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Liu WY, Li HM, Jiang H, Zhang WK. Effect of exercise training on heath, quality of life, exercise capacity in juvenile idiopathic arthritis: a meta-analysis of randomized controlled trials. Pediatr Rheumatol Online J 2024; 22:33. [PMID: 38438855 PMCID: PMC10910763 DOI: 10.1186/s12969-024-00967-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVE Little is known about the efficacy and safety of exercise training on juvenile idiopathic arthritis (JIA). This study aims to investigate the effect of exercise on health, quality of life, and different exercise capacities in individuals with JIA. METHOD A comprehensive search of Medline, Embase, Web of Science, and the Cochrane Library was conducted from database inception to October, 2023. Included studies were randomized controlled trials (RCTs) reporting the effects of exercise on JIA patients. Two independent reviewers assessed the literature quality using the Cochrane Collaboration's risk of bias tool. Standardized mean differences (SMD) were combined using random or fixed effects models. The level of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULT Five RCTs met the inclusion criteria, containing 216 female participants and 90 males. The meta-analysis results showed that exercise had no significant effect on JIA patients based on the Child Health Assessment Questionnaire (CHAQ) (SMD=-0.32, 95%CI: -0.83, 0.19; I2 = 73.2%, P = 0.011) and Quality of Life (QoL) (SMD = 0.27, 95%CI: -0.04, 0.58; I2 = 29.4%, P = 0.243) and no significant effect on peak oxygen uptake (VO2peak). However, exercise significantly reduced visual analog scale (VAS) pain scores in JIA patients (SMD = 0.50, 95%CI: -0.90, -0.10; I2 = 50.2%, P = 0.134). The quality of evidence assessed by GRADE was moderate to very low. CONCLUSION Exercise does not significantly affect the quality of life and exercise capacity in JIA patients but may relieve pain. More RCTs are needed in the future to explore the effects of exercise on JIA.
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Affiliation(s)
- Wen-Yu Liu
- Weifang Institute of Technology, Weifang, Shandong, China
- Dongshin University, Rojo, South Jeolla, South Korea
| | - Hui-Min Li
- Yantai Gold College, Yantai, Shandong, China
| | - Hao Jiang
- Weifang Institute of Technology, Weifang, Shandong, China
| | - Wen-Kui Zhang
- Dongshin University, Rojo, South Jeolla, South Korea.
- Universiti Malaysia Sarawak, East Malaysian Borneo, Sarawak, Malaysia.
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Polat MC, Çelikel E, Tekin ZE, Güngörer V, Kurt T, Tekgöz N, Sezer M, Karagöl C, Coşkun S, Kaplan MM, Öner N, Acar BÇ. Assessment of quality of life and physical activity in patients with oligoarticular juvenile idiopathic arthritis in remission. Eur J Pediatr 2024; 183:955-964. [PMID: 38071637 DOI: 10.1007/s00431-023-05367-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/22/2023] [Accepted: 12/03/2023] [Indexed: 03/05/2024]
Abstract
The purpose of this study was to evaluate physical activity (PA) and health-related quality of life (HRQOL) in children with oligoarticular juvenile idiopathic arthritis (JIA) in remission in comparison with healthy peers and to determine the disease-related factors affecting PA levels. This study was conducted with 50 oligoarticular JIA patients in remission and 50 healthy peers between 9 and 14 years. Demographic and clinical characteristics, laboratory parameters, and treatments were noted from electronic medical records. HRQOL was assessed with the Pediatric Quality of Life Inventory (PedsQL). PA was evaluated with the Physical Activity Questionnaire for Children (PAQ-C). Oligoarticular JIA patients had significantly lower self-reported median PedsQL scores in the domains of school functioning and social functioning compared to the control group (67.5 (10) vs. 75 (25), p = 0.001 and 70 (15) vs. 85 (26.3), p < 0.001, respectively). The median PAQ-C score was 2.6 (1.1) in patients with JIA and 3 (0.9) in their healthy peers (p = 0.02). The PAQ-C score was 2.8 (1.2) in patients < 8 years at the disease onset and 2.3 (1) in those aged ≥ 8 years (p = 0.022). There was no significant difference in the number of affected joints, type of affected joint, MTX and biologic agent treatment, and remission with or without drugs with the total score of the PedsQL and PAQ-C. All PedsQL domains were positively correlated with the PAQ-C. Conclusion: Oligoarticular JIA patients demonstrated lower PA and HRQOL scores compared to healthy controls despite favorable disease control. What is Known: • Oligoarticular JIA has fewer functional limitations and disabilities compared to other JIA subtypes. • As JIA can affect all aspects of a child's life, there is a need to improve the quality of life related to the disease. What is New: • It should be considered that patients with oligoarticular JIA may show lower PA and HRQOL scores compared to healthy controls despite favorable disease control. • Since there may be a relationship between PA and HRQOL, factors that may affect PA should be investigated to provide a holistic approach to JIA treatment.
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Affiliation(s)
- Merve Cansu Polat
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
| | - Elif Çelikel
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Zahide Ekici Tekin
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Vildan Güngörer
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Tuba Kurt
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Nilüfer Tekgöz
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Müge Sezer
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Cüneyt Karagöl
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Serkan Coşkun
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Melike Mehveş Kaplan
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Nimet Öner
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Banu Çelikel Acar
- Department of Pediatric Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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Oliveira Ramos F, Rodrigues AM, Melo AT, Aguiar F, Brites L, Azevedo S, Duarte AC, Gomes JAM, Furtado C, Mourão AF, Sequeira G, Cunha I, Figueira R, Santos MJ, Fonseca JE. Influence of the timing of biological treatment initiation on Juvenile Idiopathic Arthritis long-term outcomes. Arthritis Res Ther 2023; 25:177. [PMID: 37735435 PMCID: PMC10512498 DOI: 10.1186/s13075-023-03166-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) treatment is aimed at inducing remission to prevent joint destruction and disability. However, it is unclear what is the long-term impact on health-related outcomes of the timing of biological disease-modifying antirheumatic drug (bDMARD) initiation in JIA. Our aim was to evaluate the long-term impact of the time between JIA onset and the initiation of a bDMARD in achieving clinical remission, on physical disability and health-related quality of life (HRQoL). METHODS Adult JIA patients registered in the Rheumatic Diseases Portuguese Register (Reuma.pt) and ever treated with bDMARD were included. Data regarding socio-demographic, JIA-related characteristics, disease activity, physical disability (HAQ-DI), HRQoL (SF-36), and treatments were collected at the last visit. Patients were divided into 3 groups (≤ 2 years, 2-5 years, or > 5 years), according to the time from disease onset to bDMARD initiation. Regression models were obtained considering remission on/off medication, HAQ-DI, SF-36, and joint surgeries as outcomes and time from disease onset to bDMARD start as an independent variable. RESULTS Three hundred sixty-one adult JIA patients were evaluated, with a median disease duration of 20.3 years (IQR 12.1; 30.2). 40.4% had active disease, 35.1% were in remission on medication, and 24.4% were in drug-free remission; 71% reported some degree of physical disability. Starting a bDMARD > 5 years after disease onset decreased the chance of achieving remission off medication (OR 0.24; 95% CI 0.06, 0.92; p = 0.038). Patients who started a bDMARD after 5 years of disease onset had a higher HAQ and worse scores in the physical component, vitality, and social function domains of SF-36, and more joint surgeries when compared to an earlier start. CONCLUSION Later initiation of bDMARDs in JIA is associated with a greater physical disability, worse HRQoL, and lower chance of drug-free remission in adulthood.
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Affiliation(s)
- Filipa Oliveira Ramos
- Pediatric Rheumatology Unit, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.
- Unidade de Investigação Em ReumatologiaInstituto de Medicina Molecular, Lisbon, Portugal.
- Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Center, Lisbon, Portugal.
| | - Ana Maria Rodrigues
- Centre for Chronic Diseases (CEDOC), Nova Medical School, Lisbon, Portugal
- Comprehensive Health Research Centre, Nova Medical School, Lisbon, Portugal
| | - Ana Teresa Melo
- Pediatric Rheumatology Unit, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Unidade de Investigação Em ReumatologiaInstituto de Medicina Molecular, Lisbon, Portugal
| | - Francisca Aguiar
- Young Adult and Pediatric Rheumatology Unit, Centro Hospitalar Universitário São João, University of Medicine of Porto University, Porto, Portugal
| | - Luísa Brites
- Rheumatology Department, Centro Hospitalar E Universitário de Coimbra, Coimbra, Portugal
| | - Soraia Azevedo
- Rheumatology Department, Unidade Local de Saúde Do Alto Minho, Ponte de Lima, Portugal
| | | | | | - Carolina Furtado
- Rheumatology Department, Hospital Do Divino Espírito Santo, Ponta Delgada, Portugal
| | - Ana Filipa Mourão
- Centre for Chronic Diseases (CEDOC), Nova Medical School, Lisbon, Portugal
- Rheumatology Department, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Graça Sequeira
- Rheumatology Department, Centro Hospitalar Universitário Do Algarve, Faro Unit, Faro, Portugal
| | - Inês Cunha
- Rheumatoloy Department, Centro Hospitalar Do Baixo Vouga, Aveiro, Portugal
| | - Ricardo Figueira
- Rheumatoloy Department, Hospital Central Do Funchal, Funchal, Portugal
| | - Maria José Santos
- Unidade de Investigação Em ReumatologiaInstituto de Medicina Molecular, Lisbon, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Center, Lisbon, Portugal
- Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal
| | - João Eurico Fonseca
- Pediatric Rheumatology Unit, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Unidade de Investigação Em ReumatologiaInstituto de Medicina Molecular, Lisbon, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Center, Lisbon, Portugal
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Brandelli YN, Chambers CT, Mackinnon SP, Parker JA, Huber AM, Stinson JN, Wildeboer EM, Wilson JP, Piccolo O. A systematic review of the psychosocial factors associated with pain in children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2023; 21:57. [PMID: 37328738 DOI: 10.1186/s12969-023-00828-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/22/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Pain is one of the most frequently reported experiences amongst children with Juvenile Idiopathic Arthritis (JIA); however, the management of JIA pain remains challenging. As pain is a multidimensional experience that is influenced by biological, psychological, and social factors, the key to effective pain management lies in understanding these complex relationships. The objective of this study is to systematically review the literature on psychosocial factors of children with JIA and their caregivers 1) associated with and 2) predictive of later JIA pain intensity, frequency, and sensitivity in children 0-17 years of age. METHODS The Joanna Briggs Institute methodology for etiology and risk and Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement guided the conduct and reporting of this review. Terms related to pain and JIA were searched in English without date restrictions across various databases (PubMed, CINAHL, PsycINFO, Embase, Scopus, and the Cochrane Central Register of Controlled Trials) in September 2021. Two independent reviewers identified, extracted data from, and critically appraised the included studies. Conflicts were resolved via consensus. RESULTS Of the 9,929 unique studies identified, 61 were included in this review and reported on 516 associations. Results were heterogeneous, likely due to methodological differences and moderate study quality. Results identified predominantly significant associations between pain and primary and secondary appraisals (e.g., more child pain beliefs, lower parent/child self-efficacy, lower child social functioning), parent/child internalizing symptoms, and lower child well-being and health-related quality of life. Prognostically, studies had 1-to-60-month follow-up periods. Fewer beliefs of harm, disability, and no control were associated with lower pain at follow-up, whereas internalizing symptoms and lower well-being were predictive of higher pain at follow-up (bidirectional relationships were also identified). CONCLUSIONS Despite the heterogeneous results, this review highlights important associations between psychosocial factors and JIA pain. Clinically, this information supports an interdisciplinary approach to pain management, informs the role of psychosocial supports, and provides information to better optimize JIA pain assessments and interventions. It also identifies a need for high quality studies with larger samples and more complex and longitudinal analyses to understand factors that impact the pain experience in children with JIA. TRIAL REGISTRATION PROSPERO CRD42021266716.
