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Brunetto O, Cassinelli HR, Espada G, Viterbo GL, Meiorin SM, Ahumada MF, Brenzoni L, Maher MC, Chavero I, Ramírez Stieben LA, Brance ML. Guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis in pediatrics. ARCH ARGENT PEDIATR 2024; 122:e202202948. [PMID: 37382585 DOI: 10.5546/aap.2022-02948.eng] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Objective. To provide a framework for healthcare professionals managing pediatric patients who are on active glucocorticoid (GC) therapy and to develop recommendations for the prevention and treatment of GC-induced osteoporosis in the pediatric population. Methods. A panel of experts on bone and pediatric diseases developed a series of PICO questions that address issues related to the prevention and treatment of osteoporosis in patients on GC therapy. In accordance with the GRADE approach, we conducted a systematic review of the literature, summarized effect estimations, and classified the quality of the evidence. Then, voting and the formulation of recommendations followed. Results. Seven recommendations and six general principles were developed for GC-induced osteoporosis in the pediatric population. Conclusion. These recommendations provide guidance for clinicians who must make decisions concerning pediatric patients undergoing treatment with GC.
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Affiliation(s)
- Oscar Brunetto
- Department of Endocrinology, Hospital General de Niños Pedro de Elizalde, City of Buenos Aires, Argentina
| | - Hamilton R Cassinelli
- Centro de Investigaciones Endocrinológicas Dr. César Bergadá, Hospital de Niños Dr. Ricardo Gutiérrez, City of Buenos Aires, Argentina
| | - Graciela Espada
- Division of Rheumatology, Hospital de Niños Dr. Ricardo Gutiérrez, City of Buenos Aires, Argentina
| | - Gisela L Viterbo
- Department of Endocrinology, Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, City of Buenos Aires. Argentina
| | - Silvia M Meiorin
- Hospital de Niños Ricardo Gutiérrez, City of Buenos Aires, Argentina
| | - María F Ahumada
- Hospital Provincial de Pediatría Dr. Fernando Barreyro, Posadas, Argentina
| | - Luciana Brenzoni
- Department of Pediatric Endocrinology, Hospital Nacional Profesor Alejandro Posadas, El Palomar, Argentina
| | - María C Maher
- Instituto de Rehabilitación Psicofísica, City of Buenos Aires, Argentina
| | | | | | - María L Brance
- Universidad Nacional de Rosario. National Scientific and Technical Research Council (Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET). Rosario, Argentina
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2
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Fernández-Sarmiento J, Acevedo L, Niño-Serna LF, Boza R, García-Silva J, Yock-Corrales A, Yamazaki-Nakashimada MA, Faugier-Fuentes E, Del Águila O, Camacho-Moreno G, Estripeaut D, Gutiérrez IF, Luciani K, Espada G, Álvarez-Olmos MI, Pérez-Camacho P, Duarte-Passos S, Cervi MC, Cantillano EM, Llamas-Guillén BA, Saltigeral-Simental P, Criales J, Chacon-Cruz E, García-Domínguez M, Aguilar KLB, Jarovsky D, Ivankovich-Escoto G, Tremoulet AH, Ulloa-Gutierrez R. Risk Factors Associated with Intensive Care Admission in Children with Severe Acute Respiratory Syndrome Coronavirus 2-Related Multisystem Inflammatory Syndrome (MIS-C) in Latin America: A Multicenter Observational Study of the REKAMLATINA Network. J Intensive Care Med 2024:8850666241233189. [PMID: 38414438 DOI: 10.1177/08850666241233189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Background: Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 varies widely in its presentation and severity, with low mortality in high-income countries. In this study in 16 Latin American countries, we sought to characterize patients with MIS-C in the pediatric intensive care unit (PICU) compared with those hospitalized on the general wards and analyze the factors associated with severity, outcomes, and treatment received. Study Design: An observational ambispective cohort study was conducted including children 1 month to 18 years old in 84 hospitals from the REKAMLATINA network from January 2020 to June 2022. Results: A total of 1239 children with MIS-C were included. The median age was 6.5 years (IQR 2.5-10.1). Eighty-four percent (1043/1239) were previously healthy. Forty-eight percent (590/1239) were admitted to the PICU. These patients had more myocardial dysfunction (20% vs 4%; P < 0.01) with no difference in the frequency of coronary abnormalities (P = 0.77) when compared to general ward subjects. Of the children in the PICU, 83.4% (494/589) required vasoactive drugs, and 43.4% (256/589) invasive mechanical ventilation, due to respiratory failure and pneumonia (57% vs 32%; P = 0.01). On multivariate analysis, the factors associated with the need for PICU transfer were age over 6 years (aOR 1.76 95% CI 1.25-2.49), shock (aOR 7.06 95% CI 5.14-9.80), seizures (aOR 2.44 95% CI 1.14-5.36), thrombocytopenia (aOR 2.43 95% CI 1.77-3.34), elevated C-reactive protein (aOR 1.89 95% CI 1.29-2.79), and chest x-ray abnormalities (aOR 2.29 95% CI 1.67-3.13). The overall mortality was 4.8%. Conclusions: Children with MIS-C who have the highest risk of being admitted to a PICU in Latin American countries are those over age six, with shock, seizures, a more robust inflammatory response, and chest x-ray abnormalities. The mortality rate is five times greater when compared with high-income countries, despite a high proportion of patients receiving adequate treatment.
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Affiliation(s)
- Jaime Fernández-Sarmiento
- Department of Pediatrics and Intensive Care, Fundación Cardioinfantil-Instituto de Cardiología, Universidad de La Sabana, Bogotá, Colombia
| | - Lorena Acevedo
- Department of Pediatrics and Intensive Care, Fundación Cardioinfantil-Instituto de Cardiología, Universidad de La Sabana, Bogotá, Colombia
| | | | - Raquel Boza
- Unidad de Cuidados Intensivos Pediátricos, Hospital Nacional de Niños "Dr Carlos Sáenz Herrera," Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica
| | | | - Adriana Yock-Corrales
- Servicio de Emergencias, Hospital Nacional de Niños "Dr Carlos Sáenz Herrera," Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica
| | | | - Enrique Faugier-Fuentes
- Servicio de Reumatología, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Olguita Del Águila
- Unidad de Infectología Pediátrica, Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú
| | - German Camacho-Moreno
- Unidad de Infectología Pediátrica, Fundación Hospital Pediátrico La Misericordia (HOMI), Bogotá, Colombia
| | - Dora Estripeaut
- Servicio de Infectología, Hospital del Niño Dr José Renán Esquivel, Ciudad de Panamá, Panamá
| | - Iván F Gutiérrez
- Servicio de Infectología, Clínica Infantil Colsubsidio, Bogotá, Colombia
| | - Kathia Luciani
- Servicio de Infectología, Hospital de Especialidades Pediátricas Omar Torrijos Herrera, Ciudad de Panamá, Panamá
| | - Graciela Espada
- Servicio de Reumatología, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
| | | | - Paola Pérez-Camacho
- Servicio de Infectología, Fundación Valle del Lili & Departamento de Pediatría, Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | - Saulo Duarte-Passos
- Hospital Universitario de Faculdade de Medicina de Jundiai, Sao Paolo, Brazil
| | - Maria C Cervi
- Serviço de Infectología, Faculdade de Medicina de Ribeirāo Preto, Universidade de Sāo Paulo, Sao Paulo, Brazil
| | - Edwin M Cantillano
- Unidad de Cuidados Intensivos Pediátricos, Hospital Regional del Norte, Instituto Hondureño de Seguridad Social, San Pedro de Sula, Honduras
| | | | - Patricia Saltigeral-Simental
- Servicio de Infectología, Star Médica Hospital Infantil Privado e Instituto Nacional de Pediatría, Ciudad de México, México
| | | | - Enrique Chacon-Cruz
- Servicio de Infectología. Hospital General de Tijuana, Tijuana, México
- Think Vaccines LLC, Houston, Texas, USA
| | - Miguel García-Domínguez
- Servicio de Alergología e Inmunología, Hospital Pediátrico de Sinaloa "Dr Rigoberto Aguilar Pico," Sinaloa, México
| | - Karla L Borjas Aguilar
- Servicio de Inmunología, Hospital María, Especialidades Pediátricas e Instituto Hondureño de Seguridad Social, Hospital de Especialidades, Tegucigalpa, Honduras
| | - Daniel Jarovsky
- Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | - Gabriela Ivankovich-Escoto
- Servicio de Inmunología y Reumatología Pediátrica, Hospital Nacional de Niños "Dr Carlos Sáenz Herrera," Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica
| | - Adriana H Tremoulet
- Department of Pediatrics, University of California San Diego (UCSD) & Rady Children's Hospital, San Diego, California, USA
| | - Rolando Ulloa-Gutierrez
- Servicio de Infectología Pediátrica, Hospital Nacional de Niños "Dr Carlos Sáenz Herrera," Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica
- Facultad de Medicina, Universidad de Ciencias Médicas (UCIMED), San José, Costa Rica
- Instituto de Investigación en Ciencias Médicas UCIMED (IICIMED), San José, Costa Rica
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3
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Borgia RE, De Cunto CL, Terreri MT, Guerini LL, Espada G. Transition From Pediatric to Adult Rheumatology Care: An Exploratory Study From Latin America. J Clin Rheumatol 2024:00124743-990000000-00184. [PMID: 38206911 DOI: 10.1097/rhu.0000000000002055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND/PURPOSE Adequate transition from pediatric to adult care is associated with better adherence to treatment and better outcomes in pediatric patients with chronic diseases. There are little data on transition programs, outcomes, use of transition guidelines, and available tools in pediatric rheumatology centers from Latin America (LATAM). In this study, we described the characteristics of transition programs from 3 pediatric rheumatology centers. We also introduced results of the first survey examining the transition experience in countries from LATAM. METHODS The experience and implementation process of transition programs from 3 pediatric rheumatology centers were described. A survey based on a questionnaire created by Chira et al (J Rheumatol. 2014;41:768-779) from the Childhood Arthritis and Rheumatology Research Alliance was also administrated to pediatric rheumatology centers from LATAM. RESULTS A total of 49 (68%) pediatric rheumatologists answered the survey. Most centers do not have an official and written transition program and reported a need for more tools and resources in their services to facilitate the transition experience. CONCLUSIONS Transition guidelines culturally tailored to developing countries are needed in LATAM.
