51
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Varnier GC, Ferrari C, Consolaro A, Marafon D, Pilkington C, Maillard S, Jelusic Drazic M, Dalpra' S, Civino A, Martini A, Ravelli A. PReS-FINAL-2012: Introducing a new approach to clinical care of juvenile dermatomyositis: the juvenile dermatomyositis multidimensional assessment report. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044786 DOI: 10.1186/1546-0096-11-s2-p25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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52
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Verazza S, Consolaro A, Frisina A, Conti G, Rigante D, Robbiano C, Alpigiani MG, Ravelli A. PReS-FINAL-2098: Evaluation of the disease course of Italian children with juvenile idiopathic arthritis treated with etanercept: preliminary results in 313 patients. Pediatr Rheumatol Online J 2013. [PMCID: PMC4043510 DOI: 10.1186/1546-0096-11-s2-p110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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53
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Negro G, Consolaro A, Verazza S, Bracciolini G, Rosina S, Pignataro R, Civino A, Martini A, Ravelli A. PReS-FINAL-2143: Treat-to-target strategy in juvenile idiopathic arthritis: experience in 175 newly-diagnosed patients. Pediatr Rheumatol Online J 2013. [PMCID: PMC4043642 DOI: 10.1186/1546-0096-11-s2-p155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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54
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Schiappapietra B, Calandra S, Gallo MC, De Marco R, Muratore V, Lanni S, Consolaro A, Martini A, Ravelli A. PReS-FINAL-2028: ANA positivity and a younger age at onset, but not disease category, predict the risk of uveitis in italian children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2013. [PMCID: PMC4043884 DOI: 10.1186/1546-0096-11-s2-p41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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55
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Minoia F, Davì S, Horne A, Consolaro A, Rosina S, Davidsone Z, De Cunto C, De Inocencio J, Eisenstein E, Espada G, Fishbach M, Frosch M, Gallizzi R, Gamir ML, Griffin T, Grom A, Hennon T, Horneff G, Huasong Z, Ruperto N, Martini A, Cron RQ, Ravelli A. PReS-FINAL-2141: Clinical features, therapeutic interventions and outcome of 362 patients with macrophage activation syndrome enrolled in a multinational survey. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044446 DOI: 10.1186/1546-0096-11-s2-p153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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56
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Davì S, Minoia F, Horne AC, Demirkaya E, Ilowite N, Insalaco A, Ioseliani M, Jelusic-Drazic M, Kapovic MA, Kasapcopur O, Kone-Paut I, Lepore L, Li C, Magni-Manzoni S, Maritsi D, Mccurdy D, Merino R, Miettunen P, Ruperto N, Martini A, Cron RQ, Ravelli A. PReS-FINAL-2102: Comparison of sensitivity and specificity of MAS and HLH diagnostic guidelines in 362 children with MAS complicating systemic JIA. Pediatr Rheumatol Online J 2013. [PMCID: PMC4045123 DOI: 10.1186/1546-0096-11-s2-p114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
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57
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Giancane G, Pederzoli S, Norambuena X, Ioseliani M, Sato J, Gallo MC, Negro G, Ruperto N, Martini A, Ravelli A. PReS-FINAL-2345: Frequency of radiographic damage and progression in individual joints in children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044976 DOI: 10.1186/1546-0096-11-s2-p335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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58
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Consolaro A, Lanni S, Minoia F, Davì S, Dalprà S, Schiappapietra B, Muratore V, Martini A, Ravelli A. PReS-FINAL-2176: Declines in levels of disease activity and physical disability in children with juvenile idiopathic arthritis seen in standard clinical care over the last 25 years. Pediatr Rheumatol Online J 2013. [PMCID: PMC4042226 DOI: 10.1186/1546-0096-11-s2-o11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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59
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Sag E, Ravelli A, Batu ED, Tartaglione A, Khalil AS, Marks S, Ozen S. PReS-FINAL-2174: The performance of the new slicc criteria for the classification of sle in children. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044175 DOI: 10.1186/1546-0096-11-s2-o9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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60
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Ravelli A. PReS13-SPK-1332: Assessment of disease activity and damage in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044566 DOI: 10.1186/1546-0096-11-s2-i21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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61