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Affiliation(s)
- Yvonne N Brandelli
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada.
- Centre for Pediatric Pain Research, IWK Health Centre, 5859/5980 University Avenue, PO BOX 9700, Halifax, NS, B3K 6R8, Canada.
| | - Christine T Chambers
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, 5859/5980 University Avenue, PO BOX 9700, Halifax, NS, B3K 6R8, Canada
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Sean P Mackinnon
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Jennifer A Parker
- Centre for Pediatric Pain Research, IWK Health Centre, 5859/5980 University Avenue, PO BOX 9700, Halifax, NS, B3K 6R8, Canada
| | - Adam M Huber
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
- Division of Pediatric Rheumatology, IWK Health, Halifax, NS, Canada
| | - Jennifer N Stinson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
- Research Institute, Hospital for Sick Children, Toronto, ON, Canada
| | - Emily M Wildeboer
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, 5859/5980 University Avenue, PO BOX 9700, Halifax, NS, B3K 6R8, Canada
| | - Jennifer P Wilson
- Cassie and Friends: A Society for Children with Juvenile Arthritis and Other Rheumatic Diseases, Vancouver, BC, Canada
| | - Olivia Piccolo
- Centre for Pediatric Pain Research, IWK Health Centre, 5859/5980 University Avenue, PO BOX 9700, Halifax, NS, B3K 6R8, Canada
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5
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Zare N, Mansoubi M, Coe S, Najafi AA, Bailey K, Harrison K, Sheehan J, Dawes H, Barker K. An investigation into the relationship between nutritional status, dietary intake, symptoms and health-related quality of life in children and young people with juvenile idiopathic arthritis: a systematic review and meta-analysis. BMC Pediatr 2023; 23:3. [PMID: 36593466 PMCID: PMC9806873 DOI: 10.1186/s12887-022-03810-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 08/23/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The association between diet, symptoms and health related quality of life in children and young people with Juvenile idiopathic arthritis (JIA) is not clearly understood. The objectives of this systematic review and meta-analysis were to explore the evidence for a relationship between nutritional status, dietary intake, arthritis symptoms, disease activity and health-related quality of life in children and young people with JIA considering both observational and interventional studies separately. METHOD The databases PubMed, CINAHL, PsycINFO, Web of Science and Cochrane were searched in October 2019, updated in September 2020 and October 2021. Searches were restricted to English language, human and age (2-18 years old). Studies were included if they measured the effect of dietary supplements, vitamins or minerals, or diet in general, on quality of life and/ or arthritis symptom management. Two researchers independently screened titles and abstracts. Full texts were sourced for relevant articles. PRISMA guidelines were used for extracting data. For variables (vitamin D and disease activity), a random-effects meta-analysis model was performed. Two authors using a standardized data extraction form, extracted data independently. RESULTS 11,793 papers were identified through database searching, 26 studies met our inclusion criteria with 1621 participants. Overall studies quality were fair to good. Results from controlled trial and case control studies with total 146 JIA patients, found that Ɯ-3 PUFA improved the mean active joint count (p < 0.001), Juvenile Arthritis Disease Activity Score (JADAS-27) (p < 0.001) and immune system (≤ 0.05). Furthermore, n-3 and n-6 PUFAs have a negative correlation with CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate) (p < 0.05). Improvement in JIA symptoms were observed in one case, one pilot and one exploratory study with overall 9 JIA patients after receiving Exclusive Enteral Nutrition (EEN) which contains protein and what is required for a complete nutrition, A clinical trial study found Kre-Celazine nutrition (composed of a proprietary alkali buffered, creatine monohydrate and fatty acids mixture) in 16 JIA patients improved symptoms of JIA. No association was found between vitamin D and disease activity from three studies. Height and weight values in relation to healthy controls varied across studies (p = 0.029). CONCLUSIONS We were only able to include small studies, of lower design hierarchy, mainly pilot studies. We found some evidence of lower height and weight across studies in JIA, but were unable to confirm an association between diet, symptoms and health-related quality of life in children and young people with JIA. Well-designed, carefully measured and controlled interventional studies of dietary patterns in combination with important contributing factors such as medication and lifestyle behaviours, including physical activity, are required to determine the impact of diet in improving symptoms and growth patterns in children and young people with JIA, with an aim to improve the quality of their life. TRIAL REGISTRATION PROSPERO [CRD42019145587].
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Affiliation(s)
- Najmeh Zare
- Paediatric Nursing, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, United Kingdom.
| | - Maedeh Mansoubi
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Shelly Coe
- Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, United Kingdom
- Oxford Clinical Allied Technology and Trial Services Unit (OxCATTS), Oxford, United Kingdom
- Oxford Brookes Centre for Nutrition and Health, Oxford Brookes University, Oxford, United Kingdom
| | - Ali Aminalsharieh Najafi
- Health and Social Care, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Kathryn Bailey
- Consultant Paediatric Rheumatology, Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Kathryn Harrison
- Consultant Paediatric Rheumatology, Birmingham Women's and Children's NHS Foundation Trusts, Birmingham, United Kingdom
| | - Joanna Sheehan
- BSc Physiotherapy Clinical Specialist Physiotherapist in Paediatric Rheumatology, Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - Helen Dawes
- Professor Of Clinical Rehabilitation, College of Medicine and Health, University of Exeter, Exeter, United Kingdom
- NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Karen Barker
- Professor of Physiotherapy NDORMS, University of Oxford, Oxford, United Kingdom
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6
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Ziesenitz VC, Welzel T, van Dyk M, Saur P, Gorenflo M, van den Anker JN. Efficacy and Safety of NSAIDs in Infants: A Comprehensive Review of the Literature of the Past 20 Years. Paediatr Drugs 2022; 24:603-655. [PMID: 36053397 PMCID: PMC9592650 DOI: 10.1007/s40272-022-00514-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 11/29/2022]
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in infants, children, and adolescents worldwide; however, despite sufficient evidence of the beneficial effects of NSAIDs in children and adolescents, there is a lack of comprehensive data in infants. The present review summarizes the current knowledge on the safety and efficacy of various NSAIDs used in infants for which data are available, and includes ibuprofen, dexibuprofen, ketoprofen, flurbiprofen, naproxen, diclofenac, ketorolac, indomethacin, niflumic acid, meloxicam, celecoxib, parecoxib, rofecoxib, acetylsalicylic acid, and nimesulide. The efficacy of NSAIDs has been documented for a variety of conditions, such as fever and pain. NSAIDs are also the main pillars of anti-inflammatory treatment, such as in pediatric inflammatory rheumatic diseases. Limited data are available on the safety of most NSAIDs in infants. Adverse drug reactions may be renal, gastrointestinal, hematological, or immunologic. Since NSAIDs are among the most frequently used drugs in the pediatric population, safety and efficacy studies can be performed as part of normal clinical routine, even in young infants. Available data sources, such as (electronic) medical records, should be used for safety and efficacy analyses. On a larger scale, existing data sources, e.g. adverse drug reaction programs/networks, spontaneous national reporting systems, and electronic medical records should be assessed with child-specific methods in order to detect safety signals pertinent to certain pediatric age groups or disease entities. To improve the safety of NSAIDs in infants, treatment needs to be initiated with the lowest age-appropriate or weight-based dose. Duration of treatment and amount of drug used should be regularly evaluated and maximum dose limits and other recommendations by the manufacturer or expert committees should be followed. Treatment for non-chronic conditions such as fever and acute (postoperative) pain should be kept as short as possible. Patients with chronic conditions should be regularly monitored for possible adverse effects of NSAIDs.
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Affiliation(s)
- Victoria C. Ziesenitz
- grid.5253.10000 0001 0328 4908Pediatric Cardiology and Congenital Heart Diseases, Centre for Child and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany ,grid.6612.30000 0004 1937 0642Pediatric Pharmacology and Pharmacometrics, University Children’s Hospital Basel, University of Basel, Basel, Switzerland
| | - Tatjana Welzel
- grid.6612.30000 0004 1937 0642Pediatric Pharmacology and Pharmacometrics, University Children’s Hospital Basel, University of Basel, Basel, Switzerland ,grid.411544.10000 0001 0196 8249Pediatric Rheumatology and Autoinflammatory Reference Center, University Hospital Tuebingen, Tuebingen, Germany
| | - Madelé van Dyk
- grid.1014.40000 0004 0367 2697Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Adelaide, SA Australia
| | - Patrick Saur
- grid.5253.10000 0001 0328 4908Pediatric Cardiology and Congenital Heart Diseases, Centre for Child and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany
| | - Matthias Gorenflo
- grid.5253.10000 0001 0328 4908Pediatric Cardiology and Congenital Heart Diseases, Centre for Child and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany
| | - Johannes N. van den Anker
- grid.6612.30000 0004 1937 0642Pediatric Pharmacology and Pharmacometrics, University Children’s Hospital Basel, University of Basel, Basel, Switzerland ,grid.239560.b0000 0004 0482 1586Division of Clinical Pharmacology, Children’s National Hospital, Washington DC, USA ,grid.416135.40000 0004 0649 0805Intensive Care and Department of Pediatric Surgery, Sophia Children’s Hospital, Rotterdam, The Netherlands
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7
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Al-Mayouf SM, Al Mutairi M, Bouayed K, Habjoka S, Hadef D, Lotfy HM, Scott C, Sharif EM, Tahoun N. Epidemiology and demographics of juvenile idiopathic arthritis in Africa and Middle East. Pediatr Rheumatol Online J 2021; 19:166. [PMID: 34857004 PMCID: PMC8638433 DOI: 10.1186/s12969-021-00650-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/15/2021] [Indexed: 01/21/2023] Open
Abstract
Juvenile Idiopathic Arthritis (JIA) is a group of chronic heterogenous disorders that manifests as joint inflammation in patients aged <16 years. Globally, approximately 3 million children and young adults are suffering from JIA with prevalence rates consistently higher in girls. The region of Africa and Middle East constitute a diverse group of ethnicities, socioeconomic conditions, and climates which influence the prevalence of JIA. There are only a few studies published on epidemiology of JIA in the region. There is an evident paucity of adequate and latest data from the region. This review summarizes the available data on the prevalence of JIA and its subtypes in Africa and Middle East and discusses unmet needs for patients in this region. A total of 8 journal publications were identified concerning epidemiology and 42 articles describing JIA subtypes from Africa and Middle East were included. The prevalence of JIA in Africa and Middle East was observed to be towards the lower range of the global estimate. We observed that the most prevalent subtype in the region was oligoarticular arthritis. The incidence of uveitis and anti-nuclear antibody (ANA) positivity were found to be lower as compared to the incidence from other regions. There is a huge unmet medical need in the region for reliable epidemiological data, disease awareness, having regional and local treatment guidelines and timely diagnosis. Paucity of the pediatric rheumatologists and economic disparities also contribute to the challenges regarding the management of JIA.