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Affiliation(s)
- R Ezequiel Borgia
- From the Division of Pediatric Allergy, Immunology, and Rheumatology, University Hospitals Rainbow Babies and Children's Hospital, Cleveland, OH
| | - Carmen L De Cunto
- Pediatric Rheumatology Section, Department of Pediatrics, Hospital Italiano, Buenos Aires, Argentina
| | - Maria Teresa Terreri
- Pediatric Rheumatology Section, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - L Lorena Guerini
- Rheumatology Section, Hospital de Niños Dr Ricardo Gutierrez, Buenos Aires, Argentina
| | - Graciela Espada
- Rheumatology Section, Hospital de Niños Dr Ricardo Gutierrez, Buenos Aires, Argentina
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4
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Bay L, Amartino H, Antacle A, Arberas C, Berretta A, Botto H, Cazalas M, Copiz A, De Cunto C, Drelichman G, Espada G, Eiroa H, Fainboim A, Fano V, Guelber R, Maffey A, Parisi C, Pereyra M, Remondino R, Schenone A, Spécola N, Staciuk R, Zuccaro G. New recommendations for the care of patients with mucopolysaccharidosis type I. ARCH ARGENT PEDIATR 2021; 119:e121-e128. [PMID: 33749201 DOI: 10.5546/aap.2021.eng.e121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/20/2020] [Indexed: 11/12/2022]
Abstract
Considering the advances made on mucopolysaccharidosis type I after the consensus study published by a group of experts in Argentina in 2008, recommendations about genetic testing, cardiological follow-up, airway care, hearing impairment detection, spinal and neurological conditions, as well as current treatments, were reviewed. Emphasis was placed on the need for early diagnosis and treatment, as well as an interdisciplinary follow-up.
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Affiliation(s)
- Luisa Bay
- Servicio de Errores Congénitos del Metabolismo, Hospital "Prof. Dr. Juan P. Garrahan"
| | - Hernán Amartino
- Servicio de Neurología Infantil, Clínica de Mucopolisacaridosis, Hospital Universitario Austral, Pilar, Buenos Aires
| | | | - Claudia Arberas
- Sección Genética Médica, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires
| | | | - Hugo Botto
- Endoscopía Respiratoria Pediátrica, Hospital "Prof. Dr. Juan P. Garrahan"
| | - Mariana Cazalas
- División Cardiología, Hospital de Niños Dr. Ricardo Gutiérrez
| | - Adriana Copiz
- Sección de Audiología, Servicio de Otorrinolaringología, Hospital de Niños Dr. Ricardo Gutiérrez
| | - Carmen De Cunto
- Sección Reumatología Pediátrica, Servicio Clínica Pediátrica, Departamento de Pediatría, Hospital Italiano de Buenos Aires
| | - Guillermo Drelichman
- Servicio de Hematología, Hospital de Niños Dr. Ricardo Gutiérrez y Fundación Favaloro
| | - Graciela Espada
- Servicio de Reumatología Infantil, Hospital de Niños Dr. Ricardo Gutiérrez
| | - Hernán Eiroa
- Servicio de Errores Congénitos del Metabolismo, Hospital "Prof. Dr. Juan P. Garrahan"
| | - Alejandro Fainboim
- Coordinador del Hospital de Día Polivalente, Hospital de Niños Dr. Ricardo Gutiérrez
| | - Virginia Fano
- Servicio de Crecimiento y Desarrollo, Hospital "Prof. Dr. Juan P. Garrahan"
| | - Rorberto Guelber
- Servicio de Enfermedades Metabólicas, Clínica Universitaria Reina Fabiola
| | - Alberto Maffey
- Centro Respiratorio, Hospital de Niños Dr. Ricardo Gutiérrez
| | - Claudio Parisi
- Secciones Alergia Pediátrica y Adultos, Hospital Italiano de Buenos Aires. Coordinador del Grupo de Trabajo Alérgenos Alimentarios, International Life Sciences Institute (ILSI) Argentina
| | - Marcela Pereyra
- Crecimiento y Desarrollo, referente en Errores Congénitos del Metabolismo de Mendoza, Hospital Pediátrico Dr. H. J. Notti de Mendoza
| | | | | | - Norma Spécola
- Unidad de Metabolismo, Hospital Sor María Ludovica, La Plata
| | - Raquel Staciuk
- Servicio de Trasplante de Medula Ósea, Hospital "Prof. Dr. Juan P. Garrahan"
| | - Graciela Zuccaro
- Neurocirugía, Universidad de Buenos Aires (UBA), Servicio de Neurocirugía, Hospital "Prof. Dr. Juan P. Garrahan", ex presidenta de la International Society of Pediatric Neurosurgery (ISPN), medallista de Federación Latinoamericana de Sociedades de Neurocirugía (FLANC), 2018
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5
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Brunner HI, Ruperto N, Zuber Z, Cuttica R, Keltsev V, Xavier RM, Burgos-Vargas R, Penades IC, Silverman ED, Espada G, Zavaler MF, Kimura Y, Duarte C, Job-Deslandre C, Joos R, Douglass W, Wimalasundera S, Bharucha KN, Wells C, Lovell DJ, Martini A, de Benedetti F. Efficacy and Safety of Tocilizumab for Polyarticular-Course Juvenile Idiopathic Arthritis in the Open-Label Two-Year Extension of a Phase III Trial. Arthritis Rheumatol 2021; 73:530-541. [PMID: 32951358 PMCID: PMC7986602 DOI: 10.1002/art.41528] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/08/2020] [Accepted: 08/21/2020] [Indexed: 02/05/2023]
Abstract
Objective To report the 2‐year efficacy and safety of tocilizumab (TCZ) in patients with polyarticular‐course juvenile idiopathic arthritis (JIA). Methods Patients ages 2–17 years with active polyarticular‐course JIA, in whom treatment with methotrexate was unsuccessful, received 16 weeks of open‐label intravenous TCZ in part 1 (once every 4 weeks: 8 mg/kg or 10 mg/kg for body weight [BW] <30 kg; 8 mg/kg for BW ≥30 kg). Assessments were based on the JIA–American College of Rheumatology (ACR) response (defined as percentage of improvement in ≥3 of the 6 JIA core response variables [CRVs]). Patients with at least a JIA‐ACR30 response (defined as ≥30% improvement in ≥3 of the 6 JIA CRVs without worsening in >1 of the remaining JIA CRVs by >30%) at week 16 were randomly assigned (1:1) to receive TCZ or placebo in part 2. Patients remained in part 2 until either week 40 or the occurrence of JIA flare. Upon starting part 3, all patients received open‐label TCZ. At week 104 of the study, efficacy was assessed using JIA‐ACR50/70/90 response rates (defined as 50%, 70%, or 90% improvement, respectively), achievement of inactive disease, and the Juvenile Arthritis Disease Activity Score in 71 joints (JADAS‐71). Safety was assessed in the all‐exposure population per 100 patient‐years of exposure. Results Overall, 188 patients entered part 1, 166 patients entered part 2, and 160 patients entered part 3. By week 104, among the 188 patients in the modified intent‐to‐treat group who received TCZ, JIA‐ACR50/70/90 response rates were 80.3%/77.1%/59.6%, respectively, the median JADAS‐71 score decreased from 3.6 at week 40 to 0.7 at week 104, 51.1% of patients had achieved inactive disease, and 31 of 66 patients who had been receiving glucocorticoids discontinued them. Adverse event (AE) and serious AE rates were 406.5 per 100 patient‐years and 11.1 per 100 patient‐years, respectively. The infection rate was 151.4 per 100 patient‐years, and the serious infection rate was 5.2 per 100 patient‐years. Conclusion Patients treated with TCZ for polyarticular‐course JIA showed high‐level disease control for up to 2 years. The TCZ safety profile was consistent with that previously reported.
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Affiliation(s)
| | - Nicolino Ruperto
- Istituto Giannina Gaslini, Pediatria II-Rheumatologia, PRINTO, Genoa, Italy
| | - Zbigniew Zuber
- Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - Rubén Cuttica
- Hospital General de Niños Pedro de Elizalde, Buenos Aires, Argentina
| | | | - Ricardo M Xavier
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Ruben Burgos-Vargas
- Hospital General de México and Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | | | - Graciela Espada
- Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina
| | | | - Yukiko Kimura
- Joseph M. Sanzari Children's Hospital and Hackensack Meridian School of Medicine, Hackensack, New Jersey
| | - Carolina Duarte
- Instituto Nacional de Rehabilitación Luis Guillermo Ibarra, Mexico City, Mexico
| | | | - Rik Joos
- ZNA Jan Palfijn Antwerpen, Antwerp, Belgium, and University Hospital, Ghent, Belgium
| | | | | | | | - Chris Wells
- Roche Products, Ltd., Welwyn Garden City, UK
| | - Daniel J Lovell
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Alberto Martini
- Istituto Giannina Gaslini, Pediatria II-Rheumatologia, PRINTO, Genoa, Italy
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6
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Ruperto N, Brunner HI, Tzaribachev N, Vega-Cornejo G, Louw I, Cimaz R, Dare J, Espada G, Faugier E, Ferrandiz M, Gerloni V, Quartier P, Silva CA, Wagner-Weiner L, Gandhi Y, Passarell J, Nys M, Wong R, Martini A, Lovell DJ. Absence of Association Between Abatacept Exposure and Initial Infection in Patients With Juvenile Idiopathic Arthritis. J Rheumatol 2021; 48:1073-1081. [PMID: 33452173 DOI: 10.3899/jrheum.200154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess the relationship between infection risk and abatacept (ABA) exposure levels in patients with polyarticular-course juvenile idiopathic arthritis (pJIA) following treatment with subcutaneous (SC) and intravenous (IV) ABA. METHODS Data from 2 published studies (ClinicalTrials.gov: NCT01844518, NCT00095173) of ABA treatment in pediatric patients were analyzed. One study treated patients aged 2-17 years with SC ABA and the other treated patients aged 6-17 years with IV ABA. Association between serum ABA exposure measures and infection was evaluated using Kaplan-Meier plots of probability of first infection vs time on treatment by ABA exposure quartiles and log-rank tests. Number of infections by ABA exposure quartiles was investigated. RESULTS Overall, 343 patients were included in this analysis: 219 patients received SC ABA and 124 patients received IV ABA. Overall, 237/343 (69.1%) patients had ≥ 1 infection over 24 months. No significant difference in time to first infection across 4 quartiles of ABA exposure levels was observed in the pooled (P = 0.45), SC (2-5 yrs: P = 0.93; 6-17 yrs: P = 0.48), or IV (P = 0.50) analyses. Concomitant use of methotrexate and glucocorticoids (at baseline and throughout) with ABA did not increase infection risk across the ABA exposure quartiles. There was no evidence of association between number of infections and ABA exposure quartiles. No opportunistic infections related to ABA were reported. CONCLUSION In patients aged 2-17 years with pJIA, no evidence of association between higher levels of exposure to IV ABA or SC ABA and incidence of infection was observed.
