201
|
Ruperto N, Lovell D, Kingsbury D, Burgos-Vargas R, Imagawa T, Horneff G, Quartier P, Goodman S, Reiff A, Giannini E, Cardoso A, Anderson J, Varothai N, Kalabic J, Martini A. FRI0502 Long-Term Safety of Adalimumab Treatment in Pediatric Patients with Polyarticular Juvenile Idiopathic Arthritis and Enthesitis-Related Arthritis:. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
202
|
Horneff G, Huppertz H, Haas P, Tenbrock K, Minden K. OP0064 Drug Survival and Reasons for Discontinuation of Biological Therapy in 1679 Polyarticular Juvenile Idiopathic Arthritis Patients:. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2082] [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]
|
203
|
Peitz J, Becker I, Horneff G. FRI0495 What Might be the Factors for Staying in Remission in JIA? Data from the German Biker Registry:. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4534] [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]
|
204
|
Minden K, Klotsche J, Niewerth M, Zink A, Seipelt E, Haas JP, Ganser G, Horneff G. FRI0498 How Tolerable is Methotrexate in the Long-Term Use in Juvenile Idiopathic Arthritis (JIA)? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
205
|
Horneff G, Minden K, Huppertz H, Tenbrock K, Haas JP. SAT0491 Gender Specific Comorbidities in Juvenile Idiopathic Arthritis Patients: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1576] [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]
|
206
|
Niewerth M, Minden K, Klotsche J, Horneff G. [Therapy of juvenile idiopathic arthritis in early adulthood with biologics: transition from pediatric to adult care]. Z Rheumatol 2015; 73:532-40. [PMID: 25096586 DOI: 10.1007/s00393-014-1378-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The majority of patients with juvenile idiopathic arthritis (JIA) need specialized care when they enter adulthood. An increasing number of these patients take biologic disease modifying antirheumatic drugs (DMARDs) at the time of transition. The biologic register BiKeR provides information about the health status and healthcare situation of JIA patients during childhood and adolescence and with their entrance into adulthood these patients are systematically transferred to JuMBO, the follow-up register for young adults with JIA treated with biologics and nonbiologic DMARDs. OBJECTIVE The aim of this study was to investigate the healthcare situation of patients with JIA during transition from pediatric to adult care. METHODS The current analyses included patients who were successfully transferred from the BiKeR to JuMBO registers. The DMARD treatment and patient-reported outcome (i.e. disease activity, pain and functional ability) were assessed at the last documentation in BikeR and at the first as well as the last documentation in JuMBO. RESULTS During the transition period 1 in 10 JIA patients stopped DMARD therapy and 1 in 20 patients did not visit a physician for adults. Three-quarters of the adult JIA patients included in JuMBO (N = 811) reached adult rheumatology care. Adult rheumatologists usually continued therapy with biologics in these patients. Every second patient was still being treated with etanercept, 5 years after the start of the first treatment with biologics. Adult rheumatologists changed the biologic substance in every fourth patient, mainly because of treatment failure. In comparison to patients in regular adult rheumatology care, those who did not remain in specialized care had a higher discontinuation rate of biologics. Moreover, patients with sporadic use of medical care had a significantly poorer health status than those with a regular use of medical care at least every 6 months. CONCLUSION The data show that there is a need for improving healthcare during the period of transition from pediatric to adult rheumatology.
