Remission status follow-up in children with juvenile idiopathic arthritis

Fernandes, Taciana A. P.; Corrente, José Eduardo; Magalhães, Cláudia Saad

doi:10.2223/jped.1601

Cited by 6 publications

(8 citation statements)

References 21 publications

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“…Fernandes et al [28] reviewed 108 patients with JIA who had a minimum follow-up of 1 year (median follow-up, 4.6 years) from 1986 to 2005. A total of 53% (57 of 108) of patients had a total of 71 episodes of ID, of which 51% (36 of 71) achieved CR.…”

Section: Recent Studies Using Preliminary Remission Criteriamentioning

confidence: 99%

Remission in Juvenile Idiopathic Arthritis: Current Facts

Shenoi

Wallace

2010

Curr Rheumatol Rep

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Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory arthritic disease affecting children. Despite the availability of potent disease-modifying antirheumatic medications, most children still experience a chronic course with long periods of active disease. Goals of treatment should include achievement of disease remission with optimal physical functioning that allows children to lead normal lives with no structural joint damage. The term remission implies a complete lack of disease activity. This article focuses on recently developed preliminary criteria for inactive disease and remission in JIA. Recent studies using these new definitions demonstrate only modest rates of achievement of remission favoring children with persistent oligoarticular JIA. Children with rheumatoid factor-positive polyarticular JIA are least likely to achieve remission. Therapeutic strategies to achieve remission are also discussed.

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Section: Recent Studies Using Preliminary Remission Criteriamentioning

confidence: 99%

Remission in Juvenile Idiopathic Arthritis: Current Facts

Shenoi

Wallace

2010

Curr Rheumatol Rep

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“…Afeta crianças de ambos os sexos antes dos 16 anos, e a remissão completa só é vista em 75% dos pacientes [1][2][3] . O cuidado de uma criança com AIJ geralmente repousa sobre familiares, que acabam sendo submetidos a dois tipos diferentes de sobrecarga emocional: o estresse objetivo e o subjetivo 4 .…”

Section: Introductionunclassified

Evaluation of psychological stress in primary caregivers

et al. 2008

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ResumoObjetivo: Avaliar o estresse psicológico do cuidador do paciente pediátrico com artrite idiopática juvenil (AIJ). Métodos:Estudo observacional analítico transversal não controlado de 40 cuidadores de pacientes com AIJ, que foram avaliados pelo questionário Caregiver Burden Scale. Esta escala analisa cinco domínios do estresse: tensão geral, isolamento, decepção, envolvimento emocional e estresse causado por barreiras impostas pelo meio ambiente, graduando-os de 1 a 4. Os dados obtidos foram submetidos a análise estatística.Resultados: Os cuidadores de pacientes com AIJ são principalmente do sexo feminino (87,5%), casados (92,1%) e com parentesco direto com o paciente (90%). O grau de estresse é maior nos cuidadores de pacientes com AIJ forma poliarticular (p = 0,006), nos solteiros (p = 0,019) e naqueles do sexo feminino (p = 0,017). A dimensão analisada na qual se observou maior nível de estresse foi a de dificuldades relacionadas com o meio ambiente. Conclusão:Mulheres casadas e com parentesco direto com o paciente são os maiores cuidadores do paciente de AIJ. Cuidado com pacientes de forma poliarticular causa mais estresse do que o de pacientes de forma oligoarticular. Barreiras impostas pelo meio ambiente são responsáveis pelo maior índice de estresse nestes cuidadores. Artigo submetido em 05.04.07, aceito em 11.07.07. J Pediatr (Rio J)

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“…A uniform definition of remission in certain subtypes of JIA for use in clinical trials has been developed and preliminarily validated (8, 9). Retrospective cohort studies of JIA using these criteria have shown that remission is achieved in 26–40% of patients (10–14). These studies also showed that remission rates differed among JIA subtypes.…”

Section: Introductionmentioning

confidence: 99%

Do patients with juvenile idiopathic arthritis in clinical remission have evidence of persistent inflammation on 3T magnetic resonance imaging?

Brown

Hirsch

Laor

et al. 2012

Arthritis Care & Research

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Objective Up to 90% of adults with rheumatoid arthritis (RA) in clinical remission have persistent synovitis and/or bone marrow lesions (BMLs) on magnetic resonance imaging (MRI). MRI findings in patients with juvenile idiopathic arthritis (JIA) in clinical remission have not been described. We utilized 3T MRI with contrast enhancement to examine JIA patients with hand and/or wrist involvement who were in clinical remission and compared them with a cohort of adult RA patients. Methods In total, 11 JIA patients and 10 RA patients with arthritis involving the hands and/or wrists were identified by their primary rheumatologist as being in physician-defined clinical remission, having no signs or symptoms of active arthritis and no medication changes for at least 6 months. A study rheumatologist performed a joint evaluation for tenderness, swelling, and limitation of motion, and study participants self-reported tender joint counts. The participants underwent MRI with intravenous contrast enhancement of 1 hand and wrist with a history of prior symptoms. A pediatric musculoskeletal radiologist blinded to the clinical data scored the MRIs for synovitis, tenosynovitis, and/or BMLs. Results Sixty-three percent of the JIA cohort and 70% of the RA cohort had MRI findings of synovitis, BMLs, and/or tenosynovitis. All pediatric patients with MRI abnormalities had normal physician tender and swollen joint counts. The patients’ self-report of painful joint counts did not predict MRI abnormalities. Conclusion Over one-half of the patients in clinical remission had MRI evidence of persistent inflammation, defined as the presence of synovitis, tenosynovitis, or BMLs. A substantial portion of patients with JIA may have subclinical disease despite clinical remission.

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Remission status follow-up in children with juvenile idiopathic arthritis

Cited by 6 publications

References 21 publications

Remission in Juvenile Idiopathic Arthritis: Current Facts

Remission in Juvenile Idiopathic Arthritis: Current Facts

Evaluation of psychological stress in primary caregivers

Do patients with juvenile idiopathic arthritis in clinical remission have evidence of persistent inflammation on 3T magnetic resonance imaging?

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