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Affiliation(s)
- Nicolino Ruperto
- N. Ruperto, MD, MPH, IRCCS Istituto G Gaslini, Clinica Pediatrica e Reumatologia-UOSID Centro Trial, Genoa, Italy;
| | - Hermine I Brunner
- H.I. Brunner, MD, MSc, MBA, D.J. Lovell, MD, MPH, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Nikolay Tzaribachev
- N. Tzaribachev, MD, Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany
| | - Gabriel Vega-Cornejo
- G. Vega-Cornejo, MD, CREA Hospital México Americano, Guadalajara, Jalisco, Mexico
| | - Ingrid Louw
- I. Louw, MMED, MBChB, Panorama Medical Centre, Cape Town, South Africa
| | - Rolando Cimaz
- R. Cimaz, MD, University Hospital Meyer, Florence, Italy and Department of Clinical Sciences and Community Health, University of Milano, Milan, Italy
| | - Jason Dare
- J. Dare, MD, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Graciela Espada
- G. Espada, MD, Hospital de Niños Dr Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Enrique Faugier
- E. Faugier, MD, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Manuel Ferrandiz
- M. Ferrandiz, MD, Instituto Nacional de Salúd del Niño, Breña, Peru
| | - Valeria Gerloni
- V. Gerloni, MD, Istituto Ortopedico Gaetano Pini, Milan, Italy
| | - Pierre Quartier
- P. Quartier, MD, Université de Paris, IMAGINE Institute, RAISE reference centre for rare diseases, Necker-Enfants Malades hospital, AP-HP, Paris, France
| | - Clovis Artur Silva
- C.A. Silva, MD, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Yash Gandhi
- Y. Gandhi, PhD, R. Wong, MD, Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Julie Passarell
- J. Passarell, MA, Cognigen Corporation, Buffalo, New York, USA
| | - Marleen Nys
- M. Nys, MSc, Bristol Myers Squibb, Braine-L'Alleud, Belgium
| | - Robert Wong
- Y. Gandhi, PhD, R. Wong, MD, Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Alberto Martini
- A. Martini, MD, IRCCS Istituto G Gaslini, Clinica Pediatrica e Reumatologia, Genoa, Italy and Università di Genova, Genoa, Italy
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7
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Rosina S, Varnier GC, Pistorio A, Pilkington C, Maillard S, Civino A, Tsitsami E, Bracaglia C, Jelusic M, Cespedes-Cruz A, Espada G, Cimaz R, Couillault G, Joos R, Quartier P, Rao AP, Malattia C, Ruperto N, Consolaro A, Ravelli A. Development and Testing of Reduced Versions of the Manual Muscle Test-8 in Juvenile Dermatomyositis. J Rheumatol 2020; 48:898-906. [PMID: 33191283 DOI: 10.3899/jrheum.200543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To develop and test shortened versions of the Manual Muscle Test-8 (MMT-8) in juvenile dermatomyositis (JDM). METHODS Construction of reduced tools was based on a retrospective analysis of individual scores of MMT-8 muscle groups in 3 multinational datasets. The 4 and 6 most frequently impaired muscle groups were included in MMT-4 and MMT-6, respectively. Metrologic properties of reduced tools were assessed by evaluating construct validity, internal consistency, discriminant ability, and responsiveness to change. RESULTS Neck flexors, hip extensors, hip abductors, and shoulder abductors were included in MMT-4, whereas MMT-6 also included elbow flexors and hip flexors. Both shortened tools revealed strong correlations with MMT-8 and other muscle strength measures. Correlations with other JDM outcome measures were in line with predictions. Internal consistency was good (0.88-0.96) for both MMT-4 and MMT-6. Both reduced tools showed strong ability to discriminate between disease activity states, assessed by the caring physician or a parent (P < 0.001), and between patients whose parents were satisfied or not satisfied with illness course (P < 0.001). Responsiveness to change (assessed by both standardized response mean and relative efficiency) of MMT-4 and, to a lesser degree, MMT-6, was slightly superior to that of MMT-8. CONCLUSION Overall, the metrologic performance of MMT-4 and MMT-6 was comparable to that of the other established muscle strength tools, which indicates that they may be suitable for use in clinical practice and research, including clinical trials. The measurement properties of these tools should be further tested in other patient populations and evaluated prospectively.
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Affiliation(s)
- Silvia Rosina
- S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy;
| | - Giulia C Varnier
- G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children's Hospital, Manchester, UK
| | - Angela Pistorio
- A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Clarissa Pilkington
- C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK
| | - Susan Maillard
- C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK
| | - Adele Civino
- A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy
| | - Elena Tsitsami
- E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children's Hospital Agia Sofia, Athens, Greece
| | - Claudia Bracaglia
- C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Marija Jelusic
- M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Adriana Cespedes-Cruz
- A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico
| | - Graciela Espada
- G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Rolando Cimaz
- R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Gerard Couillault
- G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children's Hospital, Dijon, France
| | - Rik Joos
- R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Pierre Quartier
- P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l'Enfant (RAISE), Université de Paris and Unité d'Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Anand P Rao
- A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India
| | - Clara Malattia
- C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy
| | - Nicolino Ruperto
- S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Alessandro Consolaro
- C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy
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8
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Brunner HI, Chen C, Bovis F, De Benedetti F, Espada G, Joos R, Akikusa J, Chaitow J, Boteanu AL, Kimura Y, Rietschel C, Siri D, Smolewska E, Schmeling H, Brown DE, Martini A, Lovell DJ, Huang B, Ruperto N. Functional Ability and Health-Related Quality of Life in Randomized Controlled Trials of Tocilizumab in Patients With Juvenile Idiopathic Arthritis. Arthritis Care Res (Hoboken) 2020; 73:1264-1274. [PMID: 32702212 DOI: 10.1002/acr.24384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/14/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate changes in health-related quality of life (HRQoL) and disability in children with systemic juvenile idiopathic arthritis (JIA) or polyarticular JIA treated with tocilizumab. METHODS Secondary analyses of two double-blind, placebo-controlled trials of intravenous tocilizumab in children with active systemic JIA or polyarticular JIA were conducted. Patient-reported outcomes of disability (Childhood Health Assessment Questionnaire [C-HAQ]), HRQoL (Child Health Questionnaire Parent Form 50 [CHQ-P50], health concepts, physical summary score [CHQ-P50-PhS], psychosocial summary score [CHQ-P50-PsS]), pain, and well-being (100-mm visual analog scale [VAS]) were measured at weeks 0 and 12 for systemic JIA, weeks 16 and 40 for polyarticular JIA, and week 104 for both JIA subgroups. RESULTS The trial included 112 patients with systemic JIA and 188 patients with polyarticular JIA. In patients with polyarticular JIA, the mean ± SD C-HAQ score decreased from 1.39 ± 0.74 at baseline to 0.67 ± 0.65 at week 16 (P < 0.001). In patients with systemic JIA, the mean ± SD CHQ-P50-PhS improved more with tocilizumab therapy than with placebo at week 12 (7.3 ± 10.2 versus 2.4 ± 10.6) (P < 0.05). Almost all mean CHQ-P50 health concept scores, CHQ-P50-PsS, and CHQ-P50-PhS improved (P ≤ 0.002) by week 104 for patients with systemic JIA. Patients with polyarticular JIA and patients with systemic JIA showed significant reductions in disability (mean ± SD C-HAQ scores of -1.09 ± 0.71 and -1.17 ± 0.80, respectively), improvements in well-being (mean ± SD well-being VAS scores of -43.76 ± 26.61 and -51.53 ± 23.57, respectively), and decreases in pain (mean ± SD pain VAS scores of -41.56 ± 31.06 and -51.26 ± 26.79, respectively) (P < 0.001); in patients with polyarticular JIA and patients with systemic JIA who were treated with tocilizumab, 92.9% of polyarticular JIA patients and 96.8% of systemic JIA patients reported no more than minimal pain (a score of ≤35 mm on the VAS) at week 104. CONCLUSION Tocilizumab treatment was associated with significantly reduced disability and pain and improved HRQoL in patients with systemic JIA and polyarticular JIA.