Collapse
|
207
|
Klotsche J, Niewerth M, Haas JP, Huppertz HI, Zink A, Horneff G, Minden K. Long-term safety of etanercept and adalimumab compared to methotrexate in patients with juvenile idiopathic arthritis (JIA). Ann Rheum Dis 2015; 75:855-61. [DOI: 10.1136/annrheumdis-annrheumdis-2014-206747] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 04/05/2015] [Indexed: 12/20/2022]
|
208
|
Minoia F, Davì S, Horne A, Bovis F, Demirkaya E, Akikusa J, Ayaz NA, Al-Mayouf SM, Barone P, Bica B, Bolt I, Breda L, De Cunto C, Enciso S, Gallizzi R, Griffin T, Hennon T, Horneff G, Jeng M, Kapovic AM, Lipton JM, Magni Manzoni S, Rumba-Rozenfelde I, Magalhaes CS, Sewairi WM, Stine KC, Vougiouka O, Weaver LK, Davidsone Z, De Inocencio J, Ioseliani M, Lattanzi B, Tezer H, Buoncompagni A, Picco P, Ruperto N, Martini A, Cron RQ, Ravelli A. Dissecting the Heterogeneity of Macrophage Activation Syndrome Complicating Systemic Juvenile Idiopathic Arthritis. J Rheumatol 2015; 42:994-1001. [DOI: 10.3899/jrheum.141261] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2015] [Indexed: 10/23/2022]
Abstract
Objective.To seek insights into the heterogeneity of macrophage activation syndrome (MAS) complicating systemic juvenile idiopathic arthritis (sJIA) through the analysis of a large patient sample collected in a multinational survey.Methods.International pediatric rheumatologists and hemato-oncologists entered their patient data, collected retrospectively, in a Web-based database. The demographic, clinical, laboratory, histopathologic, therapeutic, and outcome data were analyzed in relation to (1) geographic location of caring hospital, (2) subspecialty of attending physician, (3) demonstration of hemophagocytosis, and (4) severity of clinical course.Results.A total of 362 patients were included by 95 investigators from 33 countries. Demographic, clinical, laboratory, and histopathologic features were comparable among patients seen in diverse geographic areas or by different pediatric specialists. Patients seen in North America were given biologics more frequently. Patients entered by pediatric hemato-oncologists were treated more commonly with biologics and etoposide, whereas patients seen by pediatric rheumatologists more frequently received cyclosporine. Patients with demonstration of hemophagocytosis had shorter duration of sJIA at MAS onset, higher prevalence of hepatosplenomegaly, lower levels of platelets and fibrinogen, and were more frequently administered cyclosporine, intravenous immunoglobulin (IVIG), and etoposide. Patients with severe course were older, had longer duration of sJIA at MAS onset, had more full-blown clinical picture, and were more commonly given cyclosporine, IVIG, and etoposide.Conclusion.The clinical spectrum of MAS is comparable across patients seen in different geographic settings or by diverse pediatric subspecialists. There was a disparity in the therapeutic choices among physicians that underscores the need to establish uniform therapeutic protocols.
Collapse
|
209
|
Abstract
Treatment of systemic-onset juvenile idiopathic arthritis is challenging, but the availability of cytokine antagonists targeting interleukin-1 and interleukin-6 have markedly advanced the therapeutic options. In this review, we focus on the current experience with canakinumab, an interleukin-1 monoclonal human antibody for the treatment of systemic-onset juvenile idiopathic arthritis and describe its efficacy and safety. Canakinumab is an important, safe, and valid drug in the treatment of systemic-onset juvenile idiopathic arthritis.
Collapse
|
210
|
Nimmrich S, Horneff G. Incidence of herpes zoster infections in juvenile idiopathic arthritis patients. Rheumatol Int 2015; 35:465-70. [PMID: 25583050 DOI: 10.1007/s00296-014-3197-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 12/18/2014] [Indexed: 12/19/2022]
Abstract
The risk of herpes zoster among patients with juvenile idiopathic arthritis (JIA) exposed to biologics has not been evaluated. We determined incidence rates of herpes zoster among children with JIA in correlation with medication at time of occurrence and total drug exposure. The German biologics register database was used to identify patients with herpes zoster. Crude infection rates and incidence ratios (IRR) were compared to published rates. Demographics and overall exposure and particular exposure time to corticosteroids, immunosuppressive drugs and biologics were analyzed. The JIA cohort included 3,042 patients with 5,557.9 person-years of follow-up; 1,628 have used corticosteroids, 2,930 methotrexate and 1,685 etanercept. In total, 17 herpes zoster events have been documented [6/1,000 patients (3.5-9.0); 3.1/1,000 patient-years (1.9-4.9)]. Thus, the incidence rate in JIA patients was higher than expected [IRR 2.9 (1.8-4.5), p < 0.001]. In all patients, the event resolved completely. There were two complications, one patient developed intercostal neuralgia, and one had a recurrent herpes zoster. Compared to the healthy population, a significant higher IRR is observed in JIA patients who received a monotherapy with etanercept or in combination with steroids and methotrexate, but not in JIA patients exposed to methotrexate without biologics. In comparison with our control group of patients treated with methotrexate, the IRR was higher for exposure to etanercept monotherapy and combination of etanercept and corticosteroids irrespective of methotrexate use. A generally higher incidence rate in JIA patients treated with etanercept was observed. No serious or refractory manifestations occurred.
