1
|
Lanças SHS, Furlan MZB, Fernandes TDAP, Drumond SGL, Magalhães CS. Presentation of enthesitis-related arthritis and juvenile-onset spondyloarthritis: a cross-sectional study in a pediatric and adult clinic. Adv Rheumatol 2024; 64:39. [PMID: 38720369 DOI: 10.1186/s42358-024-00378-8] [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: 12/08/2023] [Accepted: 04/30/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) comprises a whole spectrum of chronic arthritis starting before 16 years of age. The study aims to explore the clinical and demographic descriptors, treatment, and disease progression of enthesitis-related arthritis (ERA) in comparison with juvenile-onset spondyloarthritis (SpA). METHODS Cross-sectional analysis of consecutive patients in two dedicated clinics, with a single visit and retrospective case-notes review. Arthritis, enthesitis and sacroiliitis were evaluated by scoring disease activity and damage. Continuous variables were reported by median, interquartile range; categorical variables were reported by the frequency comparison of the two groups. RESULTS Thirty-three cases were included, being 23 (69.7%) with ERA. The median age at diagnosis was 12.5 y (SpA) vs. 9 y (ERA) (p < 0.01); the time from symptom onset to diagnosis was 5.5 y (SpA) vs. 1.5 y (ERA) (p < 0.03). In both groups, the predominant presentation was a single joint or < 5 lower limb joints and asymmetric involvement, with a high frequency of enthesitis. There was a higher frequency of mid-tarsal and ankle synovitis in the ERA group and hip involvement in those with SpA. The comparison of the frequency of spine symptoms at presentation, 30% SpA vs. 21.7% ERA (p = 0.7), was not significant, and radiographic progression to spinal involvement occurred in 43.5% of ERA patients. The median time for spinal progression and age at onset was 2.2 and 12 y for ERA, and 4 and 16.5 y for SpA, respectively. Activity and damage scores were not significantly different between the groups. Treatment comparison resulted in 91.3% of ERA and 100% SpA being treated, predominantly with NSAIDs in both groups, followed by DMARDs and biologics, with a higher frequency of biologics in SpA. CONCLUSION The main differences were the late diagnoses of SpA, and the hip and spine involvement, with higher frequency of biologic treatment in juvenile-onset SpA compared to ERA.
Collapse
Affiliation(s)
- Sean Hideo Shirata Lanças
- Rheumatology Division, Botucatu Medical School, São Paulo State University (UNESP), Sao Paulo, Brazil.
| | | | | | - Sula Glaucia Lage Drumond
- Rheumatology Division, Botucatu Medical School, São Paulo State University (UNESP), Sao Paulo, Brazil
| | - Claudia Saad Magalhães
- Pediatric Rheumatology Division, Botucatu Medical School, São Paulo State University (UNESP), Sao Paulo, Brazil
| |
Collapse
|
2
|
Macfarlane FR, Chaplain MAJ, Eftimie R. Quantitative Predictive Modelling Approaches to Understanding Rheumatoid Arthritis: A Brief Review. Cells 2019; 9:E74. [PMID: 31892234 PMCID: PMC7016994 DOI: 10.3390/cells9010074] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 12/19/2019] [Accepted: 12/24/2019] [Indexed: 02/07/2023] Open
Abstract
Rheumatoid arthritis is a chronic autoimmune disease that is a major public health challenge. The disease is characterised by inflammation of synovial joints and cartilage erosion, which lead to chronic pain, poor life quality and, in some cases, mortality. Understanding the biological mechanisms behind the progression of the disease, as well as developing new methods for quantitative predictions of disease progression in the presence/absence of various therapies is important for the success of therapeutic approaches. The aim of this study is to review various quantitative predictive modelling approaches for understanding rheumatoid arthritis. To this end, we start by briefly discussing the biology of this disease and some current treatment approaches, as well as emphasising some of the open problems in the field. Then, we review various mathematical mechanistic models derived to address some of these open problems. We discuss models that investigate the biological mechanisms behind the progression of the disease, as well as pharmacokinetic and pharmacodynamic models for various drug therapies. Furthermore, we highlight models aimed at optimising the costs of the treatments while taking into consideration the evolution of the disease and potential complications.
Collapse
Affiliation(s)
- Fiona R. Macfarlane
- School of Mathematics and Statistics, University of St Andrews, St Andrews KY16 9RJ, UK;
| | - Mark A. J. Chaplain
- School of Mathematics and Statistics, University of St Andrews, St Andrews KY16 9RJ, UK;
| | - Raluca Eftimie
- Department of Mathematics, University of Dundee, Dundee DD1 4HN, UK;
| |
Collapse
|
3
|
Wu Q, Chaplin H, Ambrose N, Sen D, Leandro MJ, Wing C, Daly N, Webb K, Fisher C, Suffield L, Josephs F, Pilkington C, Eleftheriou D, Al-Obaidi M, Compeyrot-Lacassagne S, Wedderburn LR, Ioannou Y. Juvenile arthritis disease activity score is a better reflector of active disease than the disease activity score 28 in adults with polyarticular juvenile idiopathic arthritis. Ann Rheum Dis 2015; 75:635-6. [PMID: 26715652 PMCID: PMC4789685 DOI: 10.1136/annrheumdis-2015-208462] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 11/24/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Qiong Wu
- Arthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK
| | - Hema Chaplin
- Arthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK
| | - Nicola Ambrose
- Arthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK Adolescent Rheumatology Department, University College London Hospital NHS Trust, London, UK
| | - Debajit Sen
- Arthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK Adolescent Rheumatology Department, University College London Hospital NHS Trust, London, UK
| | - Maria J Leandro
- Adolescent Rheumatology Department, University College London Hospital NHS Trust, London, UK
| | - Charlotte Wing
- Adolescent Rheumatology Department, University College London Hospital NHS Trust, London, UK
| | - Nicola Daly
- Adolescent Rheumatology Department, University College London Hospital NHS Trust, London, UK
| | - Kate Webb
- Arthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK Adolescent Rheumatology Department, University College London Hospital NHS Trust, London, UK
| | - Corinne Fisher
- Arthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK Adolescent Rheumatology Department, University College London Hospital NHS Trust, London, UK
| | - Linda Suffield
- Arthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK
| | - Francesca Josephs
- Arthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK
| | - Clarissa Pilkington
- Paediatric Rheumatology Department, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Despina Eleftheriou
- Arthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK
| | - Muthana Al-Obaidi
- Paediatric Rheumatology Department, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | | | - Lucy R Wedderburn
- Arthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK Infection, Immunity, Inflammation, and Physiological Medicine Programme, Institute of Child Health, University College London, London, UK
| | - Yiannis Ioannou
- Arthritis Research UK Centre for Adolescent Rheumatology, University College London, London, UK Adolescent Rheumatology Department, University College London Hospital NHS Trust, London, UK
| |
Collapse
|