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Affiliation(s)
- Hermine I Brunner
- PRCSG, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Chen Chen
- PRCSG, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | | | - Graciela Espada
- Hospital de Ninos Ricardo Gutierrez, Buenos Aires, Argentina
| | - Rik Joos
- Ghent University Hospital, Ghent, Belgium
| | | | | | | | - Yukiko Kimura
- Joseph M. Sanzari Children's Hospital, Hackensack Meridian School of Medicine, Hackensack, New Jersey
| | | | | | | | - Heinrike Schmeling
- Alberta Children's Hospital and Cumming School of Medicine/University of Calgary, Calgary, Alberta, Canada
| | - Diane E Brown
- Children's Hospital of Los Angeles, and University of Southern California, Los Angeles, California
| | - Alberto Martini
- Pediatric and Rheumatology Clinic, PRINTO, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Daniel J Lovell
- PRCSG, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Bin Huang
- PRCSG, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Nicolino Ruperto
- Pediatric and Rheumatology Clinic, PRINTO, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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9
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Papa R, Lane T, Bovis F, Minden K, Touitou I, Cantarini L, Cattalini M, Obici L, Jansson A, Belot A, Woska-Kuśnierz B, Berendes R, Remesal A, Jelusic M, Espada G, Nikishina I, Hoppenreijs E, Maggio MC, Youngstein T, Rezk T, Papadopoulou C, Brogan P, Hawkins PN, Woo P, Ruperto N, Gattorno M, Lachmann HJ. FRI0457 LONG-TERM OUTCOMES AND TREATMENT EFFICACY IN PATIENTS WITH TNF RECEPTOR-ASSOCIATED AUTOINFLAMMATORY SYNDROME (TRAPS) FROM THE EUROFEVER INTERNATIONAL REGISTRY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Tumour necrosis factor (TNF) receptor-associated periodic syndrome (TRAPS) is one of the best-known monogenic auto-inflammatory disorders resulting from an autosomal dominant variation in the TNF super family receptor 1A (TNFRSF1A) gene (1).Objectives:To define best treatment approach in patients with TRAPS and effect on long-term outcomes.Methods:We reviewed all data on patients with TRAPS enrolled in the Eurofever international registry according the INSAID gene variant classification and the new Eurofever/PRINTO classification criteria (EPCC).Results:Data on 226 patients were available. Patients not fulfilling the EPCC carrying likely benign/benign variants (21 patients, 9%) or VOUS/not classified variants (40 patients, 18%) displayed a milder disease than the patients fulfilling the EPCC with VOUS/not classified variants (38 patients, 17%) or pathogenic/likely pathogenic variants (127 patients, 56%). In particular, in patients not fulfilling the EPCC, less frequent abdominal pain and skin rashes, higher efficacy rate of colchicine and no development of AA amyloidosis have been reported. Almost 90% of patients fulfilling the EPCC required maintenance therapy and anti-interleukin (IL)-1 drugs were the most frequently used, with the highest efficacy rate (>85% complete response), while Etanercept was less effectively used and discontinued in 65% of patients.Conclusion:Anti-IL-1 drugs are the best maintenance treatment in TRAPS with potential to reverse the most serious disease complications of AA amyloidosis and infertility. The diagnosis of TRAPS should be considered very carefully in patients carrying VOUS/not classified variants not fulfilling the EPCC.References:[1]Lachmann HJ, Papa R, Gerhold K, Obici L, Touitou I, Cantarini L, et al. The phenotype of TNF receptor-associated autoinflammatory syndrome (TRAPS) at presentation: a series of 158 cases from the Eurofever/EUROTRAPS international registry. Annals of the rheumatic diseases 2014;73:2160-7.Acknowledgments:RP would like to thank the European Federation of Immunology (EFIS) for the short-term bursary and HL for her continuous support and guidance during the fellowship at the National Amyloidosis Centre in London.Disclosure of Interests:Riccardo Papa: None declared, Thirusha Lane: None declared, Francesca Bovis: None declared, Kirsten Minden Consultant of: GlaxoSmithKline, Sanofi, Speakers bureau: Roche, Isabelle Touitou: None declared, Luca Cantarini: None declared, Marco Cattalini: None declared, Laura Obici: None declared, Annette Jansson: None declared, Alexander Belot: None declared, Beata Woska-Kuśnierz: None declared, Rainer Berendes: None declared, Agustin Remesal: None declared, Marija Jelusic: None declared, Graciela Espada: None declared, Irina Nikishina: None declared, Esther Hoppenreijs: None declared, Maria Cristina Maggio: None declared, Taryn Youngstein: None declared, Tamer Rezk: None declared, Charalampia Papadopoulou: None declared, Paul Brogan Grant/research support from: Roche, Novartis, SOBI, Chemocentryx, Novimmune, Consultant of: Roche, SOBI, UCB, Novartis, Speakers bureau: Roche, SOBI, UCB, Novartis, Philip N Hawkins: None declared, Patricia Woo: None declared, Nicolino Ruperto Grant/research support from: Bristol-Myers Squibb, Eli Lily, F Hoffmann-La Roche, GlaxoSmithKline, Janssen, Novartis, Pfizer, Sobi (paid to institution), Consultant of: Ablynx, AbbVie, AstraZeneca-Medimmune, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lily, EMD Serono, GlaxoSmithKline, Hoffmann-La Roche, Janssen, Merck, Novartis, Pfizer, R-Pharma, Sanofi, Servier, Sinergie, Sobi, Takeda, Speakers bureau: Ablynx, AbbVie, AstraZeneca-Medimmune, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lily, EMD Serono, GlaxoSmithKline, Hoffmann-La Roche, Janssen, Merck, Novartis, Pfizer, R-Pharma, Sanofi, Servier, Sinergie, Sobi, Takeda, Marco Gattorno Consultant of: Sobi, Novartis, Speakers bureau: Sobi, Novartis, Helen J. Lachmann: None declared
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Rosina S, Consolaro A, van Dijkhuizen P, Pistorio A, Varnier GC, Bovis F, Nistala K, Maillard S, Civino A, Tsitsami E, de Inocencio J, Jelusic M, Vojinovic J, Espada G, Makay B, Katsicas MM, Pratsidou-Gertsi P, Lazarevic D, Rao AP, Pires Marafon D, Martini A, Pilkington C, Ruperto N, Ravelli A. Development and validation of a composite disease activity score for measurement of muscle and skin involvement in juvenile dermatomyositis. Rheumatology (Oxford) 2019; 58:1196-1205. [DOI: 10.1093/rheumatology/key421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 11/01/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Silvia Rosina
- Dipartimento di Neuroscienze Riabilitazione Oftalmologia Genetica e Scienze Materno-Infantili, Università degli Studi di Genova, Genoa, Italy
| | - Alessandro Consolaro
- Dipartimento di Neuroscienze Riabilitazione Oftalmologia Genetica e Scienze Materno-Infantili, Università degli Studi di Genova, Genoa, Italy
- Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Angela Pistorio
- Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Giulia Camilla Varnier
- Dipartimento di Neuroscienze Riabilitazione Oftalmologia Genetica e Scienze Materno-Infantili, Università degli Studi di Genova, Genoa, Italy
| | - Francesca Bovis
- Dipartimento di Neuroscienze Riabilitazione Oftalmologia Genetica e Scienze Materno-Infantili, Università degli Studi di Genova, Genoa, Italy
| | - Kiran Nistala
- Paediatric Rheumatology Department, Great Ormond Street Hospital, London, UK
| | - Susan Maillard
- Paediatric Rheumatology Department, Great Ormond Street Hospital, London, UK
| | - Adele Civino
- Oncoematologia Pediatrica, Ospedale Vito Fazzi, Lecce, Italy
| | - Elena Tsitsami
- First Department of Pediatrics, Children’s Hospital Agia Sofia, Athens, Greece
| | - Jaime de Inocencio
- Unidad de Reumatología Pediátrica, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Marija Jelusic
- Department of Pediatrics, University of Zagreb, Zagreb, Croatia
| | | | - Graciela Espada
- Pediatric Rheumatology Unit, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Balahan Makay
- Division of Pediatric Rheumatology, Dokuz Eylül University Hospital, Izmir, Turkey
| | - Maria Martha Katsicas
- Servicio de Inmunologia/Reumatologia, Hospital de Pediatría Juan P.Garrahan, Buenos Aires, Argentina
| | | | | | | | - Denise Pires Marafon
- Clinica Pediatrica De Marchi, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alberto Martini
- Dipartimento di Neuroscienze Riabilitazione Oftalmologia Genetica e Scienze Materno-Infantili, Università degli Studi di Genova, Genoa, Italy
- Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Clarissa Pilkington
- Paediatric Rheumatology Department, Great Ormond Street Hospital, London, UK
| | - Nicolino Ruperto
- Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Angelo Ravelli
- Dipartimento di Neuroscienze Riabilitazione Oftalmologia Genetica e Scienze Materno-Infantili, Università degli Studi di Genova, Genoa, Italy
- Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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11
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Pons-Estel BA, Bonfa E, Soriano ER, Cardiel MH, Izcovich A, Popoff F, Criniti JM, Vásquez G, Massardo L, Duarte M, Barile-Fabris LA, García MA, Amigo MC, Espada G, Catoggio LJ, Sato EI, Levy RA, Acevedo Vásquez EM, Chacón-Díaz R, Galarza-Maldonado CM, Iglesias Gamarra AJ, Molina JF, Neira O, Silva CA, Vargas Peña A, Gómez-Puerta JA, Scolnik M, Pons-Estel GJ, Ugolini-Lopes MR, Savio V, Drenkard C, Alvarellos AJ, Ugarte-Gil MF, Babini A, Cavalcanti A, Cardoso Linhares FA, Haye Salinas MJ, Fuentes-Silva YJ, Montandon de Oliveira E Silva AC, Eraso Garnica RM, Herrera Uribe S, Gómez-Martín D, Robaina Sevrini R, Quintana RM, Gordon S, Fragoso-Loyo H, Rosario V, Saurit V, Appenzeller S, Dos Reis Neto ET, Cieza J, González Naranjo LA, González Bello YC, Collado MV, Sarano J, Retamozo S, Sattler ME, Gamboa-Cárdenas RV, Cairoli E, Conti SM, Amezcua-Guerra LM, Silveira LH, Borba EF, Pera MA, Alba Moreyra PB, Arturi V, Berbotto GA, Gerling C, Gobbi CA, Gervasoni VL, Scherbarth HR, Brenol JCT, Cavalcanti F, Costallat LTL, Da Silva NA, Monticielo OA, Seguro LPC, Xavier RM, Llanos C, Montúfar Guardado RA, Garcia de la Torre I, Pineda C, Portela Hernández M, Danza A, Guibert-Toledano M, Reyes GL, Acosta Colman MI, Aquino AM, Mora-Trujillo CS, Muñoz-Louis R, García Valladares I, Orozco MC, Burgos PI, Betancur GV, Alarcón GS. First Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus: Latin American Group for the Study of Lupus (GLADEL, Grupo Latino Americano de Estudio del Lupus)-Pan-American League of Associations of Rheumatology (PANLAR). Ann Rheum Dis 2018; 77:1549-1557. [PMID: 30045853 PMCID: PMC6225798 DOI: 10.1136/annrheumdis-2018-213512] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 06/26/2018] [Accepted: 06/28/2018] [Indexed: 11/24/2022]
Abstract
Systemic lupus erythematosus (SLE), a complex and heterogeneous autoimmune disease, represents a significant challenge for both diagnosis and treatment. Patients with SLE in Latin America face special problems that should be considered when therapeutic guidelines are developed. The objective of the study is to develop clinical practice guidelines for Latin American patients with lupus. Two independent teams (rheumatologists with experience in lupus management and methodologists) had an initial meeting in Panama City, Panama, in April 2016. They selected a list of questions for the clinical problems most commonly seen in Latin American patients with SLE. These were addressed with the best available evidence and summarised in a standardised format following the Grading of Recommendations Assessment, Development and Evaluation approach. All preliminary findings were discussed in a second face-to-face meeting in Washington, DC, in November 2016. As a result, nine organ/system sections are presented with the main findings; an 'overarching' treatment approach was added. Special emphasis was made on regional implementation issues. Best pharmacologic options were examined for musculoskeletal, mucocutaneous, kidney, cardiac, pulmonary, neuropsychiatric, haematological manifestations and the antiphospholipid syndrome. The roles of main therapeutic options (ie, glucocorticoids, antimalarials, immunosuppressant agents, therapeutic plasma exchange, belimumab, rituximab, abatacept, low-dose aspirin and anticoagulants) were summarised in each section. In all cases, benefits and harms, certainty of the evidence, values and preferences, feasibility, acceptability and equity issues were considered to produce a recommendation with special focus on ethnic and socioeconomic aspects. Guidelines for Latin American patients with lupus have been developed and could be used in similar settings.