Collapse
|
211
|
Moorthy LN, Roy E, Kurra V, Peterson MGE, Hassett AL, Lehman TJA, Scott C, El-Ghoneimy D, Saad S, El Feky R, Al-Mayouf S, Dolezalova P, Malcova H, Herlin T, Nielsen S, Wulffraat N, van Royen A, Marks SD, Belot A, Brunner J, Huemer C, Foeldvari I, Horneff G, Saurenman T, Schroeder S, Pratsidou-Gertsi P, Trachana M, Uziel Y, Aggarwal A, Constantin T, Cimaz R, Giani T, Cantarini L, Falcini F, Manzoni SM, Ravelli A, Rigante D, Zulian F, Miyamae T, Yokota S, Sato J, Magalhaes CS, Len CA, Appenzeller S, Knupp SO, Rodrigues MC, Sztajnbok F, de Almeida RG, de Jesus AA, de Arruda Campos LM, Silva C, Lazar C, Susic G, Avcin T, Cuttica R, Burgos-Vargas R, Faugier E, Anton J, Modesto C, Vazquez L, Barillas L, Barinstein L, Sterba G, Maldonado I, Ozen S, Kasapcopur O, Demirkaya E, Benseler S. Health related quality of life measure in systemic pediatric rheumatic diseases and its translation to different languages: an international collaboration. Pediatr Rheumatol Online J 2014; 12:49. [PMID: 25705138 PMCID: PMC4334772 DOI: 10.1186/1546-0096-12-49] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 09/28/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Rheumatic diseases in children are associated with significant morbidity and poor health-related quality of life (HRQOL). There is no health-related quality of life (HRQOL) scale available specifically for children with less common rheumatic diseases. These diseases share several features with systemic lupus erythematosus (SLE) such as their chronic episodic nature, multi-systemic involvement, and the need for immunosuppressive medications. HRQOL scale developed for pediatric SLE will likely be applicable to children with systemic inflammatory diseases. FINDINGS We adapted Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY©) to Simple Measure of Impact of Illness in Youngsters (SMILY©-Illness) and had it reviewed by pediatric rheumatologists for its appropriateness and cultural suitability. We tested SMILY©-Illness in patients with inflammatory rheumatic diseases and then translated it into 28 languages. Nineteen children (79% female, n=15) and 17 parents participated. The mean age was 12±4 years, with median disease duration of 21 months (1-172 months). We translated SMILY©-Illness into the following 28 languages: Danish, Dutch, French (France), English (UK), German (Germany), German (Austria), German (Switzerland), Hebrew, Italian, Portuguese (Brazil), Slovene, Spanish (USA and Puerto Rico), Spanish (Spain), Spanish (Argentina), Spanish (Mexico), Spanish (Venezuela), Turkish, Afrikaans, Arabic (Saudi Arabia), Arabic (Egypt), Czech, Greek, Hindi, Hungarian, Japanese, Romanian, Serbian and Xhosa. CONCLUSION SMILY©-Illness is a brief, easy to administer and score HRQOL scale for children with systemic rheumatic diseases. It is suitable for use across different age groups and literacy levels. SMILY©-Illness with its available translations may be used as useful adjuncts to clinical practice and research.
Collapse
|
212
|
Schmeling H, Minden K, Foeldvari I, Ganser G, Hospach T, Horneff G. Efficacy and safety of adalimumab as the first and second biologic agent in juvenile idiopathic arthritis: the German Biologics JIA Registry. Arthritis Rheumatol 2014; 66:2580-9. [PMID: 24942886 DOI: 10.1002/art.38741] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 06/03/2014] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of adalimumab in patients with juvenile idiopathic arthritis (JIA). METHODS Baseline demographic and clinical characteristics and disease activity parameters were prospectively documented in the German Biologics JIA Registry. Efficacy was determined using the American College of Rheumatology (ACR) Pediatric (Pedi) response criteria and the Juvenile Arthritis Disease Activity Score based on a 10-joint count (JADAS-10). Safety assessments were based on adverse event reports from the responsible physician. RESULTS Two hundred eighty-nine patients with a total of 1,046 visits were identified (435.7 patient-years). A high proportion of patients demonstrated a significant response to treatment, with a marked decrease in the JADAS-10 score in both the biologics-naive group (which consisted of patients who had not received therapy with a biologic agent prior to initiation of adalimumab) and the biologic-switcher group (which consisted of patients who had been treated with a different biologic agent prior to initiation of adalimumab). The median JADAS-10 score at treatment start was significantly higher in the biologics-naive group than in the biologic-switcher group (12.9 versus 8.5; P = 0.00044), although the score in the biologics-naive group was lower over the course of adalimumab treatment. ACR Pedi 30, 50, 70, and 90 scores were achieved in 63.4%, 61.0%, 48.8%, and 34.2% of biologics-naive patients, respectively, at 6 months of treatment, while ACR Pedi 30, 50, 70, and 90 scores were achieved in 47.6%, 38.1%, 21.9%, and 15.2% of biologic-switcher patients, respectively. Forty-eight patients experienced 222 adverse events (50.9 per 100 patient-years). Eleven were reported as serious (2.5 per 100 patient-years). No malignancies were observed during adalimumab exposure. There were 16 uveitis flares in 11 patients. Treatment was discontinued in 58 patients for the following reasons: inefficacy 11.1%, adverse events 5.2%, remission 4.5%, patient request 11.8%, and other reasons 7.9%. CONCLUSION Adalimumab appears to be highly effective in children and adolescents with JIA who have been previously treated with biologic agents and in children and adolescents who switched biologic agents. The treatment is safe and its efficacy is similar to that of other biologic agents used to treat JIA. Few patients discontinued therapy due to intolerance or inefficacy.