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Affiliation(s)
- Sulaiman M Al-Mayouf
- Pediatric Rheumatology, King Faisal Specialist Hospital and Research Center College of Medicine, Alfaisal University, Po Box 3354, Riyadh, 11211, Saudi Arabia.
| | | | - Kenza Bouayed
- Department of Rheumatology and Pediatric Internal Medicine, University Hospital IBN Rochd, Casablanca, Morocco
| | - Sara Habjoka
- Pfizer Biopharmaceutical Group, Emerging Markets, Dubai, United Arab Emirates
| | - Djohra Hadef
- Department of Pediatrics, University Hospital Center of Batna Faculty of Medicine, Batna 2 University, Batna, Algeria
| | - Hala M Lotfy
- Professor of Pediatrics and Pediatric Rheumatology, Cairo University, Giza, Egypt
| | - Cristiaan Scott
- Division of Paediatric Rheumatology, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Elsadeg M Sharif
- Consultant Rheumatologist, Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates
| | - Nouran Tahoun
- Pfizer Biopharmaceutical Group, Emerging Markets, Cairo, Egypt
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8
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Abdelaleem EA, Ezzat DA, Mostafa GR. Functional disability and health-related quality of life in juvenile idiopathic arthritis children from Beni-Suef. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2021. [DOI: 10.1186/s43166-021-00060-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Juvenile idiopathic arthritis (JIA) is a common childhood disease which causes significant impairment in quality of life. The aim of the study is to assess the health-related quality of life and its relation to functional disability in JIA patients.
Child health assessment questionnaire (CHAQ) and pediatrics quality of life 4 generic core questionnaire (PedsQL) were used to evaluate functional disability and health-related quality of life.
Results
CHAQ (VAS) of JIA patients ranged from 0 to 9 with a mean of 3.64 ± 2.9 (SD), and of controls ranged from 0 to 4 with a mean of 1.32 ± 1.3 (SD) with a statistically significant difference and a p value of 0.001. CHAQ-disability index (DI) of the cases ranged from 0 to 3 with a mean of 1.06 ± 0.9 (SD) and of controls was consistent = 0. Pediatric quality of life (PedsQL) among cases ranged from 26.08 to 91.3 with a mean of 67.95 ± 19.2 (SD) and among controls ranged from 78.27 to 100 with a mean of 90.73 ± 7.7 (SD) showing statistically significant difference with a p value < 0.001.
Childhood health assessment questionnaire (CHAQ) scores were significantly higher among studied females with JIA as compared with males. The mean CHAQ-DI scores were 4.56 ± 2.7 vs. 1.29 ± 2.6 in females and males respectively with a significant p value of 0.002. The mean CHAQ-(VAS) scores were 1.38 ± 0.8 vs. 0.23 ± 0.3 in females and males respectively with a significant p value of 0.016. Pediatric quality of life (PedsQL) scores were significantly higher among studied males with JIA as compared with studied females. The childhood health assessment questionnaire (CHAQ) was negatively correlated with all (physical, emotional, social, and school) items of the pediatric quality of life (PedsQL) (p < 0.001).
Conclusion
We found a significant impairment in the functional ability and health-related quality of life in patients with JIA compared to healthy children, with more impairment in females than males. CHAQ was negatively correlated with all items of PedsQL.
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Wu HH, Wu FQ, Li Y, Lai JM, Su GX, Cui SH, Chen Z, Li H. The quality of life in Chinese juvenile idiopathic arthritis patients: psychometric properties of the pediatric quality of life inventor generic core scales and rheumatology module. Health Qual Life Outcomes 2021; 19:37. [PMID: 33516223 PMCID: PMC7847010 DOI: 10.1186/s12955-021-01683-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 01/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) may seriously affects patients' quality of life (QoL), but it was rarely focused and studied in China, so we explore JIA children's QoL using Chinese version of the PedsQL4.0 Generic Core and PedsQL3.0 Rheumatology Module scale, and analyzed the psychometric properties of these two Scales among Chinese JIA children. METHODS We recruited 180 JIA patients from Children's Hospital Affiliated to Capital Institute of Pediatrics and Hebei Yanda Hospital from July 2018 to August 2019. The questionnaires include information related on JIA, PedsQL4.0 generic core and PedsQL3.0 Rheumatology Module scales. According to the disease type, onset age of and course of JIA, we divided them into different groups, then compared the QoL status among different groups. Moreover, we analyzed the reliability and validity of these two scales in these 180 JIA children. RESULTS The mean score of PedsQL4.0 generic core scale on these 180 patients was 82.85 ± 14.82, for these in active period was 72.05 ± 15.29, in remission period was 89.77 ± 9.23; the QoL score of systemic, polyarticular and oligoarticular JIA patients were 77.05 ± 19.11, 84.33 ± 12.46 and 87.12 ± 10.23. The mean score of PedsQL3.0 Rheumatology Module scale on 180 patients was 91.22 ± 9.45, for these in active period was 84.70 ± 11.37, in remission period was 95.43 ± 4.48; the QoL score of systemic, polyarticular and oligoarticular JIA patients were 89.41 ± 11.54, 89.38 ± 10.08 and 93.71 ± 6.92. In the PedsQL 4.0 Generic Core scale, the α coefficients of total scale and almost every dimension are all greater than 0.8 except for the school activity dimension of 0.589; the correlation coefficients of 22 items' scores (total 23 items) with the scores of dimensions they belong to are greater than 0.5 (maximum value is 0.864), and the other one is 0.406. In PedsQL3.0 Rheumatology Module scale, except for the treatment and worry dimensions of 0.652 and 0.635, the α coefficients of other dimensions and the total scale are all greater than 0.7; the correlation coefficients of all items' score were greater than 0.5 (the maximum is 0.933, the minimum is 0.515). CONCLUSIONS The QoL of Chinese JIA children is worse than their healthy peers, these in active period and diagnosed as systemic type were undergoing worst quality of life. The reliability and validity of PedsQL 4.0 Generic Core and PedsQL3.0 Rheumatology Module scale in Chinese JIA children are satisfactory, and can be used in clinical and scientific researches.
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Affiliation(s)
- Hua-Hong Wu
- Department of Growth and Development, Capital Institute of Pediatrics, YaBao Road, ChaoYang District, Beijing, 100020, China
| | - Feng-Qi Wu
- Department of Rheumatism and Immunology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Yang Li
- Department of Growth and Development, Capital Institute of Pediatrics, YaBao Road, ChaoYang District, Beijing, 100020, China
| | - Jian-Ming Lai
- Department of Rheumatism and Immunology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | - Gai-Xiu Su
- Department of Rheumatism and Immunology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
| | | | - Zheng Chen
- Hebei Yanda Hospital, Yanjiao, Hebei, China
| | - Hui Li
- Department of Growth and Development, Capital Institute of Pediatrics, YaBao Road, ChaoYang District, Beijing, 100020, China.
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Juhl CB, Cagnotto G, Ahlström F, Bruschettini M, Petersson I, Dreyer L, Compagno M. TNF-alpha inhibitors for juvenile idiopathic arthritis. Hippokratia 2020. [DOI: 10.1002/14651858.cd013715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Carsten B Juhl
- SEARCH (Research group for synthesis of evidence and research), Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics; University of Southern Denmark; Odense M Denmark
| | - Giovanni Cagnotto
- Department of Clinical Sciences Malmö, Rheumatology; Lund University, Malmö, Skåne University Hospital; Lund Sweden
| | | | - Matteo Bruschettini
- Department of Clinical Sciences Lund, Paediatrics; Lund University, Skåne University Hospital; Lund Sweden
| | - Ingemar Petersson
- Institution for Clinical Sciences Lund; Lund University; Lund Sweden
| | - Lene Dreyer
- Department of Clinical Medicine; Aalborg University Hospital Reberbansgade; Aalborg Denmark
| | - Michele Compagno
- Department of Clinical Sciences Lund, Rheumatology; Lund University, Skane University Hospital; Lund Sweden
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Sleep and its relationship to health-related quality of life in children and adolescents with inactive juvenile idiopathic arthritis. EGYPTIAN RHEUMATOLOGIST 2018. [DOI: 10.1016/j.ejr.2017.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Modica RF, Lomax KG, Batzel P, Cassanas A. Impact of systemic juvenile idiopathic arthritis/Still's disease on adolescents as evidenced through social media posts. Open Access Rheumatol 2018; 10:73-81. [PMID: 29942167 PMCID: PMC6005297 DOI: 10.2147/oarrr.s165010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To understand the experience of adolescent systemic juvenile idiopathic arthritis (SJIA) patients and those of their parents based on their social media posts. Methods English language posts related to SJIA, Still’s disease, or juvenile arthritis were collected and analyzed. Results In total, 71 posts created between 2009 and 2015 on 15 websites were identified in November 2015. Of the 32 unique authors, 17 were SJIA patients aged 13–20 years (40 posts), 7 were mothers of SJIA patients (12 posts), and 8 patients had unspecified forms of juvenile arthritis (19 posts). Many patients posted about similar diagnostic experiences marked by 5 phases: 1) early prediagnosis: pain and fatigue overlooked until crisis occurred, 2) first misdiagnosis: doctors talked about “growing pains” and psychosocial problems (“fake pains” to avoid school), 3) second misdiagnosis: severity acknowledged, but diagnosed as leukemia or another cancer, 4) tests: tests leading to diagnosis and treatment conducted, and 5) cognitive identity: patient accepted the diagnosis and its implications. Many adolescent patients, looking back at disease onset in their childhood, described themselves as a “sleeping child” rather than the typical active child. Several patients tried to hide their illness from friends, but expressed concerns openly online. Many patients described SJIA as a powerful external enemy, using terms like “bulldozer,” “dragon,” and “monster.” Many posts from patients and their mothers used superhero language/imagery to help “fight” SJIA. Some patients also posted about the risk of death. Conclusion Although most adolescent SJIA patients openly posted about the difficulties of their disease online, they made efforts to hide their disease in the real world. They frequently used superhero words and images in describing their fight for better health. Physicians can use these insights when counseling SJIA patients to provide a narrative that meshes with the patients’ worldview and perhaps to improve physician–patient communication to increase treatment adherence.
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Affiliation(s)
- Renee F Modica
- Department of Pediatrics, University of Florida, Gainesville, FL, USA
| | - Kathleen G Lomax
- Immunology, Hepatology and Dermatology Medical Affairs, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
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Tollisen A, Selvaag AM, Aulie HA, Lilleby V, Aasland A, Lerdal A, Flatø B. Physical Functioning, Pain, and Health-Related Quality of Life in Adults With Juvenile Idiopathic Arthritis: A Longitudinal 30-Year Followup Study. Arthritis Care Res (Hoboken) 2018; 70:741-749. [PMID: 28732134 DOI: 10.1002/acr.23327] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 07/18/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To describe physical functioning, pain, and health-related quality of life (HRQoL) in adults with juvenile idiopathic arthritis (JIA), investigate changes over time, and identify predictors of poorer HRQoL after 30 years of disease. METHODS Patients (n = 176) clinically examined after 15 years were reassessed using the Health Assessment Questionnaire disability index (HAQ DI), the visual analog scale pain subscale (VAS pain), and the Medical Outcomes Study Short Form 36 (SF-36) after 23 years and 30 years. Patients with signs of active disease after a minimum of 15 years were clinically examined again at 30 years. Patients were compared to matched controls. RESULTS At the 30-year followup, 82 patients (47%) had HAQ DI scores >0, and the median VAS pain score in patients was 0.6 (range 0-10). Patients had lower SF-36 physical component summary (PCS) scores compared with controls (P < 0.001), and this was evident for patients both with and without clinical remission (P ≤ 0.01). No group differences were found in SF-36 mental component summary scores. Patients also scored worse than controls on all SF-36 subscales (P ≤ 0.01) except mental health. PCS scores worsened significantly between the 15- and 30-year followup time points (P = 0.001). Worse HAQ DI, VAS pain, and patient's global assessment of well-being scores, and receiving disability/social living allowance at 30 years, were correlated with lower PCS scores. Worse HAQ DI, patient's global assessment of well-being, and VAS fatigue scores at 15-year followup predicted lower PCS scores at 30-year followup. CONCLUSION JIA had a detrimental effect on physical HRQoL as measured by the PCS of the SF-36. The strongest correlates were physical disability, pain, fatigue, well-being, and receiving disability/social living allowance.