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Affiliation(s)
- Bernardo A Pons-Estel
- Departamento de Medicina Interna, Grupo Oroño-Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
| | - Eloisa Bonfa
- Rheumatology Division, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Enrique R Soriano
- Sección de Reumatología, Servicio de Clínica Médica, Instituto Universitario, Escuela de Medicina, and Fundación Dr Pedro M Catoggio para el Progreso de la Reumatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Mario H Cardiel
- Centro de Investigación Clínica de Morelia, SC, Morelia, México
| | - Ariel Izcovich
- Servicio de Clínica Médica del Hospital Alemán de Buenos Aires, Hospital Alemán de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Federico Popoff
- Servicio de Clínica Médica del Hospital Alemán de Buenos Aires, Hospital Alemán de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Juan M Criniti
- Servicio de Clínica Médica del Hospital Alemán de Buenos Aires, Hospital Alemán de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Gloria Vásquez
- Grupo de Inmunología Celular e Inmunogenética, Universidad de Antioquia, Hospital Universitario, Fundación San Vicente, Medellín, Colombia
| | - Loreto Massardo
- Centro de Biología Celular y Biomedicina, Facultad de Medicina y Ciencia. Universidad San Sebastián, Santiago, Chile
| | - Margarita Duarte
- Departamento de Reumatología, Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, Asunción, Paraguay
| | | | - Mercedes A García
- Servicio de Reumatología, HIGA General San Martín, La Plata, Argentina
| | - Mary-Carmen Amigo
- Servicio de Reumatología, Centro Médico ABC, Ciudad de México, México
| | - Graciela Espada
- Servicio de Reumatología Infantil, Hospital de Niños Dr Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Luis J Catoggio
- Sección de Reumatología, Servicio de Clínica Médica, Instituto Universitario, Escuela de Medicina, and Fundación Dr Pedro M Catoggio para el Progreso de la Reumatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Emilia Inoue Sato
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paul, Brazil
| | - Roger A Levy
- Discipline of Rheumatology, University of the State of Rio de Janeiro, Rio de Janeiro, Brasil
| | - Eduardo M Acevedo Vásquez
- Facultad de Medicina., Universidad Nacional Mayor de San Marcos. Servicio de Reumatología. Clínica San Felipe, J. María., Lima, Perú
| | - Rosa Chacón-Díaz
- Servicio de Reumatología, Policlínica Méndez Gimón, Caracas, Venezuela
| | | | | | | | - Oscar Neira
- Sección de Reumatología, Hospital del Salvador. Universidad de Chile. Unidad de Reumatología. Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo., Santiago, Chile
| | - Clóvis A Silva
- Pediatric Department, Faculdade de Medicina, Children's Institute, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Andrea Vargas Peña
- Clínica Reumatológica, Universidad de la República, and Unidad Docente Asistencial, Hospital Pasteur, Instituto Nacional de Reumatología., Montevideo, Uruguay
| | | | - Marina Scolnik
- Sección de Reumatología, Servicio de Clínica Médica, Instituto Universitario, Escuela de Medicina, and Fundación Dr Pedro M Catoggio para el Progreso de la Reumatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Guillermo J Pons-Estel
- Departamento de Medicina Interna, Grupo Oroño-Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
- Servicio de Reumatología, Hospital Provincial de Rosario, Rosario, Argentina
| | - Michelle R Ugolini-Lopes
- Rheumatology Division, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Verónica Savio
- Servicio de Reumatología, Hospital Italiano de Córdoba, Córdoba, Argentina
| | - Cristina Drenkard
- Division of Rheumatology, Department of Medicine, Emory School of Medicine, Atlanta, Georgia, USA
| | | | - Manuel F Ugarte-Gil
- Servicio de Reumatología, Hospital General Guillermo Almenara Irigoyen, EsSalud., Lima, Perú
- Universidad Científica del Sur, Lima, Perú
| | - Alejandra Babini
- Servicio de Reumatología, Hospital Italiano de Córdoba, Córdoba, Argentina
| | - André Cavalcanti
- Serviço de Reumatologia do Hospital das Clínicas da Universidade Federal de Pernambuco (HC-UFPE), Recife, Brazil
| | - Fernanda Athayde Cardoso Linhares
- Clínica Reumatológica, Universidad de la República, and Unidad Docente Asistencial, Hospital Pasteur, Instituto Nacional de Reumatología., Montevideo, Uruguay
| | | | - Yurilis J Fuentes-Silva
- Unidad de Reumatología, Departamento de Medicina, Universidad de Oriente, Complejo Hospitalario Universitario Ruiz y Páez, Ciudad Bolívar, Venezuela
| | | | - Ruth M Eraso Garnica
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, Hospital Pablo Tobón Uribe, Medellín, Colombia
| | - Sebastián Herrera Uribe
- Servicio de Reumatología, Hospital General de Medellín 'Luz Castro de Gutierrez' ESE, ARTMEDICA, Medellín, Colombia
| | - Diana Gómez-Martín
- Departamento de Inmunología y Reumatología, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Ciudad de México, Mexico
| | - Ricardo Robaina Sevrini
- Unidad de Enfermedades Autoinmunes Sistémicas, Facultad de Medicina, Clínica Médica 'C', Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - Rosana M Quintana
- Departamento de Medicina Interna, Grupo Oroño-Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina
- Servicio de Reumatología, Hospital Provincial de Rosario, Rosario, Argentina
| | - Sergio Gordon
- Unidad de Reumatología y Enfermedades Autoinmunes Sistémicas, HIGA Dr Oscar Alende, Mar del Plata, Argentina
| | - Hilda Fragoso-Loyo
- Departamento de Inmunología y Reumatología, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Ciudad de México, Mexico
| | - Violeta Rosario
- Servicio de Reumatología, Enfermedades Reumatológicas e Investigación Clínica (ERIC), Hospital Docente Padre Billini, Santo Domingo, Dominican Republic
| | - Verónica Saurit
- Servicio de Reumatología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - Simone Appenzeller
- Departamento de Clínica Médica, Disciplina de Reumatologia, Faculdade de Ciências Medicas da UNICAMP, Universidade Estadual de Campinas, Campinas, Brazil
| | | | - Jorge Cieza
- Servicio de Reumatología, Departamento de Especialidades Médicas, Hospital Nacional Edgardo Rebagliati Martins, EsSalud., Lima, Perú
| | - Luis A González Naranjo
- Grupo de Inmunología Celular e Inmunogenética, Universidad de Antioquia, Hospital Universitario, Fundación San Vicente, Medellín, Colombia
| | | | - María Victoria Collado
- Servicio de Inmunología, Instituto de Investigaciones Médicas "Alfredo "Lanari", Ciudad Autónoma de Buenos Aires, Argentina
| | - Judith Sarano
- Servicio de Inmunología, Instituto de Investigaciones Médicas "Alfredo "Lanari", Ciudad Autónoma de Buenos Aires, Argentina
| | - Soledad Retamozo
- Servicio de Reumatología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - María E Sattler
- Servicio de Reumatología, Hospital Escuela "Eva Perón", Granadero Baigorria, Argentina
| | - Rocio V Gamboa-Cárdenas
- Servicio de Reumatología, Hospital General Guillermo Almenara Irigoyen, EsSalud., Lima, Perú
| | - Ernesto Cairoli
- Unidad de Enfermedades Autoinmunes Sistémicas, Facultad de Medicina, Clínica Médica 'C', Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - Silvana M Conti
- Servicio de Reumatología, Hospital Provincial de Rosario, Rosario, Argentina
| | - Luis M Amezcua-Guerra
- Departamento de Inmunología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico
| | - Luis H Silveira
- Departamento de Reumatología, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de México, México
| | - Eduardo F Borba
- Rheumatology Division, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Mariana A Pera
- Servicio de Reumatología, HIGA General San Martín, La Plata, Argentina
| | - Paula B Alba Moreyra
- Unidad de Reumatología, Cátedra de Clínica Médica I, Hospital Córdoba. Cátedra de Semiología, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba., Córdoba, Argentina
| | - Valeria Arturi
- Servicio de Reumatología, HIGA General San Martín, La Plata, Argentina
| | - Guillermo A Berbotto
- Servicio de Reumatología, Hospital Escuela "Eva Perón", Granadero Baigorria, Argentina
| | - Cristian Gerling
- Unidad de Reumatología y Enfermedades Autoinmunes Sistémicas, HIGA Dr Oscar Alende, Mar del Plata, Argentina
| | - Carla A Gobbi
- Unidad de Reumatología, Cátedra de Clínica Médica I, Hospital Córdoba. Cátedra de Semiología, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba., Córdoba, Argentina
| | - Viviana L Gervasoni
- Servicio de Reumatología, Hospital Provincial de Rosario, Rosario, Argentina
| | - Hugo R Scherbarth
- Unidad de Reumatología y Enfermedades Autoinmunes Sistémicas, HIGA Dr Oscar Alende, Mar del Plata, Argentina
| | - João C Tavares Brenol
- Rheumatology Division, Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Cavalcanti
- Serviço de Reumatologia do Hospital das Clínicas da Universidade Federal de Pernambuco (HC-UFPE), Recife, Brazil
| | - Lilian T Lavras Costallat
- Departamento de Clínica Médica, Disciplina de Reumatologia, Faculdade de Ciências Medicas da UNICAMP, Universidade Estadual de Campinas, Campinas, Brazil
| | - Nilzio A Da Silva
- Serviço de Reumatologia, Departamento de Clinica Medica, Faculdade de Medicina, Hospital das Clínicas, Universidade Federal de Goiás, Goiânia, Brazil
| | - Odirlei A Monticielo
- Rheumatology Division, Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciana Parente Costa Seguro
- Rheumatology Division, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Ricardo M Xavier
- Rheumatology Division, Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carolina Llanos
- Departamento de Inmunología Clínica y Reumatología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rubén A Montúfar Guardado
- Departamento de Reumatología, Consultorio de Especialidades del Instituto Salvadoreño de la Seguridad Social, San Salvador, El Salvador
| | | | - Carlos Pineda
- Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico
| | | | - Alvaro Danza
- Grupo de Trabajo en Enfermedades Autoinmunes Sistémicas, Servicio de Clínica Médica, Facultad de Medicina, Universidad de la Republica, Hospital Pasteur, Administración de Servicios de Salud del Estado, Montevideo, Uruguay
| | - Marlene Guibert-Toledano
- Servicio Nacional de Reumatología, Centro de Investigaciones Médico Quirúrgicas (CIMEQ)., La Habana, Cuba
| | - Gil Llerena Reyes
- Servicio Nacional de Reumatología, Centro de Investigaciones Médico Quirúrgicas (CIMEQ)., La Habana, Cuba
| | - Maria Isabel Acosta Colman
- Departamento de Reumatología, Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Alicia M Aquino
- Departamento de Reumatología, Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Claudia S Mora-Trujillo
- Servicio de Reumatología, Departamento de Especialidades Médicas, Hospital Nacional Edgardo Rebagliati Martins, EsSalud., Lima, Perú
| | - Roberto Muñoz-Louis
- Servicio de Reumatología, Enfermedades Reumatológicas e Investigación Clínica (ERIC), Hospital Docente Padre Billini, Santo Domingo, Dominican Republic
| | | | - María Celeste Orozco
- Servicio de Reumatología, Instituto de Rehabilitación Psicofísica (IREP), Ciudad Autónoma de Buenos Aires, Argentina