Collapse
|
213
|
Windschall D, Müller T, Becker I, Horneff G. Safety and efficacy of etanercept in children with juvenile idiopathic arthritis below the age of 2 years. Rheumatol Int 2014; 35:613-8. [PMID: 25208527 DOI: 10.1007/s00296-014-3125-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 08/29/2014] [Indexed: 12/19/2022]
Abstract
Etanercept is approved for the treatment of patients with juvenile idiopathic arthritis (JIA) above the age of 2 years. Experience with younger children is limited. The aim of the present study was to evaluate the efficacy and safety of treatment with etanercept in children with JIA younger than 2 years. The prospective long-term observational BIKER registry documents baseline demographics, clinical characteristics, disease activity parameters and safety issues. Efficacy was determined using the PedACR response criteria, the JADAS-10 and the proposed criteria for inactive disease and remission after 3, 6, 12, 18 and 24 months. Safety assessments were based on adverse events (AE) and serious adverse events (SAEs) reports. Between January 2001 and June 2013, a total of 13 patients including four patients with systemic JIA (sJIA), four patients with extended oligoarthritis, one patient with persistent oligoarthritis and four patients with RF negative polyarthritis were treated with etanercept. Eleven patients with follow-up assessments were analysed in our study. Prior to etanercept, all patients have been exposed to methotrexate. At last observation, 6/11 patients reached a PedACR 70 response. Two patients with sJIA and 1 with nonsystemic JIA achieved inactive disease. Tolerability was good in most of the patients. Eight AE and one SAE occurred. One patient with sJIA was affected by Hodgkin's disease 18 months after discontinuation of etanercept. New onset uveitis occurred in two patients. Reasons for discontinuation were inefficacy in three (2 sJIA), intolerance in two, remission in three (2 sJIA) and the parents' request in one patient. Etanercept seems to improve JIA patients younger than 2 years including some of the patients with sJIA. Attention should be paid to the development of malignancies and autoimmune disorders.
Collapse
|
214
|
Van Dijkhuizen P, Pouw J, Scheuern A, Hügle B, Hardt S, Ganser G, Kümmerle-Deschner JB, Horneff G, Holzinger D, Ćalasan MB, Wulffraat N. Intolerance in oral versus subcutaneous administration of methotrexate in patients with juvenile idiopathic arthritis: a cross-sectional, observational study. Pediatr Rheumatol Online J 2014. [PMCID: PMC4190938 DOI: 10.1186/1546-0096-12-s1-p131] [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: 11/25/2022] Open
|
215
|
De Benedetti F, Ruperto N, Zuber Z, Cuttica R, Keltsev V, Xavier R, Calvo I, Nikishina I, Rubio N, Alekseeva E, Chasnyk V, Chavez J, Horneff G, Opoka-Winiarska V, Quartier P, Silva C, Silverman E, Spindler A, Keane C, Bharucha K, Wang J, Lovell D, Martini A, Brunner HI. Efficacy and safety of tocilizumab in patients with polyarticular juvenile idiopathic arthritis: 2-year data from the CHERISH study. Rheumatology (Oxford) 2014. [DOI: 10.1093/rheumatology/keu268.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
216
|
Vastert S, Boom V, Ravelli A, Martini A, Foster H, Wulffraat N, Anton J, Constantin T, Dolezalova P, Horneff G, Lahdenne P, Magnussen B, Minden K, Nistala K, Quartier P, Rumbla I, Ruperto N, Piccolo VR, Russo R, Uziel S, Wouters C. Share – Workpackage 5: evidence based recommendations for diagnosis and treatment of juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2014. [PMCID: PMC4191152 DOI: 10.1186/1546-0096-12-s1-p171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
217
|
Davì S, Minoia F, Horne A, Bovis F, Demirkaya E, Akikusa J, Ayaz NA, Barone P, Bica B, Bolt I, Breda L, Davidsone Z, De Cunto C, De Inocencio J, Enciso S, Gallizzi R, Griffin T, Hennon T, Horneff G, Ioseliani M, Jeng M, Kapovic AM, Lattanzi B, Lipton JM, Magni-Manzoni S, Nassif C, Rumba I, Magalhaes CS, Al-Mayouf S, Sewairi WM, Stine KC, Vougiouka O, Weaver L, Zletni MA, Ruperto N, Martini A, Cron RQ, Ravelli A. Dissecting the heterogeneity of macrophage activation syndrome. Pediatr Rheumatol Online J 2014. [PMCID: PMC4184269 DOI: 10.1186/1546-0096-12-s1-p54] [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
|
218
|