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Affiliation(s)
- Anita Tollisen
- Oslo University Hospital, Rikshospitalet, and Lovisenberg Diaconal Hospital, Oslo, Norway
| | | | - Hanne A Aulie
- Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Vibke Lilleby
- Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | | | - Anners Lerdal
- Lovisenberg Diaconal Hospital and Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Berit Flatø
- Oslo University Hospital, Rikshospitalet, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Fellas A, Singh-Grewal D, Chaitow J, Santos D, Coda A. Effectiveness of preformed foot orthoses in reducing lower limb pain, swollen and tender joints and in improving quality of life and gait parameters in children with juvenile idiopathic arthritis: a randomised controlled trial (Protocol). BMJ Paediatr Open 2017; 1:e000121. [PMID: 29637144 PMCID: PMC5862209 DOI: 10.1136/bmjpo-2017-000121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 10/31/2017] [Accepted: 11/07/2017] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Many children and adolescents with juvenile idiopathic arthritis experience lower limb problems which may lead to physical disabilities significantly impacting on their quality of life and symptoms. Emerging evidence has identified the effective role of podiatry in the management of juvenile idiopathic arthritis, suggesting the clinical benefit of different orthotic therapies. METHODS This study will be a parallel-group designed, multicentre, randomised controlled trial, aiming to recruit 66 children and adolescents with juvenile idiopathic arthritis aged between 5 and 18 years. Those recruited will need to be diagnosed according to the International League of Associations for Rheumatology criteria, and present with lower limb joint pain, swelling and/or tenderness. Participants will be recruited from three outpatient hospital clinics in New South Wales, Australia. Participants will be randomly allocated to receive a trial or control intervention. The trial group will be prescribed a customised preformed foot orthoses; instead, the control group will receive a flat 1 mm insole with no corrective modifications. Primary outcome measure recorded will be pain. Secondary outcomes will be quality of life, foot disability, swollen and tender joint count and gait parameters (such as plantar pressures, walking speed, stance and swing time). The allocated foot orthoses will be worn for 12 months, with data collected at baseline, 4 weeks, 3, 6 and 12 months intervals. Group allocation will be concealed and all analyses will be carried out on an intention to treat. DISCUSSION The purpose of this trial is to explore the efficacy of a cost-effective, non-invasive podiatric intervention that will be prescribed at the initial biomechanical consultation. This approach will promote early clinical intervention, which is the gold standard in paediatric rheumatology. Furthermore, this study has the potential to provide new evidence for the effectiveness of a mechanical intervention alone to reduce swollen and tender joints in juvenile idiopathic arthritis. TRIAL REGISTRATION NUMBER This clinical trial has been registered with the Australian New Zealand Clinical Trials Registry: ACTRN12616001082493p. Ethics for this randomised controlled trial has been approved (16/09/21/4.03).
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Affiliation(s)
- Antoni Fellas
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Davinder Singh-Grewal
- The Sydney Children's Hospital Network, Randwick and Westmead, Australia.,Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.,Discipline of Paediatrics, University of Western Sydney, Sydney, New South Wales, Australia
| | - Jeffrey Chaitow
- The Sydney Children's Hospital Network, Randwick and Westmead, Australia
| | - Derek Santos
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Andrea Coda
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
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15
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Angelis A, Kanavos P, López-Bastida J, Linertová R, Serrano-Aguilar P. Socioeconomic costs and health-related quality of life in juvenile idiopathic arthritis: a cost-of-illness study in the United Kingdom. BMC Musculoskelet Disord 2016; 17:321. [PMID: 27484740 PMCID: PMC4971720 DOI: 10.1186/s12891-016-1129-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 06/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) refers to a number of rare chronic inflammatory diseases. Although JIA imposes a significant societal burden, limited data are available on the cost of JIA. The study's objective is to quantify the socioeconomic burden of JIA patients in the United Kingdom (UK), along with their health-related quality of life (HRQoL). METHODS A bottom-up, cross-sectional, cost-of-illness analysis of 23 patients was carried out. To collect data on demographic characteristics, health resource utilization, informal care, productivity losses and HRQoL, questionnaires were administered to and completed by patients or their caregivers. The EuroQol five dimensions (EQ-5D) instrument was used to measure HRQoL. RESULTS This study found that the average annual cost for a JIA patient was €31,546, with direct health care costs equalling €14,509 (46.0 % of total costs), direct non-health care costs amounting to €8,323 (26.4 %) and productivity losses being €8,715 (27.6 %). This was calculated using unit costs for 2012. The largest expenditures on average were accounted for by early retirement (27.0 %), followed by informal care (24.1 %), medications (21.1 %), outpatient and primary health care visits (13.2 %) and diagnostic tests (7.9 %). Important differences existed between JIA patients in need of caregiver assistance and those with no need (€39,469 vs. €25,452 respectively). Among adult JIA patients, mean EQ-5D index scores and visual analogue scale (VAS) scores were found to be 0.26 and 49.00 respectively; the same scores among caregivers were 0.66 and 67.14 respectively. CONCLUSION JIA poses a significant cost burden on the UK society. Over half of the total average costs (54 %) are related to non-health care and productivity losses. HRQoL of JIA patients is considerably worse than the UK general population.
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Affiliation(s)
- Aris Angelis
- Medical Technology Research Group, LSE Health, London School of Economics and Political Science, London, UK.
| | - Panos Kanavos
- Medical Technology Research Group, LSE Health, London School of Economics and Political Science, London, UK
| | - Julio López-Bastida
- University of Catilla-La Mancha, Talavera de la Reina, Toledo, Spain.,Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - Renata Linertová
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain.,Canary Islands Foundation for Health and Research (FUNCANIS), Las Palmas de Gran Canaria, Spain
| | - Pedro Serrano-Aguilar
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain.,Evaluation and Planning Service at Canary Islands Health Service, Santa Cruz de Tenerife, Spain
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Long-Term Health-Related Quality of Life in German Patients with Juvenile Idiopathic Arthritis in Comparison to German General Population. PLoS One 2016; 11:e0153267. [PMID: 27115139 PMCID: PMC4846020 DOI: 10.1371/journal.pone.0153267] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 03/25/2016] [Indexed: 11/19/2022] Open
Abstract
Objective Aims of the study were to investigate health-related quality of life (HRQOL) in adult patients with former diagnosis of Juvenile Idiopathic Arthritis (JIA), to compare their HRQOL with the general population and to identify factors related to a poor outcome. Methods In 2012, a cross-sectional survey was performed by mailing a questionnaire to a large cohort of former and current patients of the German Centre for Rheumatology in Children and Adolescents. Only adult patients (≥18 years) with a diagnosis compatible with JIA were included (n = 2592; response 66%). The questionnaire included information about HRQOL (EQ5D), disease-related questions and socio-demographics. Prevalence and 95% confidence intervals (CI) of problems with mobility, self-care, usual activities, pain and anxiety/depression were standardized to the German general population. Factors associated with low HRQOL in JIA patients were identified using logistic regression models. Results Sixty-two percent of the study population was female; age range was 18–73 years. In all dimensions, JIA patients reported statistically significantly more problems than the general population with largest differences in the pain dimension (JIA patients 56%; 95%CI 55–58%; general population 28%; 26–29%) and the anxiety/depression dimension (28%; 27–29% vs. 4%; 4–5%). Lower HRQOL in JIA patients was associated with female sex, older age, lower level of education, still being under rheumatic treatment and disability. Conclusions HRQOL in adult JIA patients is considerably lower than in the general population. As this cohort includes historic patients the new therapeutic schemes available today are expected to improve HRQOL in future.
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Kuhlmann A, Schmidt T, Treskova M, López-Bastida J, Linertová R, Oliva-Moreno J, Serrano-Aguilar P, Posada-de-la-Paz M, Kanavos P, Taruscio D, Schieppati A, Iskrov G, Péntek M, Delgado C, von der Schulenburg JM, Persson U, Chevreul K, Fattore G. Social/economic costs and health-related quality of life in patients with juvenile idiopathic arthritis in Europe. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2016; 17 Suppl 1:79-87. [PMID: 27086322 DOI: 10.1007/s10198-016-0786-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 01/13/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this study was to determine the economic burden from a societal perspective and the health-related quality of life (HRQOL) of patients with juvenile idiopathic arthritis (JIA) in Europe. METHODS We conducted a cross-sectional study of patients with JIA from Germany, Italy, Spain, France, the United Kingdom, Bulgaria, and Sweden. Data on demographic characteristics, healthcare resource utilization, informal care, labor productivity losses, and HRQOL were collected from the questionnaires completed by patients or their caregivers. HRQOL was measured with the EuroQol 5-domain (EQ-5D-5L) questionnaire. RESULTS A total of 162 patients (67 Germany, 34 Sweden, 33 Italy, 23 United Kingdom, 4 France, and 1 Bulgaria) completed the questionnaire. Excluding Bulgarian results, due to small sample size, country-specific annual health care costs ranged from €18,913 to €36,396 (reference year: 2012). Estimated direct healthcare costs ranged from €11,068 to €22,138; direct non-healthcare costs ranged from €7837 to €14,155 and labor productivity losses ranged from €0 to €8715. Costs are also shown to differ between children and adults. The mean EQ-5D index score for JIA patients was estimated at between 0.44 and 0.88, and the mean EQ-5D visual analogue scale score was estimated at between 62 and 79. CONCLUSIONS JIA patients incur considerable societal costs and experience substantial deterioration in HRQOL in some countries. Compared with previous studies, our results show a remarkable increase in annual healthcare costs for JIA patients. Reasons for the increase are the inclusion of non-professional caregiver costs, a wider use of biologics, and longer hospital stays.