| | - Paula I Burgos
- Departamento de Inmunología Clínica y Reumatología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Graciela V Betancur
- Servicio de Reumatología, Instituto de Rehabilitación Psicofísica (IREP), Ciudad Autónoma de Buenos Aires, Argentina
| | - Graciela S Alarcón
- Division of Clinical Immunology and Rheumatology, Department of Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
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12
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Varnier GC, Rosina S, Ferrari C, Pistorio A, Consolaro A, Bovis F, Dalprà S, Pilkington C, Maillard S, Civino A, Tsitsami E, de Inocencio J, Jelusic M, Vojinovic J, Espada G, Makay B, Katsicas MM, Pratsidou-Gertsi P, Lazarevic D, Rao AP, Marafon DP, Ruperto N, Martini A, Ravelli A. Development and Testing of a Hybrid Measure of Muscle Strength in Juvenile Dermatomyositis for Use in Routine Care. Arthritis Care Res (Hoboken) 2018; 70:1312-1319. [DOI: 10.1002/acr.23491] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 12/05/2017] [Indexed: 11/07/2022]
Affiliation(s)
| | | | | | | | | | | | - Sara Dalprà
- Università degli Studi di Genova; Genoa Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alberto Martini
- Università degli Studi di Genova and Istituto Giannina Gaslini; Genoa Italy
| | - Angelo Ravelli
- Università degli Studi di Genova and Istituto Giannina Gaslini; Genoa Italy
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13
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Ferreira JCOA, Trindade VC, Espada G, Morel Z, Bonfá E, Magalhães CS, Silva CA. Epidemiology and management practices for childhood-onset systemic lupus erythematosus patients: a survey in Latin America. Clin Rheumatol 2018; 37:3299-3307. [PMID: 30094748 DOI: 10.1007/s10067-018-4254-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/18/2018] [Accepted: 08/02/2018] [Indexed: 01/06/2023]
Abstract
To assess epidemiology and management practices of Latin America Pediatric Rheumatologists (LAPR) about childhood-onset systemic lupus erythematosus (cSLE). A cross-sectional study was performed in 288 LAPR PANLAR members based on online survey about cSLE practices. The response rate of web-based survey by LAPR was 170/288(59%) and the majority worked in university hospitals (63%). The ACR and/or SLICC classification criteria (99%) and disease activity tools (97%) were almost universally used by LAPR, whereas damage index (70%) and CHAQ (58%) instruments were less frequently used. Laboratory exams, diagnostic imaging, and biopsies were generally available (> 75%), however low availability for densitometry (66%). Drug access was excellent for the most common prescribed medications (> 75%), except for belimumab (11%). Emerging mosquito-borne diseases were also reported: dengue (20%), chikungunya (11%), and Zika (8%). Groups were further divided in two, according to the median number of cSLE patients followed by LAPR in the last year: groups A and B (≥ 25 and < 25, respectively). Frequencies of condom in combination with other contraceptive methods were significantly higher in group A than B (p = 0.01). The frequencies of reported pregnancy (p < 0.001) and non-adherence to therapy were significantly higher in group A (p = 0.023). Alcohol intake (p = 0.004) and illicit drug use (p = 0.007) were also reported more frequently by LAPR of group A in at least one cSLE patient. This first large web-based survey demonstrated an overall excellent access for diagnosis and therapy by LAPR, probably related to their high rate of practices in tertiary care of university hospitals. Adherence to therapy, pregnancy, and substance abuse was identified as major challenges in this population, particularly in larger centers.
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Affiliation(s)
- Juliana C O A Ferreira
- Pediatric Rheumatology Unit, Children's Institute, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Eneas Carvalho de Aguiar, 647 - Cerqueira César, São Paulo, SP, 05403-000, Brazil
| | - Vitor C Trindade
- Pediatric Rheumatology Unit, Children's Institute, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Eneas Carvalho de Aguiar, 647 - Cerqueira César, São Paulo, SP, 05403-000, Brazil
| | - Graciela Espada
- Pediatric Rheumatology Unit, Hospital de Niños Dr Ricardo Gutierrez, Buenos Aires, Argentina
| | - Zoilo Morel
- Pediatric Rheumatology Unit, Pediatric Service, Hospital de Clinicas, Universidad Nacional De Asunción, Asunción, Paraguay
| | - Eloisa Bonfá
- Division of Rheumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Claudia S Magalhães
- Pediatric Rheumatology Unit, São Paulo State University (UNESP) - Faculdade de Medicina de Botucatu, São Paulo, Brazil
| | - Clovis Artur Silva
- Pediatric Rheumatology Unit, Children's Institute, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Eneas Carvalho de Aguiar, 647 - Cerqueira César, São Paulo, SP, 05403-000, Brazil.
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14
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Garay SM, Cuttica R, Katsicas MM, Espada G, De Cunto C, Fabi M, Gomez Sosa J, Russo R, de Los Angeles Britos M, Consolaro A, Bovis F, Ruperto N. The Argentinian Spanish version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR). Rheumatol Int 2018; 38:51-58. [PMID: 29637334 PMCID: PMC5893703 DOI: 10.1007/s00296-018-3934-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 01/11/2018] [Indexed: 11/24/2022]
Abstract
The Juvenile Arthritis Multidimensional Assessment Report (JAMAR) is a new parent/patient reported outcome measure that enables a thorough assessment of the disease status in children with juvenile idiopathic arthritis (JIA). We report the results of the cross-cultural adaptation and validation of the parent and patient versions of the JAMAR in the Argentinian Spanish language. The reading comprehension of the questionnaire was tested in 10 JIA parents and patients. Each participating centre was asked to collect demographic, clinical data and the JAMAR in 100 consecutive JIA patients or all consecutive patients seen in a 6-month period and to administer the JAMAR to 100 healthy children and their parents. The statistical validation phase explored descriptive statistics and the psychometric issues of the JAMAR: the three Likert assumptions, floor/ceiling effects, internal consistency, Cronbach’s alpha, interscale correlations, test–retest reliability, and construct validity (convergent and discriminant validity). A total of 373 JIA patients (23.1% systemic, 30.8% oligoarticular, 28.1% RF negative polyarthritis, 18% other categories) and 100 healthy children were enrolled in five centres. The JAMAR components discriminated well healthy subjects from JIA patients. Notably, there was no significant difference between healthy subjects and their affected peers in the school-related item. All JAMAR components revealed good psychometric performances. In conclusion, the Argentinian Spanish version of the JAMAR is a valid tool for the assessment of children with JIA and is suitable for use both in routine clinical practice and clinical research.
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Affiliation(s)
- Stella Maris Garay
- Hospital Sor María Ludovica, Servicio de Reumatologia, Unidad de Reumatologia, Calle 14 No 1631, 1900, La Plata, Argentina.
| | - Ruben Cuttica
- Rheumatology Section, Hospital General de Ninos Pedro de Elizalde, Buenos Aires, Argentina
| | - Maria Martha Katsicas
- Servicio de Inmunologia/Reumatologia, Hospital de Pediatria Juan P. Garrahan, Buenos Aires, Argentina
| | - Graciela Espada
- Sección Reumatologia, Hospital de Ninos Ricardo Gutierrez, Buenos Aires, Argentina
| | - Carmen De Cunto
- Pediatrics, Rheumatology and Immunology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Mariana Fabi
- Hospital Sor María Ludovica, Servicio de Reumatologia, Unidad de Reumatologia, Calle 14 No 1631, 1900, La Plata, Argentina
| | - Jimena Gomez Sosa
- Rheumatology Section, Hospital General de Ninos Pedro de Elizalde, Buenos Aires, Argentina
| | - Ricardo Russo
- Servicio de Inmunologia/Reumatologia, Hospital de Pediatria Juan P. Garrahan, Buenos Aires, Argentina
| | - María de Los Angeles Britos
- Pediatrics, Rheumatology and Immunology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Alessandro Consolaro
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy.,Dipartimento di Pediatria, Università di Genova, Genoa, Italy
| | - Francesca Bovis
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy
| | - Nicolino Ruperto
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy.
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15
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Papa R, Doglio M, Lachmann HJ, Ozen S, Frenkel J, Simon A, Neven B, Kuemmerle-Deschner J, Ozgodan H, Caorsi R, Federici S, Finetti M, Trachana M, Brunner J, Bezrodnik L, Pinedo Gago MC, Maggio MC, Tsitsami E, Al Suwairi W, Espada G, Shcherbina A, Aksu G, Ruperto N, Martini A, Ceccherini I, Gattorno M. A web-based collection of genotype-phenotype associations in hereditary recurrent fevers from the Eurofever registry. Orphanet J Rare Dis 2017; 12:167. [PMID: 29047407 PMCID: PMC5648458 DOI: 10.1186/s13023-017-0720-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 10/06/2017] [Indexed: 11/16/2022] Open
Abstract
Background Hereditary recurrent fevers (HRF) are a group of rare monogenic diseases leading to recurrent inflammatory flares. A large number of variants has been described for the four genes associated with the best known HRF, namely MEFV, NLRP3, MVK, TNFRSF1A. The Infevers database (http://fmf.igh.cnrs.fr/ISSAID/infevers) is a large international registry collecting variants reported in these genes. However, no genotype-phenotype associations are provided, but only the clinical phenotype of the first patient(s) described for each mutation. The aim of this study is to develop a registry of genotype-phenotype associations observed in patients with HRF, enrolled and validated in the Eurofever registry. Results Genotype-phenotype associations observed in all the patients with HRF enrolled in the Eurofever registry were retrospectively analyzed. For autosomal dominant diseases (CAPS and TRAPS), all mutations were individually analyzed. For autosomal recessive diseases (FMF and MKD), homozygous and heterozygous combinations were described. Mean age of onset, disease course (recurrent or chronic), mean duration of fever episodes, clinical manifestations associated with fever episodes, atypical manifestations, complications and response to treatment were also studied. Data observed in 751 patients (346 FMF, 133 CAPS, 114 MKD, 158 TRAPS) included in the Eurofever registry and validated by experts were summarized in Tables. A total of 149 variants were described: 46 TNFRSF1A and 27 NLRP3 variants, as well as various combinations of 48 MVK and 28 MEFV variants were available. Conclusions We provide a potentially useful tool for physicians dealing with HRF, namely a registry of genotype-phenotype associations for patients enrolled in the Eurofever registry. This tool is complementary to the Infevers database and will be available at the Eurofever and Infevers websites.