Horneff G, Foeldvari I, Ganser G, Thon A, Schmeling H. Methotrexate in oligoarticular persistent juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2014. [PMCID: PMC4190976 DOI: 10.1186/1546-0096-12-s1-p139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
219
|
Ruperto N, Lovell D, Quartier P, Ravelli A, Karunaratne M, Kalabic J, Cardoso A, Martini A, Horneff G. Treating to target of minimal disease activity and normal function in polyarticular juvenile idiopathic arthritis with adalimumab: analysis from a phase 3 clinical trial. Pediatr Rheumatol Online J 2014. [PMCID: PMC4184352 DOI: 10.1186/1546-0096-12-s1-p9] [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
|
220
|
Horneff G, Becker I. Serious infections in JIA patients upon MTX, TFN inhibitors and combinations. Pediatr Rheumatol Online J 2014. [PMCID: PMC4184128 DOI: 10.1186/1546-0096-12-s1-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: 11/10/2022] Open
|
221
|
De Benedetti F, Ruperto N, Espada G, Gerloni V, Flato B, Horneff G, Myones BL, Onel K, Frane J, Wang J, Lipman TH, Bharucha KN, Martini A. Catch-up growth during tocilizumab therapy for systemic juvenile idiopathic arthritis: 2-year data from a phase 3 clinical trial. Rheumatology (Oxford) 2014. [DOI: 10.1093/rheumatology/keu268.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
222
|
Albarouni M, Becker I, Horneff G. Predictors of response to methotrexate in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2014; 12:35. [PMID: 25143761 PMCID: PMC4138941 DOI: 10.1186/1546-0096-12-35] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Accepted: 08/02/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The response to methotrexate so far is unpredictable in patients with juvenile idiopathic arthritis. Thus such predictors have to be determined in a large patient cohort. METHODS Demographic, clinical, articular and laboratory variables of patients newly treated with methotrexate were analysed by bivariate and logistic regression analysis to identify predictors of response to methotrexate. Minimal response was defined by the American College of Rheumatology pediatric (PedACR) 30 and strong response by the PedACR 70 criteria. RESULTS The patient population consisted of 731 patients. At month 3, 77.4% and at month 12 83.1% of patients were responders according to the PedACR 30 criteria, while 43.1% and 65.9% of patients had a PedACR 70 response at month 3 and at month 12. Thus minimal response was frequently already reached at month 3 while strong response to MTX treatment took usually longer to achieve. In multivariate analysis the number of tender joints (p = 0.002), active joints (p < 0.001), concomitant use of NSAID (p = 0.027) and the parents evaluation of overall well-being (p < 0.001) were significant baseline parameters for minimal response at month 3, while at month 12 the determinants for reaching PedACR 70 were a disease duration < 1 year (p =0.001), a lower number of tender (p <0.001) but a higher number of active joints (p <0.001), a higher score of the parent's evaluation of child's pain (p =0.029), and the presence of morning stiffness (p =0.014). CONCLUSIONS Baseline parameters for minimal response after 3 months of treatment and strong response after 12 months of treatment could be identified. Beside parameters defining activity and severity of disease, the disease duration and the concomitant use of NSAID were influencing factors. Overall the model of prediction could support physicians in making treatment decisions.
Collapse
|
223
|
Horneff G. Moderne Behandlung der juvenilen idiopathischen Arthritis. Monatsschr Kinderheilkd 2014. [DOI: 10.1007/s00112-014-3101-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
224
|
Windschall D, Müller T, Becker I, Horneff G. Safety and efficacy of etanercept in children with the JIA categories extended oligoarthritis, enthesitis-related arthritis and psoriasis arthritis. Clin Rheumatol 2014; 34:61-9. [DOI: 10.1007/s10067-014-2744-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 06/25/2014] [Accepted: 07/07/2014] [Indexed: 12/19/2022]
|
225
|
Horneff G, Foeldvari I, Minden K, Tenbrock K, Huppertz H, Becker I. OP0186 Analysis of Uveitis Events in the BIOLOGICS in Pediatric Rheumatology (BIKER)-Registry: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|