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Marafon D, Consolaro A, Ferrari C, Dalprà S, Madeo A, Providenti A, Malattia C, Ruperto N, Civino A, Martini A, Ravelli A. PReS-FINAL-2011: Preliminary validation of a new hybrid measure of muscle strength for juvenile dermatomyositis. Pediatr Rheumatol Online J 2013. [PMCID: PMC4042387 DOI: 10.1186/1546-0096-11-s2-p24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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62
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Naselli A, Tibaldi J, Accogli A, Buoncompagni A, Viola S, Signa S, Picco P, Ravelli A, Martini A, Gattorno M. PW01-039 – Long-term efficacy of anakinra in SoJIA patients. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952229 DOI: 10.1186/1546-0096-11-s1-a92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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63
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Solari N, Palmisani E, Consolaro A, Pistorio A, Lanni S, Dalprà S, Schiappapietra B, Bracciolini G, Frisina A, Martini A, Ravelli A. OP0004 Predictors of achievement of inactive disease in children with juvenile idiopathic arthritis treated with etanercept. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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64
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Papadopoulou C, Kostik M, Böhm M, Nieto-Gonzalez JC, Gonzalez-Fernandez MI, Gallo MC, Calandra S, Consolaro A, Martini A, Ravelli A. SAT0451 Methotrexate Therapy may Prevent the Onset of Uveitis in Juvenile Idiopathic Arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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65
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Davì S, Lattanzi B, Demirkaya E, Rosina S, Novelli A, Ruperto N, Martini A, Cron R, Ravelli A. OP0135 Clinical and therapeutic features of 270 patients with macrophage activation syndrome enrolled in a multinational survey:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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66
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Ravelli A. SP0102 Toward new diagnostic criteria for macrophage activation syndrome in systemic juvenile idiopathic arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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67
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Bertamino M, Consolaro A, Magni-Manzoni S, Bracciolini G, Muratore V, Daniela T, Martini A, Ravelli A. AB1178 Comparison of the prevalence of proxy- or self-reported side effects of methotrexate administered orally, subcutaneously or intramuscularly in children with juvenile idiopathic arthritis:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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68
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Ferrari C, Consolaro A, Varnier G, Rao A, Lazarevic D, Demirkaya E, Kadel J, Civino A, Ruperto N, Martini A, Ravelli A. FRI0336 Comparison of construct validity of two functional ability measures in children with juvenile dermatomyositis:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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69
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Marafon D, Consolaro A, Ferrari C, Dalprà S, Madeo A, Providenti A, Malattia C, Ruperto N, Martini A, Ravelli A. SAT0455 Preliminary Validation of a New Hybrid Measure of Muscle Strength for Juvenile Dermatomyositis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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70
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Consolaro A, Verazza S, Lanni S, Gallo MC, Bracciolini G, Negro G, Frisina A, Ruperto N, Martini A, Ravelli A. SAT0447 Preliminary Definition of Cutoffs for High Disease Activity Based on Original and Simplified Jadas in Juvenile Idiopathic Arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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71
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Consolaro A, Bracciolini G, Frisina A, Ruperto N, Magni-Manzoni S, Malattia C, Pederzoli S, Solari N, Davì S, Martini A, Ravelli A. FRI0330 Development of cut-off values for high disease activity in juvenile idiopathic arthritis based on the juvenile arthritis disease activity score (JADAS):. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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72
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Ravelli A. SP0138 The Long Term Outcome of Juvenile Idiopathic Arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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73
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Lanni S, Bovis F, Demirkaya E, Galasso R, Ravelli A, Martini A, Ruperto N, Pistorio A. SAT0446 A Meta-Analysis to Assess the “Real” Placebo Effect in Juvenile Idiopathic Arthritis (JIA). Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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74
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Fidanci B, Ozen S, Acikel C, Fidanci K, Yildiz D, Basbozkurt G, Ravelli A, Demirkaya E. THU0473-HPR Living with childhood vasculitis; a qualitative study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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75