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Affiliation(s)
- A Kuhlmann
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany.
| | - T Schmidt
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany
| | - M Treskova
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany
| | - J López-Bastida
- Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - R Linertová
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Las Palmas de Gran Canaria, Spain
| | - J Oliva-Moreno
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Universidad de Castilla-La Mancha, Toledo, Spain
| | - P Serrano-Aguilar
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Evaluation and Planning Service at Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - M Posada-de-la-Paz
- Institute of Rare Diseases Research, ISCIII, SpainRDR & CIBERER, Madrid, Spain
| | - P Kanavos
- Department of Social Policy and LSE Health, London School of Economics and Political Science, London, United Kingdom
| | - D Taruscio
- National Center for Rare Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - A Schieppati
- Centro di Ricerche Cliniche per Malattie Rare Aldo e Cele Daccò, Istituto di Ricerche Farmacologiche Mario Negri, Ranica (Bergamo), Italy
| | - G Iskrov
- Institute of Rare Diseases, Plovdiv, Bulgaria
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - C Delgado
- Federación Española de Enfermedades Raras (FEDER), Madrid, Spain
| | - J M von der Schulenburg
- Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Germany
| | - U Persson
- Swedish Institute for Health Economics, Lund, Sweden
| | - K Chevreul
- URC Eco Ile de France, AP-HP, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, Paris, France
- INSERM, ECEVE, U1123, Paris, France
| | - G Fattore
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy
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Adunuri NR, Feldman BM. Critical appraisal of studies measuring quality of life in juvenile idiopathic arthritis. Arthritis Care Res (Hoboken) 2015; 67:880-4. [PMID: 25384887 DOI: 10.1002/acr.22514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 10/12/2014] [Accepted: 11/04/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To critically evaluate studies purporting to measure quality of life (QOL) or health-related QOL (HRQOL) in juvenile idiopathic arthritis (JIA) by assessing the face validity of studies via a predefined set of criteria based on Gill and Feinstein (1994). METHODS Systematic review was conducted of studies in Medline, Embase, and PsycInfo purporting to measure QOL or HRQOL in JIA. Studies were evaluated based on a set of 8 yes/no criteria set forth by Gill and Feinstein in 1994. RESULTS Thirty-four of 50 studies (68%) purported to measure HRQOL, 13 of 50 (26%) measured QOL, and 3 of 50 (6%) measured both QOL and HRQOL. The descriptive analysis of studies is as follows: 22 of 50 studies (44%) explained and defined the authors' meaning of QOL or HRQOL, 42 of 50 studies (84%) stated and explained the domains of the instruments used to measure QOL and HRQOL, authors gave reasons for using a particular instrument in 25 of 50 studies (50%), 14 of 50 studies (28%) asked the patients to give their own global rating, 4 of 50 study authors (8%) tried to differentiate QOL from HRQOL, 5 of 50 authors (10%) provided an opportunity for patients to add items to an instrument, 30 of 50 study authors (60%) reported providing the patients with an opportunity to rate items of importance, and 18 of 50 studies (36%) reported an overall composite score for QOL or HRQOL. CONCLUSION Our results show that the face validity of studies measuring QOL in JIA is not up to the standards and recommendations set forth by Gill and Feinstein in 1994.
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Hsin YC, Zhuang LZ, Yeh KW, Chang CW, Horng JT, Huang JL. Risk of Tuberculosis in Children with Juvenile Idiopathic Arthritis: A Nationwide Population-Based Study in Taiwan. PLoS One 2015; 10:e0128768. [PMID: 26047099 PMCID: PMC4457914 DOI: 10.1371/journal.pone.0128768] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 05/01/2015] [Indexed: 11/29/2022] Open
Abstract
Objective We aimed to determine the risk of tuberculosis in children with juvenile idiopathic arthritis (JIA) in Taiwan. Methods We used the Taiwan National Health Insurance Research Database (NHIRD) to conduct a nested case-control study. We identified a JIA cohort and matched each JIA child with non-JIA children for comparison. Methotrexate (MTX), tumor necrosis factor (TNF) inhibitor administration, and new tuberculosis cases were determined during our study period. To compare tuberculosis (TB) risk among our study groups, Cox proportional regression models were used to determine adjusted hazard ratios (aHRs). Results We identified 1495 children with JIA and 11592 non-JIA children. Majority (68.7%) children with JIA had not received MTX or TNF inhibitors; 23.9% used MTX without TNF inhibitors, and 7.4% received TNF inhibitors, irrespective of MTX administration. In total, 43 children developed tuberculosis. The overall tuberculosis infection rate for children with JIA was two times higher than that for non-JIA children. Compared with non-JIA children, children with JIA who used MTX without TNF inhibitors revealed a significantly increased of tuberculosis infection rate (aHR = 4.67; 95% CI: 1.65–13.17; P = 0.004). Children with JIA who either received TNF inhibitors or never used MTX and TNF inhibitors revealed a tuberculosis infection rate comparable to that of non-JIA children. Conclusions Analysis of nationwide data of Taiwan suggested that children with JIA were at higher risk of tuberculosis compared with those without JIA.
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Affiliation(s)
- Yi-Chen Hsin
- Department of Pediatric Allergy Immunology and Rheumatology, Division of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Lai-Zhen Zhuang
- Department of Computer Science and Information Engineering, National Central University, Chungli, Taiwan
| | - Kuo-Wei Yeh
- Department of Pediatric Allergy Immunology and Rheumatology, Division of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Cheng-Wei Chang
- Department of Information Management, Hsing Wu University, New Taipei City, Taiwan
| | - Jorng-Tzong Horng
- Department of Computer Science and Information Engineering, National Central University, Chungli, Taiwan
- Department of Biomedical Informatics, Asia University, Taichung, Taiwan
- * E-mail: (JLH); (JTH)
| | - Jing-Long Huang
- Department of Pediatric Allergy Immunology and Rheumatology, Division of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- * E-mail: (JLH); (JTH)
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Kwon HJ, Kim YL, Lee SM. Relation between functional ability and health-related quality of life of children with juvenile rheumatoid arthritis. J Phys Ther Sci 2015; 27:837-40. [PMID: 25931742 PMCID: PMC4395726 DOI: 10.1589/jpts.27.837] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 11/05/2014] [Indexed: 12/04/2022] Open
Abstract
[Purpose] The aim of this study was to assess patients’ health-related quality of life,
compare it with a healthy age-matched population, and examine associations between
functional ability and quality of life among juvenile rheumatoid arthritis (JRA) patients.
[Subjects and Methods] The study participants were 26 JRA patients and 25 controls. The
Childhood Health Assessment Questionnaire and the Pediatric Quality of Life Inventory 4.0
Generic Core Scales were used to evaluate functional ability and health-related quality of
life, respectively. [Results] Functional ability scores averaged 0.37 in the JRA group and
0.08 in the control group. There were significant between-group differences in functional
ability scores in the overall cohort and in the subgroup of participants aged 14–16 years.
Health-related quality of life scores were significantly lower in the JRA group than in
the control group (68.39 vs. 85.17). In the JRA group, functional ability was
statistically positively correlated with health-related quality of life. [Conclusion] We
conclude that the mental state of adolescents with JRA affects their particular functional
abilities. Subjects in the 14–16 age group who had a longer disease duration and higher
difficulty scores showed a lower health-related quality of life than children in the other
age groups.
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Affiliation(s)
- Hyo-Jeong Kwon
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - You Lim Kim
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - Suk Min Lee
- Department of Physical Therapy, Sahmyook University, Republic of Korea
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Guzman J, Gómez-Ramírez O, Jurencak R, Shiff NJ, Berard RA, Duffy CM, Oen K, Petty RE, Benseler SM, Brant R, Tucker LB. What matters most for patients, parents, and clinicians in the course of juvenile idiopathic arthritis? A qualitative study. J Rheumatol 2014; 41:2260-9. [PMID: 25225279 DOI: 10.3899/jrheum.131536] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To assess which clinical features are most important for patients, parents, and clinicians in the course of juvenile idiopathic arthritis (JIA). METHODS Forty-nine people participated in 6 audience-specific focus group discussions and 112 reciprocal interviews in 3 Canadian cities. Participants included youth with JIA, experienced English- and French-speaking parents, novice parents (<6 mos since diagnosis), pediatric rheumatologists, and allied health professionals. Participants discussed the importance of 34 JIA clinical features extracted from medical literature. Transcripts and interview reports underwent qualitative analysis to establish relative priorities for each group. RESULTS Most study participants considered medication requirements, medication side effects, pain, participant-defined quality of life, and active joints as high priority clinical features of JIA. Active joint count was the only American College of Rheumatology core variable accorded high or medium priority by all groups. Rheumatologists and allied health professionals considered physician global assessment as high priority, but it had very low priority for patients and parents. The parent global assessment was considered high priority by clinicians, medium to high by parents, and low by patients. Child Health Assessment Questionnaire scores were considered low priority by patients and parents, and moderate or high by clinicians. The number of joints with limited motion was given low to very low priority by all groups. Parents gave high priority to arthritis flares. CONCLUSION If our findings are confirmed, medication requirements, medication side effects, pain, participant-defined quality of life, and active joint counts should figure prominently in describing the course of JIA.
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Affiliation(s)
- Jaime Guzman
- From the British Columbia Children's Hospital; University of British Columbia, Vancouver; Children's Hospital of Eastern Ontario; University of Ottawa, Ottawa, Ontario; University of Saskatchewan, Saskatoon; Children's Hospital, London Health Sciences Centre; Western University, London, Ontario; Children's Hospital of Winnipeg; University of Manitoba, Winnipeg; Alberta Children's Hospital; University of Calgary, Calgary, Alberta, Canada.J. Guzman, MD, MSc; O. Gómez-Ramírez, MA, PhD Candidate; R.E. Petty, MD; R. Brant, PhD; L.B. Tucker, MD, British Columbia Children's Hospital, University of British Columbia; R. Jurencak, MD; C.M. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, University of Ottawa; N.J. Shiff, MD, MHSc, University of Saskatchewan, Saskatoon; R.A. Berard, MD, MSc, Children's Hospital, London Health Sciences Centre, Western University; K. Oen, MD, Children's Hospital of Winnipeg, University of Manitoba; S.M. Benseler, MD, Alberta Children's Hospital, University of Calgary.
