Spondyloarthritis Research Consortium of Canada Scoring System for Sacroiliitis in Juvenile Spondyloarthritis/Enthesitis-related Arthritis: A Reliability, Validity, and Responsiveness Study

Panwar, Jyoti; Tse, Shirley M. L.; Lim, Lillian; Tolend, Mirkamal; Radhakrishnan, Shilpa; Salman, Muayad; Moineddin, Rahim; Doria, A.; Stimec, Jennifer

doi:10.3899/jrheum.180222

Cited by 19 publications

(10 citation statements)

References 25 publications

(24 reference statements)

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“…Synovial hypertrophy, a component of the score, changed significantly in 15 consecutive JIA patients who were treated for 12 months with DMARDs and/or TNF-α blockers (Hemke et al, 2013). The Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system for the assessment of sacroiliac joints has also been evaluated in juvenile spondyloarthritis; the standardized response mean calculated from paired MRI examinations before and after treatment (18/ 35 on biologic treatment) was moderate (Panwar et al, 2019). Moreover, a retrospective analysis of serial MRI scans of the sacroiliac joints in ERA patients, before and after initiation of TNF inhibitors, using again the SPARCC score, showed reduction of inflammation after treatment, but progression of structural damage (Bray et al, 2019).…”

Section: Imaging Biomarkers Of Response To Biologic Treatmentsmentioning

confidence: 99%

Biomarkers of Response to Biologic Therapy in Juvenile Idiopathic Arthritis

et al. 2021

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Background: Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory arthritis of childhood, characterized by various clinical phenotypes associated with variable prognosis. Significant progress has been achieved with the use of biologic treatments, which specifically block pro-inflammatory molecules involved in the disease pathogenesis. The most commonly used biologics in JIA are monoclonal antibodies and recombinant proteins targeting interleukins 1 (IL-1) and 6 (IL-6), and tumor necrosis factor α (TNF-α). Several biomarkers have been investigated in JIA.Aims: To assess the level of evidence available regarding the role of biomarkers in JIA related to guiding clinical and therapeutic decisions, providing disease prognostic information, facilitating disease activity monitoring and assessing biologic treatment response in JIA, as well as propose new strategies for biologic therapy-related biomarker use in JIA.Methods: We searched PubMed for relevant literature using predefined key words corresponding to several categories of biomarkers to assess their role in predicting and assessing biologic treatment response and clinical remission in JIA.Results: We reviewed serological, cellular, genetic, transcriptomic and imaging biomarkers, to identify candidates that are both well-established and widely used, as well as newly investigated in JIA on biologic therapy. We evaluated their role in management of JIA as well as identified the unmet needs for new biomarker discovery and better clinical applications.Conclusion: Although there are no ideal biomarkers in JIA, we identified serological biomarkers with potential clinical utility. We propose strategies of combining biomarkers of response to biologics in JIA, as well as routine implementation of clinically acceptable imaging biomarkers for improved disease assessment performance.

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Section: Imaging Biomarkers Of Response To Biologic Treatmentsmentioning

confidence: 99%

Biomarkers of Response to Biologic Therapy in Juvenile Idiopathic Arthritis

et al. 2021

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“…In adults, there are scoring systems, of which the Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system is most widely accepted. The early studies in children are promising and describe good feasibility and reliability of the SPARCC scoring systems; however, these are not yet widely used and some adaptations may be necessary [ 43 – 45 ] (Table 2 ). Developing reliable paediatric-specific definition for sacroiliitis is a difficult task currently undergoing active study [ 44 , 68 ].…”

Section: Paediatric-specific Items Per Jointmentioning

confidence: 99%

Imaging assessment of children presenting with suspected or known juvenile idiopathic arthritis: ESSR-ESPR points to consider