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Malattia C, Damasio MB, Basso C, Santoro M, Verri A, Pederzoli S, Mattiuz C, Viola S, Buoncompagni A, Madeo A, Mazzoni M, Rosendahl K, Lambot-Juhan K, Tanturri de Horatio L, Magnano GM, Ravelli A, Martini A. Novel automated system for magnetic resonance imaging quantification of the inflamed synovial membrane volume in patients with juvenile idiopathic arthritis. Arthritis Care Res (Hoboken) 2012; 64:1657-64. [DOI: 10.1002/acr.21739] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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76
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Malattia C, Consolaro A, Pederzoli S, Madeo A, Pistorio A, Mazzoni M, Mattiuz C, Magnano GM, Viola S, Buoncompagni A, Palmisani E, Hasija R, Ruperto N, Ravelli A, Martini A. MRI versus conventional measures of disease activity and structural damage in evaluating treatment efficacy in juvenile idiopathic arthritis. Ann Rheum Dis 2012; 72:363-8. [DOI: 10.1136/annrheumdis-2011-201049] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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77
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Minoli M, Angeli I, Ravelli A, Gigli F, Lodi F. Detection and quantification of 11-nor-Δ9-tetrahydrocannabinol-9-carboxylic acid in hair by GC/MS/MS in Negative Chemical Ionization mode (NCI) with a simple and rapid liquid/liquid extraction. Forensic Sci Int 2012; 218:49-52. [DOI: 10.1016/j.forsciint.2011.10.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 06/06/2011] [Indexed: 11/30/2022]
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78
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Ravelli A, Grom AA, Behrens EM, Cron RQ. Macrophage activation syndrome as part of systemic juvenile idiopathic arthritis: diagnosis, genetics, pathophysiology and treatment. Genes Immun 2012; 13:289-98. [PMID: 22418018 DOI: 10.1038/gene.2012.3] [Citation(s) in RCA: 265] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Macrophage activation syndrome (MAS) is a severe, frequently fatal complication of systemic juvenile idiopathic arthritis (sJIA) with features of hemophagocytosis leading to coagulopathy, pancytopenia, and liver and central nervous system dysfunction. MAS is overt in 10% of children with sJIA but occurs subclinically in another 30-40%. It is difficult to distinguish sJIA disease flare from MAS. Development of criteria for establishing MAS as part of sJIA are under way and will hopefully prove sensitive and specific. Mutations in cytolytic pathway genes are increasingly being recognized in children who develop MAS as part of sJIA. Identification of these mutations may someday assist in MAS diagnosis. Defects in cytolytic genes have provided murine models of MAS to study pathophysiology and treatment. Recently, the first mouse model of MAS not requiring infection but rather dependent on repeated stimulation through Toll-like receptors was reported. This provides a model of MAS that may more accurately reflect MAS pathology in the setting of autoinflammation or autoimmunity. This model confirms the importance of a balance between pro- and anti-inflammatory cytokines. There has been remarkable progress in the use of anti-pro-inflammatory cytokine therapy, particularly against interleukin-1, in the treatment of secondary forms of MAS, such as in sJIA.
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79
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Miettunen P, Pistorio A, Ravelli A, Oliveira S, Alessio M, Cuttica R, Mihaylova D, Espada G, Pasic S, Cortis E, Ozen S, Porras O, Sztajnbok F, Palmisani E, Martini A, Ruperto N. Therapeutic approaches for the treatment of new onset and flared juvenile systemic lupus erythematosus with active renal disease: an international multicenter PRINTO study. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194622 DOI: 10.1186/1546-0096-9-s1-p258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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80
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Demirkaya E, Ruperto N, Galasso R, Ravelli A, Palmisani E, Martini A, Pistorio A. A meta-analysis to estimate the “real” placebo effect in juvenile idiopathic arthritis (JIA) trials. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194549 DOI: 10.1186/1546-0096-9-s1-p192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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81
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Lazarevic D, Pistorio A, Miettunen P, Ravelli A, Malattia C, Pilkington C, Wulffraat N, Garay S, Hofer M, Quartier P, Dolezalova P, Penades IC, Ferriani V, Ganser G, Kasapcopur O, Melo-Gomes JA, Wierzbowska M, Martini A, Ruperto N. The PRINTO provisional definition of remission in juvenile dermatomyositis. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194551 DOI: 10.1186/1546-0096-9-s1-p194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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82