| | - Oralia Gómez-Ramírez
- From the British Columbia Children's Hospital; University of British Columbia, Vancouver; Children's Hospital of Eastern Ontario; University of Ottawa, Ottawa, Ontario; University of Saskatchewan, Saskatoon; Children's Hospital, London Health Sciences Centre; Western University, London, Ontario; Children's Hospital of Winnipeg; University of Manitoba, Winnipeg; Alberta Children's Hospital; University of Calgary, Calgary, Alberta, Canada.J. Guzman, MD, MSc; O. Gómez-Ramírez, MA, PhD Candidate; R.E. Petty, MD; R. Brant, PhD; L.B. Tucker, MD, British Columbia Children's Hospital, University of British Columbia; R. Jurencak, MD; C.M. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, University of Ottawa; N.J. Shiff, MD, MHSc, University of Saskatchewan, Saskatoon; R.A. Berard, MD, MSc, Children's Hospital, London Health Sciences Centre, Western University; K. Oen, MD, Children's Hospital of Winnipeg, University of Manitoba; S.M. Benseler, MD, Alberta Children's Hospital, University of Calgary
| | - Roman Jurencak
- From the British Columbia Children's Hospital; University of British Columbia, Vancouver; Children's Hospital of Eastern Ontario; University of Ottawa, Ottawa, Ontario; University of Saskatchewan, Saskatoon; Children's Hospital, London Health Sciences Centre; Western University, London, Ontario; Children's Hospital of Winnipeg; University of Manitoba, Winnipeg; Alberta Children's Hospital; University of Calgary, Calgary, Alberta, Canada.J. Guzman, MD, MSc; O. Gómez-Ramírez, MA, PhD Candidate; R.E. Petty, MD; R. Brant, PhD; L.B. Tucker, MD, British Columbia Children's Hospital, University of British Columbia; R. Jurencak, MD; C.M. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, University of Ottawa; N.J. Shiff, MD, MHSc, University of Saskatchewan, Saskatoon; R.A. Berard, MD, MSc, Children's Hospital, London Health Sciences Centre, Western University; K. Oen, MD, Children's Hospital of Winnipeg, University of Manitoba; S.M. Benseler, MD, Alberta Children's Hospital, University of Calgary
| | - Natalie J Shiff
- From the British Columbia Children's Hospital; University of British Columbia, Vancouver; Children's Hospital of Eastern Ontario; University of Ottawa, Ottawa, Ontario; University of Saskatchewan, Saskatoon; Children's Hospital, London Health Sciences Centre; Western University, London, Ontario; Children's Hospital of Winnipeg; University of Manitoba, Winnipeg; Alberta Children's Hospital; University of Calgary, Calgary, Alberta, Canada.J. Guzman, MD, MSc; O. Gómez-Ramírez, MA, PhD Candidate; R.E. Petty, MD; R. Brant, PhD; L.B. Tucker, MD, British Columbia Children's Hospital, University of British Columbia; R. Jurencak, MD; C.M. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, University of Ottawa; N.J. Shiff, MD, MHSc, University of Saskatchewan, Saskatoon; R.A. Berard, MD, MSc, Children's Hospital, London Health Sciences Centre, Western University; K. Oen, MD, Children's Hospital of Winnipeg, University of Manitoba; S.M. Benseler, MD, Alberta Children's Hospital, University of Calgary
| | - Roberta A Berard
- From the British Columbia Children's Hospital; University of British Columbia, Vancouver; Children's Hospital of Eastern Ontario; University of Ottawa, Ottawa, Ontario; University of Saskatchewan, Saskatoon; Children's Hospital, London Health Sciences Centre; Western University, London, Ontario; Children's Hospital of Winnipeg; University of Manitoba, Winnipeg; Alberta Children's Hospital; University of Calgary, Calgary, Alberta, Canada.J. Guzman, MD, MSc; O. Gómez-Ramírez, MA, PhD Candidate; R.E. Petty, MD; R. Brant, PhD; L.B. Tucker, MD, British Columbia Children's Hospital, University of British Columbia; R. Jurencak, MD; C.M. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, University of Ottawa; N.J. Shiff, MD, MHSc, University of Saskatchewan, Saskatoon; R.A. Berard, MD, MSc, Children's Hospital, London Health Sciences Centre, Western University; K. Oen, MD, Children's Hospital of Winnipeg, University of Manitoba; S.M. Benseler, MD, Alberta Children's Hospital, University of Calgary
| | - Ciaran M Duffy
- From the British Columbia Children's Hospital; University of British Columbia, Vancouver; Children's Hospital of Eastern Ontario; University of Ottawa, Ottawa, Ontario; University of Saskatchewan, Saskatoon; Children's Hospital, London Health Sciences Centre; Western University, London, Ontario; Children's Hospital of Winnipeg; University of Manitoba, Winnipeg; Alberta Children's Hospital; University of Calgary, Calgary, Alberta, Canada.J. Guzman, MD, MSc; O. Gómez-Ramírez, MA, PhD Candidate; R.E. Petty, MD; R. Brant, PhD; L.B. Tucker, MD, British Columbia Children's Hospital, University of British Columbia; R. Jurencak, MD; C.M. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, University of Ottawa; N.J. Shiff, MD, MHSc, University of Saskatchewan, Saskatoon; R.A. Berard, MD, MSc, Children's Hospital, London Health Sciences Centre, Western University; K. Oen, MD, Children's Hospital of Winnipeg, University of Manitoba; S.M. Benseler, MD, Alberta Children's Hospital, University of Calgary
| | - Kiem Oen
- From the British Columbia Children's Hospital; University of British Columbia, Vancouver; Children's Hospital of Eastern Ontario; University of Ottawa, Ottawa, Ontario; University of Saskatchewan, Saskatoon; Children's Hospital, London Health Sciences Centre; Western University, London, Ontario; Children's Hospital of Winnipeg; University of Manitoba, Winnipeg; Alberta Children's Hospital; University of Calgary, Calgary, Alberta, Canada.J. Guzman, MD, MSc; O. Gómez-Ramírez, MA, PhD Candidate; R.E. Petty, MD; R. Brant, PhD; L.B. Tucker, MD, British Columbia Children's Hospital, University of British Columbia; R. Jurencak, MD; C.M. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, University of Ottawa; N.J. Shiff, MD, MHSc, University of Saskatchewan, Saskatoon; R.A. Berard, MD, MSc, Children's Hospital, London Health Sciences Centre, Western University; K. Oen, MD, Children's Hospital of Winnipeg, University of Manitoba; S.M. Benseler, MD, Alberta Children's Hospital, University of Calgary
| | - Ross E Petty
- From the British Columbia Children's Hospital; University of British Columbia, Vancouver; Children's Hospital of Eastern Ontario; University of Ottawa, Ottawa, Ontario; University of Saskatchewan, Saskatoon; Children's Hospital, London Health Sciences Centre; Western University, London, Ontario; Children's Hospital of Winnipeg; University of Manitoba, Winnipeg; Alberta Children's Hospital; University of Calgary, Calgary, Alberta, Canada.J. Guzman, MD, MSc; O. Gómez-Ramírez, MA, PhD Candidate; R.E. Petty, MD; R. Brant, PhD; L.B. Tucker, MD, British Columbia Children's Hospital, University of British Columbia; R. Jurencak, MD; C.M. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, University of Ottawa; N.J. Shiff, MD, MHSc, University of Saskatchewan, Saskatoon; R.A. Berard, MD, MSc, Children's Hospital, London Health Sciences Centre, Western University; K. Oen, MD, Children's Hospital of Winnipeg, University of Manitoba; S.M. Benseler, MD, Alberta Children's Hospital, University of Calgary
| | - Susanne M Benseler
- From the British Columbia Children's Hospital; University of British Columbia, Vancouver; Children's Hospital of Eastern Ontario; University of Ottawa, Ottawa, Ontario; University of Saskatchewan, Saskatoon; Children's Hospital, London Health Sciences Centre; Western University, London, Ontario; Children's Hospital of Winnipeg; University of Manitoba, Winnipeg; Alberta Children's Hospital; University of Calgary, Calgary, Alberta, Canada.J. Guzman, MD, MSc; O. Gómez-Ramírez, MA, PhD Candidate; R.E. Petty, MD; R. Brant, PhD; L.B. Tucker, MD, British Columbia Children's Hospital, University of British Columbia; R. Jurencak, MD; C.M. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, University of Ottawa; N.J. Shiff, MD, MHSc, University of Saskatchewan, Saskatoon; R.A. Berard, MD, MSc, Children's Hospital, London Health Sciences Centre, Western University; K. Oen, MD, Children's Hospital of Winnipeg, University of Manitoba; S.M. Benseler, MD, Alberta Children's Hospital, University of Calgary
| | - Rollin Brant
- From the British Columbia Children's Hospital; University of British Columbia, Vancouver; Children's Hospital of Eastern Ontario; University of Ottawa, Ottawa, Ontario; University of Saskatchewan, Saskatoon; Children's Hospital, London Health Sciences Centre; Western University, London, Ontario; Children's Hospital of Winnipeg; University of Manitoba, Winnipeg; Alberta Children's Hospital; University of Calgary, Calgary, Alberta, Canada.J. Guzman, MD, MSc; O. Gómez-Ramírez, MA, PhD Candidate; R.E. Petty, MD; R. Brant, PhD; L.B. Tucker, MD, British Columbia Children's Hospital, University of British Columbia; R. Jurencak, MD; C.M. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, University of Ottawa; N.J. Shiff, MD, MHSc, University of Saskatchewan, Saskatoon; R.A. Berard, MD, MSc, Children's Hospital, London Health Sciences Centre, Western University; K. Oen, MD, Children's Hospital of Winnipeg, University of Manitoba; S.M. Benseler, MD, Alberta Children's Hospital, University of Calgary
| | - Lori B Tucker
- From the British Columbia Children's Hospital; University of British Columbia, Vancouver; Children's Hospital of Eastern Ontario; University of Ottawa, Ottawa, Ontario; University of Saskatchewan, Saskatoon; Children's Hospital, London Health Sciences Centre; Western University, London, Ontario; Children's Hospital of Winnipeg; University of Manitoba, Winnipeg; Alberta Children's Hospital; University of Calgary, Calgary, Alberta, Canada.J. Guzman, MD, MSc; O. Gómez-Ramírez, MA, PhD Candidate; R.E. Petty, MD; R. Brant, PhD; L.B. Tucker, MD, British Columbia Children's Hospital, University of British Columbia; R. Jurencak, MD; C.M. Duffy, MB, BCh, MSc, Children's Hospital of Eastern Ontario, University of Ottawa; N.J. Shiff, MD, MHSc, University of Saskatchewan, Saskatoon; R.A. Berard, MD, MSc, Children's Hospital, London Health Sciences Centre, Western University; K. Oen, MD, Children's Hospital of Winnipeg, University of Manitoba; S.M. Benseler, MD, Alberta Children's Hospital, University of Calgary
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Giménez-Roca C, Iglesias E, Torrente-Segarra V, Bou R, Sánchez-Manubens J, Calzada-Hernández J, Hernández S, Ricart S, Antón J. Efficacy and safety of TNF-alpha antagonists in children with juvenile idiopathic arthritis who started treatment under 4 years of age. Rheumatol Int 2014; 35:323-6. [DOI: 10.1007/s00296-014-3103-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 07/21/2014] [Indexed: 10/24/2022]
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Klotsche J, Minden K, Thon A, Ganser G, Urban A, Horneff G. Improvement in health-related quality of life for children with juvenile idiopathic arthritis after start of treatment with etanercept. Arthritis Care Res (Hoboken) 2014; 66:253-62. [PMID: 23983081 DOI: 10.1002/acr.22112] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 08/07/2013] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Improvement in health-related quality of life (HRQOL) is an important therapy goal in the treatment of patients with juvenile idiopathic arthritis (JIA). We investigated the 12-month course of HRQOL in patients with JIA after the start of therapy with etanercept and identified its determining factors. METHODS Children with JIA were enrolled in the BiKer (Biologics in Pediatric Rheumatology) registry at the start of etanercept treatment. Children were prospectively followed in the first year of treatment and completed the Pediatric Quality of Life Inventory (PedsQL) at each occasion. The change in HRQOL was investigated by random-effect regression models. The time-varying variables pain and inactive disease were used for predicting the change in HRQOL. Inactive disease was defined by the Wallace et al criteria and pain was assessed on a visual analog scale (range 0-100). RESULTS The children (n = 61) had a mean age of 10.6 years and a mean disease duration of 3.4 years at the start of etanercept. The mean PedsQL total score was 75. The PedsQL total score increased at a rate of 2.8 units per month (P < 0.001) in the first 6 months of treatment, up to a level of 89.7. A low HRQOL score was significantly highly associated with the number of tender joints, functional restrictions, pain, disease activity, and the existence of a comorbid condition at baseline. Inactive disease and reduced pain predicted better HRQOL under etanercept treatment. CONCLUSION HRQOL was dramatically improved in children who started etanercept treatment. Inactive disease and lower pain were important predictors for improvement of HRQOL over time.