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Affiliation(s)
- Riccardo Papa
- EULAR Centre of Excellence in Rheumatology 2008-2018, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
| | - Matteo Doglio
- EULAR Centre of Excellence in Rheumatology 2008-2018, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Helen J Lachmann
- National Amyloidosis Centre, Royal Free Campus, University College Division of Medicine, London, UK
| | - Seza Ozen
- Department of Pediatric Nephrology and Rheumatology, Hacettepe University, Ankara, Turkey
| | - Joost Frenkel
- Division of Pediatrics, University Medical Center, Utrecht, The Netherlands
| | - Anna Simon
- Department of Internal Medicine, Radboudumc Expertise Centre for Immunodeficiency and Autoinflammation, Radboudumc, Nijmegen, The Netherlands
| | - Bénédicte Neven
- Centre de reference national pour les Arthrites Juveniles, Unite d'Immunologie, Hematologie et Rhumatologie Pediatrique, Universite Paris-Descartes, IMAGINE Institute, Hopital Necker-Enfants Malades, Paris, France
| | - Jasmin Kuemmerle-Deschner
- Rheumatologisches Zentrum/Ambulanzfur Autoimmunerkrankungen, Universitatsklinikum Tubingen, Tubingen, Germany
| | - Huri Ozgodan
- Ic Hastalıkları ABD, Romatoloji BD, Istanbul Universitesi Cerrahpaşa Tıp Fakültesi, Istanbul, Turkey
| | - Roberta Caorsi
- EULAR Centre of Excellence in Rheumatology 2008-2018, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Silvia Federici
- EULAR Centre of Excellence in Rheumatology 2008-2018, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Martina Finetti
- EULAR Centre of Excellence in Rheumatology 2008-2018, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Maria Trachana
- Department of Pediatrics I, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Jurgen Brunner
- Department fur Kinder-und Jugendheilkunde, Klinikfur Padiatrie I, Padiatrische Rheumatologie, Medizinische Universität Innsbruck, Innsbruck, Austria
| | - Liliana Bezrodnik
- Immunology Unit, Hospital de Ninos Ricardo Gutierrez, Buenos Aires, Argentina
| | | | | | - Elena Tsitsami
- Pediatric Rheumatology Unit, 1st Department of Pediatrics, Children's Hospital Aghia Sophia, University of Athens, Athens, Greece
| | - Wafaa Al Suwairi
- Department of Pediatrics, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Graciela Espada
- Seccion Reumatologia, Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina
| | - Anna Shcherbina
- Research Institute for Paediatric Hematology, Moscow, Russia
| | - Guzide Aksu
- EgeUniversitesi Tıp Fakultesi, Pediatrik Romatoloji, Izmir, Turkey
| | - Nicolino Ruperto
- EULAR Centre of Excellence in Rheumatology 2008-2018, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Alberto Martini
- Direzione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Marco Gattorno
- EULAR Centre of Excellence in Rheumatology 2008-2018, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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Minoia F, Bovis F, Davì S, Insalaco A, Lehmberg K, Shenoi S, Weitzman S, Espada G, Gao YJ, Anton J, Kitoh T, Kasapcopur O, Sanner H, Merino R, Astigarraga I, Alessio M, Jeng M, Chasnyk V, Nichols KE, Huasong Z, Li C, Micalizzi C, Ruperto N, Martini A, Cron RQ, Ravelli A, Horne A, Aggarwal A, Akikusa J, Al-Mayouf S, Alessio M, Anton J, Apaz MT, Astigarraga I, Avcin T, Ayaz NA, Barone P, Bica B, Bolt I, Bovis F, Breda L, Chasnyk V, Cimaz R, Corona F, Cron RQ, Cuttica R, Davì S, Davidsone Z, De Cunto C, De Inocencio J, Demirkaya E, Eisenstein EM, Enciso S, Espada G, Fischbach M, Frosch M, Gallizzi R, Gamir ML, Gao YJ, Griffin T, Grom A, Hashad S, Hennon T, Henter JI, Horne A, Horneff G, Huasong Z, Huber A, Ilowite N, Insalaco A, Ioseliani M, Jeng M, Kapović AM, Kasapcopur O, Khubchandani R, Kitoh T, Koné-Paut I, de Oliveira SKF, Lattanzi B, Lehmberg K, Lepore L, Li C, Lipton JM, Magni-Manzoni S, Maritsi D, Martini A, McCurdy D, Merino R, Micalizzi C, Miettunen P, Minoia F, Mulaosmanovic V, Nichols KE, Nielsen S, Ozen S, Pal P, Prahalad S, Ravelli A, Rigante D, Rumba-Rozenfelde I, Ruperto N, Russo R, Magalhães CS, Sanner H, Sewairi WMS, Shenoi S, Artur Silva C, Stanevicha V, Sterba G, Stine KC, Susic G, Sztajnbok F, Takei S, Trauzeddel R, Tsitsami E, Unsal E, Uziel Y, Vougiouka O, Wallace CA, Weaver L, E. Weiss J, Weitzman S, Wouters C, Wulffraat N, Zletni M, Arico M, Egeler RM, Filipovich AH, Gadner H, Imashuku S, Janka G, Ladisch S, McClain KL, Webb D. Development and Initial Validation of the Macrophage Activation Syndrome/Primary Hemophagocytic Lymphohistiocytosis Score, a Diagnostic Tool that Differentiates Primary Hemophagocytic Lymphohistiocytosis from Macrophage Activation Syndrome. J Pediatr 2017; 189:72-78.e3. [PMID: 28807357 DOI: 10.1016/j.jpeds.2017.06.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 05/02/2017] [Accepted: 06/02/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To develop and validate a diagnostic score that assists in discriminating primary hemophagocytic lymphohistiocytosis (pHLH) from macrophage activation syndrome (MAS) related to systemic juvenile idiopathic arthritis. STUDY DESIGN The clinical, laboratory, and histopathologic features of 362 patients with MAS and 258 patients with pHLH were collected in a multinational collaborative study. Eighty percent of the population was assessed to develop the score and the remaining 20% constituted the validation sample. Variables that entered the best fitted model of logistic regression were assigned a score, based on their statistical weight. The MAS/HLH (MH) score was made up with the individual scores of selected variables. The cutoff in the MH score that discriminated pHLH from MAS best was calculated by means of receiver operating characteristic curve analysis. Score performance was examined in both developmental and validation samples. RESULTS Six variables composed the MH score: age at onset, neutrophil count, fibrinogen, splenomegaly, platelet count, and hemoglobin. The MH score ranged from 0 to 123, and its median value was 97 (1st-3rd quartile 75-123) and 12 (1st-3rd quartile 11-34) in pHLH and MAS, respectively. The probability of a diagnosis of pHLH ranged from <1% for a score of <11 to >99% for a score of ≥123. A cutoff value of ≥60 revealed the best performance in discriminating pHLH from MAS. CONCLUSION The MH score is a powerful tool that may aid practitioners to identify patients who are more likely to have pHLH and, thus, could be prioritized for functional and genetic testing.