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Consolaro A, Filocamo G, Bertamino M, Palmisani E, Bracciolini G, Suffia C, Muratore V, Ruperto N, Martini A, Ravelli A. A new approach to defining inactive disease, minimal disease activity and parent- and child-acceptable symptom state in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194553 DOI: 10.1186/1546-0096-9-s1-p196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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83
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Bertamino M, Consolaro A, Lattanzi B, Magni-Manzoni S, Lanni S, Suffia C, Dalprà S, Rosina S, Martini A, Ravelli A. Children with juvenile idiopathic arthritis currently followed in a tertiary care setting have a better psychosocial well-being than healthy peers. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194417 DOI: 10.1186/1546-0096-9-s1-o22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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84
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Heijstek M, Ott de Bruin L, Borrow R, van der Klis F, Koné-Paut I, Fasth A, Minden K, Ravelli A, Abinun M, Pileggi G, Borte M, Bijl M, Wulffraat N. Vaccination in paediatric patients with auto-immune rheumatic diseases: A systemic literature review for the European League against Rheumatism evidence-based recommendations. Autoimmun Rev 2011; 11:112-22. [DOI: 10.1016/j.autrev.2011.08.010] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 08/22/2011] [Indexed: 01/11/2023]
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85
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Malattia C, Consolaro A, Pederzoli S, Damasio MB, Hasija R, Mazzoni M, Madeo A, Beltramo A, Viola S, Buoncompagni A, Mattiuz C, Ravelli A, Martini A. MRI and ultrasound versus conventional measures of disease activity and structural damage in evaluating treatment efficacy in JIA. Do these imaging techniques have an additional value? Pediatr Rheumatol Online J 2011. [PMCID: PMC3194706 DOI: 10.1186/1546-0096-9-s1-p48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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86
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Varnier GC, Consolaro A, Malattia C, Rao AP, Madeo A, Demirkaya E, Lazarevic D, Civino A, Martini A, Ravelli A. Development and initial validation of a new functional ability tool for juvenile dermatomyositis. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194721 DOI: 10.1186/1546-0096-9-s1-p61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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87
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Schiappapietra B, Consolaro A, Magni-Manzoni S, Solari N, Lanni S, Davì S, Pederzoli S, Bracciolini G, Martini A, Ravelli A. Agreement between objective and subjective definitions of inactive disease, remission and minimal disease activity in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194554 DOI: 10.1186/1546-0096-9-s1-p197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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88
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Ravelli A, Lattanzi B, Consolaro A, Martini A. Glucocorticoids in paediatric rheumatology. Clin Exp Rheumatol 2011; 29:S148-S152. [PMID: 22018202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 09/14/2011] [Indexed: 05/31/2023]
Abstract
Glucocorticoid (GC) drugs are the most potent anti-inflammatory agents available for the treatment of paediatric rheumatic diseases. These medications are used for the management of extra-articular features of systemic juvenile idiopathic arthritis and are the mainstay of therapy in children with juvenile systemic lupus erythematosus, juvenile dermatomyositis, and systemic vasculitis. The general objective of GC therapy is to limit the maximal dose and the exposure to the highest doses to what is needed to achieve disease control and, then, to gradually taper the dose until the minimum level sufficient to maintain disease quiescence over time is reached. High-dose intravenous 'pulse' methylprednisolone administration is sometimes chosen to treat the most severe or acute manifestations of systemic inflammatory diseases. The rationale that underlies this treatment modality is to achieve an immediate, profound anti-inflammatory effect and to lessen toxicity associated with long-term continuous therapy in moderate to high daily doses. Intra-articular corticosteroid (IAC) injection is a safe and rapidly effective treatment for synovitis in children with JIA. Triamcinolone hexacetonide is the optimal corticosteroid preparation. Local injection therapy is used most frequently to treat oligoarthritis, but the strategy of performing multiple IAC injections to induce disease remission, while simultaneously initiating therapy with second-line or biologic agents, has been proposed also for children with polyarticular JIA. Administration of GCs is associated with potentially deleterious adverse effects, some of which can be irreversible. This highlights the need of a judicious use of these medications and a careful monitoring of their toxicity.