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Affiliation(s)
- Jens Klotsche
- German Rheumatism Research Centre Berlin, Leibniz Institute, Berlin, Germany
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Determinants of health-related quality of life impairment in Egyptian children and adolescents with juvenile idiopathic arthritis: Sharkia Governorate. Rheumatol Int 2014; 34:1095-101. [PMID: 24469640 DOI: 10.1007/s00296-014-2950-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Accepted: 01/17/2014] [Indexed: 10/25/2022]
Abstract
The aim of this study was to identify the possible determinants of impaired health-related quality of life (HRQOL) in Egyptian children and adolescents with juvenile idiopathic arthritis (JIA). Fifty-eight consecutive patients of JIA aged from 8 to 18 years underwent assessment of socio-economic and demographic characteristics; HRQOL using Pediatric Quality of Life Inventory 4.0 Generic Core Scale, disease activity using the Juvenile Arthritis Disease Activity Score based on 27 joints (JADAS-27), functional ability using the childhood health assessment questionnaire (CHAQ), pain score on visual analog scale and psychological symptoms using the Children's Depression Inventory (CDI) score. Multivariate modeling was applied to determine the factors that associated with HRQOL impairment. A total of 55 % of the patients (32 of 58) had impaired HRQOL (<78.6). In multiple regression analyses, high CHAQ scores (OR 6.0, 95 % CI 2.0-17.5, P = 0.001), pain (OR 3.1, 95 % CI 1.9-6.3, P = 0.01), stop going to school (OR 3.9, 95 % CI 2.0-7.3, P = 0.01), low socioeconomic status (OR 2.3, 95 % CI 1.09-4.7, P = 0.04) and high psychological symptoms (OR 4.2, 95 % CI 2.0-12.6, P = 0.001) were determinants for HRQOL impairment. HRQOL impairment is a significant problem in Egyptian children and adolescents with JIA. These findings underscore the critical need for monitoring of HRQOL in these patients. More attention should be given to JIA patients who stop going to school and who has low socioeconomic status.
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Ezzahri M, Amine B, Rostom S, Badri D, Mawani N, Gueddari S, Shyen S, Wabi M, Moussa F, Abouqal R, Chkirate B, Hajjaj-Hassouni N. Factors influencing the quality of life of Moroccan patients with juvenile idiopathic arthritis. Clin Rheumatol 2014; 33:1621-6. [DOI: 10.1007/s10067-014-2489-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 12/30/2013] [Accepted: 01/05/2014] [Indexed: 10/25/2022]
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El Emrani L, Bendriss A, Senhaji M. Santé et qualité de vie : situation pour la population de Tétouan (Maroc). SANTÉ PUBLIQUE 2013. [DOI: 10.3917/spub.135.0639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Childhood chronic physical condition, self-reported health, and life satisfaction in adolescence. Eur J Pediatr 2013; 172:1197-206. [PMID: 23652935 DOI: 10.1007/s00431-013-2015-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 04/16/2013] [Accepted: 04/18/2013] [Indexed: 02/06/2023]
Abstract
The present study investigates the prevalence and type of chronic conditions at 7 years of age-with special reference to atopic conditions-and their longitudinal associations with self-reported health and life satisfaction in adolescence. The data were obtained from Northern Finland Birth Cohort 1986 (NFBC 1986), which is a longitudinal 1-year birth cohort from an unselected, regionally defined population (n = 9,432). The present study investigated a sample of 8,036 children with data of chronic conditions at 7 years of age and a sample of 6,680 children with data of chronic conditions at 16 years of age. According to parents' report the prevalence of CC at 7 years of age was 14.8 % among boys and 13.2 % among girls, these figures being at 16 years of age 20.7 and 19.4 %, respectively. Atopic conditions were the most common chronic conditions at 7 years of age (12.7 % vs. other chronic conditions 4.7 %). Childhood chronic condition was associated with subsequent self-reported health in adolescence, but not with subsequent self-reported life satisfaction. Chronic condition at 7 years of age increased the risk of reporting health as "poor" even if the chronic condition was no longer prevalent at 16 years of age. Atopic conditions seemed to be linked with self-reported poor/moderate health more often than other chronic conditions among girls. Conclusion Childhood chronic conditions seem to affect adolescent's subjective health, but fortunately, they do not affect adolescents' subjective well-being to such an extent that it could lower their life satisfaction.
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Quality of life of children with juvenile idiopathic arthritis and its relationship with parental stress. INDIAN JOURNAL OF RHEUMATOLOGY 2013. [DOI: 10.1016/j.injr.2013.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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29
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Ezzahri M, Amine B, Rostom S, Rifay Y, Badri D, Mawani N, Gueddari S, Shyen S, Wabi M, Moussa F, Abouqal R, Chkirate B, Hajjaj-Hassouni N. The uveitis and its relationship with disease activity and quality of life in Moroccan children with juvenile idiopathic arthritis. Clin Rheumatol 2013; 32:1387-91. [PMID: 23636793 DOI: 10.1007/s10067-013-2262-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 03/19/2013] [Accepted: 04/07/2013] [Indexed: 10/26/2022]
Abstract
The aim of our study is to investigate ocular involvement in juvenile idiopathic arthritis (JIA) and its relationship with disease activity and quality of life in Moroccan patients who suffer from JIA. This is a cross-sectional study conducted between January and June 2012 which includes patients with juvenile idiopathic arthritis (n = 30). All patients have undergone clinical and paraclinical assessment of JIA and a complete eye examination. Functional impairment is assessed by the Childhood Health Assessment Questionnaire while visual function is studied by the Effect of Youngsters' Eyesight in Quality of Life instrument (EYE-Q). Quality of life is assessed using the Pediatric Quality of Life Inventory Version 4.0 (PedsQL 4.0). Four patients (13.33 %) have uveitis with a confidence interval between 3.4 and 30.7. Involvement is bilateral in three children (75 %). One patient (25 %) has elevated intraocular pressure with loss of the right eye due to glaucoma. There is a strong but not significant relationship between uveitis and the number of awakenings (r = 0.71, p = 0.69) and morning stiffness (r = 3.05, p = 0, 21). This relationship is moderate with erythrocyte sedimentation rate (r = 0.48, p = 0.78) and C-reactive protein (r = 0.25, p = 0.88). A strong but not significant association is found between the overall quality of life assessed by the PedsQL 4.0 and visual function assessed by EYE-Q in the uveitis group (r = -0.64, p = 0.55). This study suggests that uveitis associated with JIA can present serious complications and could have a direct relationship with the activity of the JIA as well as with the quality of life of the patient.
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Affiliation(s)
- M Ezzahri
- LIRPOS-URAC30, Service de rhumatologie, Hôpital El Ayachi, CHU Rabat-Salé, Université Mohammed V Souissi, Rabat, Morocco.
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Akel BS, Öksüz Ç, Oskay D, Fırat T, Tarakcı E, Leblebicioğlu G. Health-related quality of life in children with obstetrical brachial plexus palsy. Qual Life Res 2013; 22:2617-24. [DOI: 10.1007/s11136-013-0369-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2013] [Indexed: 10/27/2022]
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Body experiences, emotional competence, and psychosocial functioning in juvenile idiopathic arthritis. Rheumatol Int 2013; 33:2045-52. [PMID: 23392772 DOI: 10.1007/s00296-013-2685-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 01/23/2013] [Indexed: 10/27/2022]
Abstract
We investigated self-image, psychological functioning, and quality of life in children and adolescents with juvenile idiopathic arthritis (JIA). Thirty-nine children with JIA were compared with 80 healthy peers. We first administered the Human Figure Drawing Test (HFDT) to all subjects; children also completed standardized questionnaires evaluating health-related quality of life (PEDSQL 4.0 Generic Core Scales) and the main aspects of psychological functioning: anxiety (SAFA-A) and depression (CDI). Parents were asked to complete the Child Behaviour Checklist (CBCL) and the PEDSQL 4.0. For each patient with JIA, clinical notes were gathered and a global disease assessment (visual analog scale--VAS) was performed. Compared to healthy peers, patients with JIA reported reduced maturity quotients at HFDT, more depressive traits, greater anxiety, and lower health-related quality of life. Among the subjects with JIA, HFDT revealed that adolescents had a greater impairment in all areas investigated. Furthermore, there was a significant correlation between the physical well-being rated by VAS and the perception of poorer quality of life in patients, mostly in the psychosocial domains. Children and adolescents with JIA exhibit emotional difficulties and a delay of psychological development leading to low self-esteem, a distorted self-image, more anxiety and depression traits, and a worse quality of life, when compared to healthy subjects.
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Weakley K, Esser M, Scott C. Juvenile idiopathic arthritis in two tertiary centres in the Western Cape, South Africa. Pediatr Rheumatol Online J 2012; 10:35. [PMID: 23050608 PMCID: PMC3551695 DOI: 10.1186/1546-0096-10-35] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 10/04/2012] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) is a disease that shows wide variations between differing populations. Since the recent international consensus on classification criteria, JIA has been widely described in many countries and population groups. There has been almost no data that describes JIA in an African, specifically Sub-Saharan African, setting. Therefore, the aim of this study is to describe disease characteristics, disease course, and functional disability in two tertiary centres in the Western Cape, South Africa and compare the findings to other JIA populations. METHODS Eighty-six children were recruited during random clinic visits to rheumatology clinics at Tygerberg and Groote Schuur Hospital between April 2010 and April 2011. Children were diagnosed using International League of Associations for Rheumatology (ILAR) 2001 classification criteria. Consent was obtained and medical records examined. The Childhood Health Assessment Questionnaires (CHAQ) and visual analogue scales (VAS) for pain and general well-being were completed and all children were examined by a researcher in conjunction with a paediatric rheumatologist. HIV status as well as tuberculosis disease and treatment were investigated. RESULTS A total of 86 children were enrolled. Eight children were excluded (2 HIV arthropathy, 1 TB arthritis, 1 SLE, 4 with insufficient data), leaving a total of 78 patients. There was an equal female to male ratio-39 males and 39 females. There were 6 systemic JIA patients (7.69%), 17 persistent oligoarthritis (21.79%), 4 extended oligoarthritis (5.12%), 11 polyarthritis rheumatoid factor (RF) positive (14.10%), 21 polyarthritis RF negative (26.9%), 1 psoriatic arthritis (1.28%), and 18 enthesitis-related arthritis (23%). The median CHAQ for the group was 0.5 (IQR 0.1-1.25), the median VAS for pain was 18 mm (IQR 4-42) and median VAS for general well-being was 25 mm (IQR 3-49). Enthesitis-related arthritis and polyarthritis disease subtypes in this South African population may be more common than seen in JIA populations described in northern Europe, India, United Kingdom, and Turkey. CONCLUSION This Western Cape South African JIA population appears to have a different profile of JIA than what has been described elsewhere. Enthesitis-related arthritis and polyarthritis disease subtypes appear to be more prevalent. There are also significant challenges in this setting such as later presentation to pediatric rheumatologists, different disease characteristics, and variable disease courses.
