far, there is no definitive or clear evidence to confirm the preventive or therapeutic effect of vitamin D supplementation in JRDs, because results from randomized controlled trials (RCTs) have produced inconsistent outcomes. This review aims to explore and discuss the potential role of vitamin D in treating selected JRDs. Medline/PubMed, EMBASE, and Scopus were comprehensively searched in June 2023 for any study on vitamin D supplementary role in treating the most common JRDs. We used the following keywords: “vitamin D” combined with the terms “juvenile idiopathic arthritis”, “juvenile systemic scleroderma”, “juvenile systemic lupus erythematosus”, “juvenile inflammatory myopathies”, “Behcet disease”, “periodic fever syndromes” and “juvenile rheumatic diseases”. Observational studies have found that serum 25(OH)D concentrations are lower in juvenile idiopathic arthritis, juvenile systemic lupus erythematosus, juvenile systemic scleroderma, Behcet disease and proinflammatory cytokine concentrations are higher. This suggests that vitamin D supplementation might be beneficial, however, current data are insufficient to confirm definitively the complementary role of vitamin D in the treatment of JRDs. Considering the high prevalence of vitamin D deficiency worldwide, children and adolescents should be encouraged to supplement vitamin D according to current recommendations. More interventional studies, especially well-designed RCTs, assessing the dose–response effect and adjuvant effect in specific diseases, are needed to determine the potential significance of vitamin D in JRDs treatment.

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Is it time to re-think juvenile-onset Rheumatic and Musculoskeletal Diseases? – First steps towards individualised treatments to meet agreed targets

Cited by 2 publications

References 96 publications

Research priority setting for paediatric rheumatology in the UK

Research priority setting for paediatric rheumatology in the UK

Can vitamin D be an adjuvant therapy for juvenile rheumatic diseases?

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