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89
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Heijstek MW, Ott de Bruin LM, Bijl M, Borrow R, van der Klis F, Koné-Paut I, Fasth A, Minden K, Ravelli A, Abinun M, Pileggi GS, Borte M, Wulffraat NM. EULAR recommendations for vaccination in paediatric patients with rheumatic diseases. Ann Rheum Dis 2011; 70:1704-12. [PMID: 21813547 DOI: 10.1136/ard.2011.150193] [Citation(s) in RCA: 138] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Evidence-based recommendations for vaccination of paediatric patients with rheumatic diseases (PaedRD) were developed by following the EULAR standardised procedures for guideline development. The EULAR task force consisted of (paediatric) rheumatologists/immunologists, one expert in vaccine evaluation, one expert in public health and infectious disease control, and one epidemiologist. A systematic literature review was conducted in MEDLINE, EMBASE, and abstracts of the EULAR and American College of Rheumatology meetings of 2008/9. The level of evidence and strength of recommendation were based on customary scoring systems. Delphi voting was applied to assess the level of agreement between task force members. 107 papers and eight abstracts were used. The majority of papers considered seasonal influenza (41) or pneumococcal (23) vaccination. 26 studies were performed specifically in paediatric patients, and the majority in adult rheumatoid arthritis and systemic lupus erythematosus patients. Fifteen recommendations were developed with an overall agreement of 91.7%. More research is needed on the safety and immunogenicity of (live-attenuated) vaccination in PaedRD, particularly in those using biologicals, and the effect of vaccination on prevention of infections.
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Scott C, Meiorin S, Filocamo G, Lanni S, Valle M, Martinoli C, Martini A, Ravelli A. A reappraisal of intra-articular corticosteroid therapy in juvenile idiopathic arthritis. Clin Exp Rheumatol 2010; 28:774-781. [PMID: 20863449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Accepted: 04/22/2010] [Indexed: 05/29/2023]
Abstract
Intraarticular corticosteroid (IAC) injection is a safe and rapidly effective treatment for synovitis in children with juvenile idiopathic arthritis (JIA). This procedure can be performed in an ambulatory care setting using local anaesthesia, with or without conscious sedation. Younger children, or those candidate to multiple injections, require general anaesthesia. Triamcinolone hexacetonide is the optimal corticosteroid preparation. However, for smaller joints or joints that are not easy to assess clinically, use of a more soluble corticosteroid drug is advised. Imaging guidance may facilitate accurate placement of the needle within the joint space. Use of ultrasound for this purpose has gained increasing popularity in the recent years. IAC injections are used most frequently to treat oligoarthritis, but the strategy of performing multiple IAC injections to induce disease remission, while simultaneously initiating therapy with second-line or biologic agents, has been proposed also for children with polyarticular JIA. However, the current place of IAC therapy in the management of children with JIA is uncertain due to the lack of controlled studies. Furthermore, it is still unknown whether this therapy has a disease-modifying effect over the long-term. This review summarises the present information about the use of IAC therapy in children with JIA.
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Vilca I, Munitis PG, Pistorio A, Ravelli A, Buoncompagni A, Bica B, Campos L, Hafner R, Hofer M, Ozen S, Huemer C, Bae SC, Sztajnbok F, Arguedas O, Foeldvari I, Huppertz HI, Gamir ML, Magnusson B, Dressler F, Uziel Y, van Rossum MAJ, Hollingworth P, Cawkwell G, Martini A, Ruperto N. Predictors of poor response to methotrexate in polyarticular-course juvenile idiopathic arthritis: analysis of the PRINTO methotrexate trial. Ann Rheum Dis 2010; 69:1479-83. [DOI: 10.1136/ard.2009.120840] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ruperto N, Ozen S, Pistorio A, Dolezalova P, Brogan P, Cabral DA, Cuttica R, Khubchandani R, Lovell DJ, O'Neil KM, Quartier P, Ravelli A, Iusan SM, Filocamo G, Magalhaes CS, Unsal E, Oliveira S, Bracaglia C, Bagga A, Stanevicha V, Manzoni SM, Pratsidou P, Lepore L, Espada G, Paut IK, Zulian F, Barone P, Bircan Z, Maldonado MDR, Russo R, Vilca I, Tullus K, Cimaz R, Horneff G, Anton J, Garay S, Nielsen S, Barbano G, Martini A. EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part I: Overall methodology and clinical characterisation. Ann Rheum Dis 2010; 69:790-7. [DOI: 10.1136/ard.2009.116624] [Citation(s) in RCA: 146] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ravelli A. Zur Deutung und Benennung überzähliger Karpalelemente: (Bemerkungen zur Arbeit von E. de Cuveland, Fortschr. Röntgenstr. 84 [1955]:847). ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1212894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ravelli A. Appendixstumpf im Zökum. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1231816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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