et al. 2020

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Juvenile idiopathic arthritis (JIA) is the most common paediatric rheumatic disease. It represents a group of heterogenous inflammatory disorders with unknown origin and is a diagnosis of exclusion in which imaging plays an important role. JIA is defined as arthritis of one or more joints that begins before the age of 16 years, persists for more than 6 weeks and is of unknown aetiology and pathophysiology. The clinical goal is early suppression of inflammation to prevent irreversible joint damage which has shifted the emphasis from detecting established joint damage to proactively detecting inflammatory change. This drives the need for imaging techniques that are more sensitive than conventional radiography in the evaluation of inflammatory processes as well as early osteochondral change. Physical examination has limited reliability, even if performed by an experienced clinician, emphasising the importance of imaging to aid in clinical decision-making. On behalf of the European Society of Musculoskeletal Radiology (ESSR) arthritis subcommittee and the European Society of Paediatric Radiology (ESPR) musculoskeletal imaging taskforce, based on literature review and/or expert opinion, we discuss paediatric-specific imaging characteristics of the most commonly involved, in literature best documented and clinically important joints in JIA, namely the temporomandibular joints (TMJs), spine, sacroiliac (SI) joints, wrists, hips and knees, followed by a clinically applicable point to consider for each joint. We will also touch upon controversies in the current literature that remain to be resolved with ongoing research. Key Points • Juvenile idiopathic arthritis (JIA) is the most common chronic paediatric rheumatic disease and, in JIA imaging, is increasingly important to aid in clinical decision-making. • Conventional radiographs have a lower sensitivity and specificity for detection of disease activity and early destructive change, as compared to MRI or ultrasound. Nonetheless, radiography remains important, particularly in narrowing the differential diagnosis and evaluating growth disturbances. • Mainly in peripheral joints, ultrasound can be helpful for assessment of inflammation and guiding joint injections. In JIA, MRI is the most validated technique. MRI should be considered as the modality of choice to assess the axial skeleton or where the clinical presentation overlaps with JIA.

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“…The SPARCC SIS and SSS have face validity and reliability for the assessment of the pediatric joint based on cross-sectional data [4,8,9]. One recent pilot study demonstrated high rater agreement in SIS change scores for a pair of radiologist raters assessing 15 juvenile spondyloarthritis subjects with two or more scans [9]. Due to patterns and variations of normal development [10], scoring of pediatric SIJ pathology is particularly challenging.…”

Section: (Continued From Previous Page)mentioning

confidence: 99%

Spondyloarthritis Research Consortium of Canada sacroiliac joint inflammation and structural scores: change score reliability and recalibration utility in children

et al. 2020

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Background: The SPARCC sacroiliac joint inflammation (SIS) and structural (SSS) scores are reliable measures to quantify abnormalities in the pediatric sacroiliac joint. We aimed to evaluate the utility of online calibration modules for the SIS and SSS and the reliability of their component change scores.Methods: Change score reliability of 6 raters was assessed by overall and pairwise intraclass correlation coefficients (ICCs) before and after the use of real-time iterative calibration (RETIC) modules for both the SIS and SSS comprised of 20 adult cases. Acceptable ICC for change scores was > 0.7 for SIS and > 0.5 for all SSS components. Sensitivity to change was assessed by the standardized response mean (SRM). Results: In scoring exercise 1, the SIS had acceptable reliability with a change score ICC of 0.80 and sclerosis was the only SSS lesion that met the acceptability threshold with a change score ICC of 0.52. After RETIC calibration, the SIS overall (ICC = 0.83) and mean pairwise (ICC = 0.83) change scores remained reliable with a large SRM (0.90). All SSS components except sclerosis met the overall and mean pairwise change score ICC acceptability thresholds-backfill: overall = 0.54, mean pairwise = 0.50; fat metaplasia: overall = 0.65, mean pairwise = 0.57; erosion: overall = 0.60, mean pairwise = 0.58; and ankylosis: overall = 0.96, mean pairwise = 0.96. The SSS RETIC module augmented the number of SSS components surpassing the acceptability threshold from 1 to 4. Sensitivity to change, as measured by the SRM, was large for erosion (0.96), moderate for backfill (0.55) and sclerosis (0.70), and small for fat metaplasia (0.36) and ankylosis (0.28).

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Spondyloarthritis Research Consortium of Canada Scoring System for Sacroiliitis in Juvenile Spondyloarthritis/Enthesitis-related Arthritis: A Reliability, Validity, and Responsiveness Study

Cited by 19 publications

References 25 publications

Biomarkers of Response to Biologic Therapy in Juvenile Idiopathic Arthritis

Biomarkers of Response to Biologic Therapy in Juvenile Idiopathic Arthritis

Imaging assessment of children presenting with suspected or known juvenile idiopathic arthritis: ESSR-ESPR points to consider

Spondyloarthritis Research Consortium of Canada sacroiliac joint inflammation and structural scores: change score reliability and recalibration utility in children

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