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Affiliation(s)
- Kate Weakley
- Dept of Paediatric Rheumatology, School of Child and Adolescent Health, University of Cape Town, Red Cross Childrens Hospital, Klipfontein Rd, Rondebosch, Cape Town, South Africa.
| | - Monika Esser
- Department of Paediatric Rheumatology and Immunology, Tygerberg Hospital, Stellenbosch University, Tygerberg, South Africa
| | - Christiaan Scott
- Dept of Paediatric Rheumatology, School of Child and Adolescent Health, University of Cape Town, Red Cross Childrens Hospital, Klipfontein Rd, Rondebosch, Cape Town, South Africa
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Imagawa T, Takei S, Umebayashi H, Yamaguchi K, Itoh Y, Kawai T, Iwata N, Murata T, Okafuji I, Miyoshi M, Onoe Y, Kawano Y, Kinjo N, Mori M, Mozaffarian N, Kupper H, Santra S, Patel G, Kawai S, Yokota S. Efficacy, pharmacokinetics, and safety of adalimumab in pediatric patients with juvenile idiopathic arthritis in Japan. Clin Rheumatol 2012; 31:1713-21. [PMID: 23053683 PMCID: PMC3505492 DOI: 10.1007/s10067-012-2082-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 08/01/2012] [Accepted: 08/28/2012] [Indexed: 11/29/2022]
Abstract
The objective of this study was to evaluate the efficacy, pharmacokinetics, and safety of adalimumab in patients with polyarticular juvenile idiopathic arthritis (JIA) in Japan. Patients aged 4 to 17 years were enrolled in a single-arm, open-label, multicentre study of adalimumab. Patients weighing <30 kg received 20 mg every other week (eow), and those ≥30 kg received 40 mg eow. Concomitant methotrexate (MTX) was allowed (≤10 mg/m2 per week). The primary efficacy outcome was the percent of patients with American College of Rheumatology Pediatric 30 response (ACR Pedi 30) at week 16. JIA core variables, serum adalimumab concentrations, and anti-adalimumab antibodies (AAAs) were analysed. Patients were monitored for adverse events (AEs). Twenty-five patients (20 with concomitant MTX at baseline and 5 without) were enrolled: 24 patients completed 16 weeks of therapy and 22 patients completed 60 weeks. At week 16, 90 % of patients with MTX and 100 % without MTX achieved ACR Pedi 30; response rates were maintained through week 60 in 94 and 80 % of patients, respectively. Each JIA core variable improved over time. Six patients became AAA positive (two each at weeks 8, 16, and 60), some of which were transient. All six AAA-positive patients achieved ACR Pedi 30 at week 16, and four maintained that response at week 60. Six patients (all with MTX) experienced nine serious AEs (JIA, pyrexia, arthralgia, pneumonia, hepatitis B infection, pharyngitis, dehydration, pharyngeal pain, and pneumonia). In pediatric patients with polyarticular JIA in Japan, adalimumab was safe and effective for reducing disease activity for up to 60 weeks.
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Lundberg V, Lindh V, Eriksson C, Petersen S, Eurenius E. Health-related quality of life in girls and boys with juvenile idiopathic arthritis: self- and parental reports in a cross-sectional study. Pediatr Rheumatol Online J 2012; 10:33. [PMID: 22985358 PMCID: PMC3523024 DOI: 10.1186/1546-0096-10-33] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 09/12/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Juvenile Idiopathic Arthritis (JIA) affects children and adolescents with both short-term and long-term disability. These children also report lower health-related quality of life (HRQOL) compared to their healthy peers. However, there seems to be some discrepancies between self- and parent-reports, and gender differences need to be further studied. This study aims to describe HRQOL in girls and boys with JIA, and to explore gender differences in self-reports compared to parent-reports of HRQOL in children with JIA. METHODS Fifty-three children and adolescents with JIA (70% girls and 30% boys) with a median age of 14 years (8-18 years), and their parents, participated in this cross-sectional study in Sweden. Data was systematically collected prior to ordinary visits at a Pediatric outpatient clinic, during a period of 16 months (2009-2010). Disability was assessed with the Childhood Health Assessment Questionnaire (CHAQ), and disease activity by physicians' assessments and Erythrocyte Sedimentation Rate (ESR). The Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL) was used to assess self- and parent-reports of HRQOL in the child. RESULTS In this sample of children with generally low disease activity and mild to moderate disability, more than half of the children experienced suboptimal HRQOL, equally in girls and boys. Significant differences between self- and parent-reports of child HRQOL were most evident among girls, with lower parent-reports regarding the girl's physical- and psychosocial health as well as in the total HRQOL score. Except for the social functioning subscale, where parents' reports were higher compared to their sons, there were no significant differences between boys- and parent-reports. CONCLUSIONS More than half of the girls and boys experienced suboptimal HRQOL in this sample, with no gender differences. However, there were differences between self- and parent-reports of child HRQOL, with most significant differences found among the girls. Thus, differences between self- and parent-reports of child HRQOL must be taken into account in clinical settings, especially among girls with JIA.
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Affiliation(s)
- Veronica Lundberg
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
| | - Viveca Lindh
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Catharina Eriksson
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Solveig Petersen
- Department of Clinical Sciences, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
| | - Eva Eurenius
- Department of Public health and Clinical medicine, Epidemiology and Global health, Umeå University, Umeå, Sweden
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Haverman L, Grootenhuis MA, van den Berg JM, van Veenendaal M, Dolman KM, Swart JF, Kuijpers TW, van Rossum MAJ. Predictors of health-related quality of life in children and adolescents with juvenile idiopathic arthritis: Results from a web-based survey. Arthritis Care Res (Hoboken) 2012. [DOI: 10.1002/acr.21609 order by 8029-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Haverman L, Grootenhuis MA, van den Berg JM, van Veenendaal M, Dolman KM, Swart JF, Kuijpers TW, van Rossum MAJ. Predictors of health-related quality of life in children and adolescents with juvenile idiopathic arthritis: Results from a web-based survey. Arthritis Care Res (Hoboken) 2012. [DOI: 10.1002/acr.21609 order by 8029-- awyx] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Haverman L, Grootenhuis MA, van den Berg JM, van Veenendaal M, Dolman KM, Swart JF, Kuijpers TW, van Rossum MAJ. Predictors of health-related quality of life in children and adolescents with juvenile idiopathic arthritis: Results from a web-based survey. Arthritis Care Res (Hoboken) 2012. [DOI: 10.1002/acr.21609 order by 1-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Haverman L, Grootenhuis MA, van den Berg JM, van Veenendaal M, Dolman KM, Swart JF, Kuijpers TW, van Rossum MAJ. Predictors of health-related quality of life in children and adolescents with juvenile idiopathic arthritis: Results from a web-based survey. Arthritis Care Res (Hoboken) 2012. [DOI: 10.1002/acr.21609 order by 1-- #] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Haverman L, Grootenhuis MA, van den Berg JM, van Veenendaal M, Dolman KM, Swart JF, Kuijpers TW, van Rossum MAJ. Predictors of health-related quality of life in children and adolescents with juvenile idiopathic arthritis: Results from a web-based survey. Arthritis Care Res (Hoboken) 2012. [DOI: 10.1002/acr.21609 order by 1-- gadu] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Haverman L, Grootenhuis MA, van den Berg JM, van Veenendaal M, Dolman KM, Swart JF, Kuijpers TW, van Rossum MAJ. Predictors of health-related quality of life in children and adolescents with juvenile idiopathic arthritis: Results from a web-based survey. Arthritis Care Res (Hoboken) 2012. [DOI: 10.1002/acr.21609 and 1880=1880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Haverman L, Grootenhuis MA, van den Berg JM, van Veenendaal M, Dolman KM, Swart JF, Kuijpers TW, van Rossum MAJ. Predictors of health-related quality of life in children and adolescents with juvenile idiopathic arthritis: Results from a web-based survey. Arthritis Care Res (Hoboken) 2012. [DOI: 10.1002/acr.21609 order by 8029-- #] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Haverman L, Grootenhuis MA, van den Berg JM, van Veenendaal M, Dolman KM, Swart JF, Kuijpers TW, van Rossum MAJ. Predictors of health-related quality of life in children and adolescents with juvenile idiopathic arthritis: Results from a web-based survey. Arthritis Care Res (Hoboken) 2012; 64:694-703. [DOI: 10.1002/acr.21609] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Ardon MS, Janssen WG, Hovius SE, Stam HJ, Selles RW. Low Impact of Congenital Hand Differences on Health-Related Quality of Life. Arch Phys Med Rehabil 2012; 93:351-7. [DOI: 10.1016/j.apmr.2011.09.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 08/18/2011] [Accepted: 09/06/2011] [Indexed: 11/30/2022]
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Amine B, Ibn Yacoub Y, Rostom S, Hajjaj-Hassouni N. Prevalence of overweight among Moroccan children and adolescents with juvenile idiopathic arthritis. Joint Bone Spine 2011; 78:584-6. [DOI: 10.1016/j.jbspin.2011.02.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2010] [Accepted: 02/01/2011] [Indexed: 11/27/2022]
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Butbul Aviel Y, Stremler R, Benseler SM, Cameron B, Laxer RM, Ota S, Schneider R, Spiegel L, Stinson JN, Tse SML, Feldman BM. Sleep and fatigue and the relationship to pain, disease activity and quality of life in juvenile idiopathic arthritis and juvenile dermatomyositis. Rheumatology (Oxford) 2011; 50:2051-60. [PMID: 21873265 DOI: 10.1093/rheumatology/ker256] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES To determine and compare the prevalence of disturbed sleep in JIA and JDM and the relationship of sleep disturbance to pain, function, disease activity and medications. METHODS One hundred fifty-five patients (115 JIA, 40 JDM) were randomly sampled and were mailed questionnaires. Sleep disturbance was assessed by the sleep self-report (SSR) and the children's sleep habits questionnaire (CSHQ). Fatigue, pain and function were assessed by the paediatric quality of life inventory (PedsQL) and disease activity by visual analogue scales (VASs). Joint counts were self-reported. RESULTS Eighty-one per cent responded, of whom 44% reported disturbed sleep (CSHQ > 41); there were no differences between disease groups. Poor reported sleep (SSR) was highly correlated with PedsQL fatigue (r = 0.56, P < 0.0001). Fatigue was highly negatively correlated with quality of life (r = -0.77, P < 0.0001). The worst pain intensity in the last week was correlated to sleep disturbance (r = 0.32, P = 0.0005). Fatigue was associated with prednisone and DMARD use. CONCLUSIONS Sleep disturbance and fatigue are prevalent among children with different rheumatic diseases. Sleep disturbance and fatigue are strongly associated with increased pain and decreased quality of life. Strategies aimed at improving sleep and reducing fatigue should be studied as possible ways of improving quality of life for children with rheumatic illness.
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Affiliation(s)
- Yonatan Butbul Aviel
- Department of Pediatrics, Technion Institution, Pediatric Department Rheumatology Unit, Technion Faculty of Medicine, Meyer Children’s Hospital of Haifa, Haifa, Israel
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Moorthy LN, Peterson MGE, Hassett AL, Lehman TJA. Burden of childhood-onset arthritis. Pediatr Rheumatol Online J 2010; 8:20. [PMID: 20615240 PMCID: PMC2914068 DOI: 10.1186/1546-0096-8-20] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2010] [Accepted: 07/08/2010] [Indexed: 03/04/2023] Open
Abstract
Juvenile arthritis comprises a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated morbidity, and life-long disability and risk for emotional and social dysfunction. In this article we will review the burden of juvenile arthritis for the patient and society and focus on the following areas: patient disability; visual outcome; other medical complications; physical activity; impact on HRQOL; emotional impact; pain and coping; ambulatory visits, hospitalizations and mortality; economic impact; burden on caregivers; transition issues; educational occupational outcomes, and sexuality.The extent of impact on the various aspects of the patients', families' and society's functioning is clear from the existing literature. Juvenile arthritis imposes a significant burden on different spheres of the patients', caregivers' and family's life. In addition, it imposes a societal burden of significant health care costs and utilization. Juvenile arthritis affects health-related quality of life, physical function and visual outcome of children and impacts functioning in school and home. Effective, well-designed and appropriately tailored interventions are required to improve transitioning to adult care, encourage future vocation/occupation, enhance school function and minimize burden on costs.
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Affiliation(s)
- Lakshmi N Moorthy
- Robert Wood Johnson Medical School-UMDNJ, Dept, of Pediatrics Room 1361, 89 French Street, New Brunswick, NJ, USA.
| | | | - Afton L Hassett
- University of Michigan Medical School, Chronic Pain & Fatigue Research Center, Dept of Anesthesiology, Ann Arbor, MI, USA
| | - Thomas JA Lehman
- Hospital For Special Surgery, 535 East 70th Street, New York, NY, USA,Weill Medical College of Cornell University, New York, NY, USA
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