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Affiliation(s)
| | | | | | | | | | - Susan Shenoi
- Seattle Children's Hospital and University of Washington, Seattle, WA
| | | | - Graciela Espada
- Ricardo Gutierrez Children's Hospital, Buenos Aires, Argentina
| | - Yi-Jin Gao
- Children's Hospital of Fudan University, Shanghai, China
| | - Jordi Anton
- Hospital Saint Joan de Déu, Barcelona, Spain
| | | | - Ozgur Kasapcopur
- Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey
| | - Helga Sanner
- Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | | | - Itziar Astigarraga
- BioCruces Health Research Institute, Cruces University Hospital, University of the Basque Country, Barakaldo, Spain
| | | | | | - Vyacheslav Chasnyk
- Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
| | | | | | - Caifeng Li
- Beijing Children's Hospital, Beijing, China
| | | | | | | | | | - Angelo Ravelli
- G. Gaslini Institute, Genoa, Italy; University of Genova, Genoa, Italy
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Lomakina O, Alekseeva E, Valieva S, Bzarova T, Nikishina I, Zholobova E, Rodionovskaya S, Kaleda M, Nakagishi Y, Shimizu M, Mizuta M, Yachie A, Sugita Y, Okamoto N, Shabana K, Murata T, Tamai H, Smith EM, Yin P, Jorgensen AL, Beresford MW, Smith EM, Eleuteri A, Goilav B, Lewandowski L, Phuti A, Wahezi D, Rubinstein T, Jones C, Newland P, Marks S, Corkhill R, Ekdawy D, Pilkington C, Tullus K, Putterman C, Scott C, Fisher AC, Beresford MW, Smith EM, Lewandowski L, Phuti A, Jorgensen A, Scott C, Beresford MW, Batu ED, Kosukcu C, Taskiran E, Akman S, Ozturk K, Sozeri B, Unsal E, Ekinci Z, Bilginer Y, Alikasifoglu M, Ozen S, Lythgoe H, Beresford MW, Brunner HI, Gulati G, Jones JT, Altaye M, Eaton J, Difrancesco M, Yeo JG, Leong J, Bathi LDT, Arkachaisri T, Albani S, Abdelrahman N, Beresford MW, Leone V, Groot N, Shaikhani D, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Wright RD, Smith EM, Beresford MW, Abdawani R, Al Shaqshi L, Al 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Simou S, Dossetter L, Wedderburn LR, Pilkington C, Campanilho-Marques R, Ozcakar ZB, Deakin C, Simou S, Wedderburn LR, Pilkington CA, Rosina S, Consolaro A, van Dijkhuizen P, Nistala K, Ruperto N, Pilkington C, Çakar N, Ravelli A, Soponkanaporn S, Simou S, Deakin CT, Wedderburn LR, Arıcı ZS, Tuğcu GD, Batu ED, Sönmez HE, Doğru-Ersöz D, Uncu N, Bilginer Y, Talim B, Kiper N, Özen S, Solyom A, Hügle B, Makay B, Magnusson B, Batu E, Mitchell J, Gür G, Kariminejad A, Hadipour F, Hadipour Z, Torcoletti M, Agostoni C, Di Rocco M, Tanpaiboon P, Superti-Furga A, Bonafé L, Arslan N, Özdel S, Guelbert N, Kostik M, Ehlert K, Grigelioniene G, Puri R, Ozen S, Schuchman E, Malagon C, Gomez P, Mosquera AC, Yalçınkaya F, Gonzalez T, Yepez R, Vargas C, Fernanda F, Lepri G, Ferrari A, Rigante D, Matucci-Cerinic M, Meini A, Moneta GM, Scott C, Caiello I, Marasco E, Nicolai R, Pardeo M, Bracaglia C, Insalaco A, Bracci-Laudiero L, De Benedetti F, Kopchak O, Kostik M, Brice N, Mushkin A, Maletin A, Makay B, 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C CSM, Lira L, Ladino M, Eraso R, Arroyo I, Lopes AS, Sztajnbok F, Silva C, Rose C, Russo GCS, Sallum AEM, Kozu K, Bonfá E, Saad-Magalhães C, Pereira RMR, Len CA, Terreri MT, Suri D, Didel S, Rawat A, Singh S, Maritsi D, Onoufriou MA, Vougiouka O, Tsolia M, Bosak EP, Vidović M, Lamot M, Lamot L, Harjaček M, Van Nieuwenhove E, Liston A, Wouters C, Tahghighi F, Ziaee V, Raeeskarami SR, Aguiar F, Pereira S, Rodrigues M, Moura C, Rocha G, Guimarães H, Brito I, Aguiar F, Fonseca R, Rodrigues M, Brito I, Horneff G, Klein A, Minden K, Huppertz HI, Weller-Heinemann F, Kuemmerle-Deschner J, Haas JP, Hospach A, Menendez-Castro R, Huegle B, Haas JP, Swart J, Giancane G, Bovis F, Castagnola E, Groll A, Horneff G, Huppertz HI, Lovell DJ, Wolfs T, Hofer M, Alekseeva E, Panaviene V, Nielsen S, Anton J, Uettwiller F, Stanevicha V, Trachana M, Marafon DP, Ailioaie C, Tsitsami E, Kamphuis S, Herlin T, Doležalová P, Susic G, Flatø B, Sztajnbok F, Pistorio A, Martini A, Wulffraat N, Ruperto N, Gattorno M, Brucato A, Finetti M, Lazaros G, Maestroni S, Carraro M, Cumetti D, Carobbio A, Lorini M, Rimini A, Marcolongo R, Valenti A, Erre GL, Belli R, Gaita F, Sormani MP, Ruperto N, Imazio M, Martini A, Abinun M, Smith N, Rapley T, McErlane F, Kearsley-Fleet L, Hyrich KL, Foster H, Ruperto N, Lovell DJ, Tzaribachev N, Zeft A, Cimaz R, Stanevicha V, Horneff G, Bohnsack J, Griffin T, Carrasco R, Trachana M, Dare J, Foeldvari I, Vehe R, Bovis F, Simon T, Martini A, Brunner H, Verazza S, Davì S, Consolaro A, Insalaco A, Gerloni V, Cimaz R, Zulian F, Pastore S, Corona F, Conti G, Barone P, Cattalini M, Cortis E, Breda L, Olivieri AN, Civino A, Podda R, Rigante D, La Torre F, D’Angelo G, Jorini M, Gallizzi R, Maggio MC, Consolini R, De Fanti A, Alpigiani MG, Martini A, Ravelli A, Sozeri B, Kısaarslan AP, Gunduz Z, Dusunsel R, Dursun I, Poyrazoglu H, Kuchinskaya E, Abduragimova F, Kostik M, Sundberg E, Omarsdottir S, Klevenvall L, Erlandsson-Harris H, Basbozkurt G, Erdemli O, Simsek D, Yazici F, Karsioglu Y, Tezcaner A, Keskin D, Ozkan H, Acikel C, Ozen S, Demirkaya E, Orbán I, Sevcic K, Brodszky V, Kiss E, Tekko IA, Rooney M, McElnay J, Taggart C, McCarthy H, Donnelly RF, Abinun M, Slatter M, Nademi Z, Friswell M, Foster H, Jandial S, McErlane F, Flood T, Hambleton S, Gennery A, Cant A, Finetti M, Bovis F, Swart J, Doležalová P, Tsitsami E, Trachana M, Demirkaya E, Duong PN, Koné-Paut I, Vougiouka O, Marafon DP, Cimaz R, Filocamo G, Gamir ML, Stanevicha V, Sanner H, Carenini L, Wulffraat N, Martini A, Ruperto N, Topdemir M, Basbozkurt G, Karslioglu Y, Ozkan H, Acikel C, Demirkaya E, Gok F, Zholobova E, Tsurikova N, Ligostaeva E, Ramchurn NR, Friswell M, Kostareva O, Nikishina I, Arsenyeva S, Rodionovskaya S, Kaleda M, Alexeev D, Dursun ID, Sozeri B, Kısaarslan AP, Dusunsel R, Poyrazoglu H, Poyrazoglu H, Murias S, Barral E, Alcobendas R, Enriquez E, Remesal A, de Inocencio J, Castro TM, Lotufo SA, Freye T, Carlomagno R, Zumbrunn T, Bonhoeffer J, Schneider EC, Kaiser D, Hofer M, Hentgen V, Woerner A, Schwarz T, Klotsche J, Niewerth M, Horneff G, Haas JP, Hospach A, Huppertz HI, Ganser G, Minden K, Jeyaratnam J, ter Haar N, Kasapcopur O, Rigante D, Dedeoglu F, Baris E, Vastert S, Wulffraat N, Frenkel J, Hausmann JS, Lomax KG, Shapiro A, Durrant KL, Brogan PA, Hofer M, Kuemmerle-Deschner JB, Lauwerys B, Speziale A, Leon K, Wei X, Laxer RM, Signa S, Rusmini M, Campione E, Chiesa S, Grossi A, Omenetti A, Caorsi R, Viglizzo G, Martini A, Ceccherini I, Gattorno M, Federici S, Frenkel J, Ozen S, Lachmann H, Finetti M, Martini A, Ruperto N, Gattorno M, Federici S, Vanoni F, Ozen S, Hofer M, Frenkel J, Lachmann H, Martini A, Ruperto N, Gattorno M, Gomes SM, Omoyinmi E, Arostegui JI, Gonzalez-Roca E, Eleftheriou D, Klein N, Brogan P, Volpi S, Santori E, Picco P, Pastorino C, Caorsi R, Rice G, Tesser A, Martini A, Crow Y, Candotti F, Gattorno M, Barut K, Sahin S, Adrovic A, Sinoplu AB, Yucel G, Pamuk G, Kasapcopur O, Damian LO, Lazea C, Sparchez M, Vele P, Muntean L, Albu A, Rednic S, Lazar C, Mendonça LO, Pontillo A, Kalil J, Castro FM, Barros MT, Pardeo M, Messia V, De Benedetti F, Insalaco A, Malighetti G, Gorio C, Ricci F, Parissenti I, Montesano P, Bonafini B, Medeghini V, Cattalini M, Giordano L, Zani G, Ferraro R, Vairo D, Giliani S, Cattalini M, Maggio MC, Luppino G, Corsello G, Fernandez MIG, Montesinos BL, Vidal AR, Gorospe JIA, Penades IC, Rafiq NK, Wynne K, Hussain K, Brogan PA, Ang E, Ng N, Kacar A, Gucenmez OA, Makay B, Unsal SE, Sahin Y, Barut K, Kutlu T, Cullu-Cokugras F, Sahin S, Adrovic A, Ayyildiz-Civan H, Kasapcopur O, Erkan T, Abdawani R, Al Zuhbi S, Abdalla E, Russo RA, Katsicas MM, Caorsi R, Minoia F, Viglizzo G, Grossi A, Chiesa S, Picco P, Ravelli A, Gattorno M, Bhattad S, Rawat A, Gupta A, Suri D, Pandiarajan V, Nada R, Tiewsoh K, Hawkins P, Rowczenio D, Singh S, Fingerhutova S, Franova J, Prochazkova L, Hlavackova E, Dolezalova P, Evrengül H, Yüksel S, Doğan M, Gürses D, Evrengül H, De Pauli S, Pastore S, Bianco AM, Severini GM, Taddio A, Tommasini A, Salugina SO, Fedorov E, Kamenets E, Zaharova E, Kaleda M, Salugina SO, Fedorov E, Kamenets E, Zaharova E, Kaleda M, Sleptsova T, Alexeeva E, Savostyanov K, Pushkov A, Bzarova T, Valieva S, Denisova R, Isayeva K, Chistyakova E, Lomakina O, Soloshenko M, Kaschenko E, Kaneko U, Imai C, Saitoh A, Teixeira VA, Ramos FO, Costa M, Aviel YB, Fahoum S, Brik R, Özçakar ZB, Çakar N, Uncu N, Celikel BA, Yalcinkaya F, Schiappapietra B, Davi’ S, Mongini F, Giannone L, Bava C, Alpigiani MG, Martini A, Ravelli A, Consolaro A, Lazarevic DS, Vojinovic J, Susic G, Basic J, Giancane G, Muratore V, Marzetti V, Quilis N, Benavente BS, Alongi A, Civino A, Quartulli L, Consolaro A, Martini A, Ravelli A, Januskeviciute G, van Dijkhuizen P, Muratore V, Giancane G, Schiappapietra B, Martini A, Ravelli A, Consolaro A, Groot N, van Dijk W, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Groot N, Kardolus A, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Suárez RG, Nordal EB, Rypdal VG, Berntson L, Ekelund M, Aalto K, Peltoniemi S, Zak M, Nielsen S, Glerup M, Herlin T, Arnstad ED, Fasth A, Rygg M, Duarte AC, Sousa S, Teixeira L, Cordeiro A, Santos MJ, Mourão AF, Santos MJ, Eusébio M, Lopes A, Oliveira-Ramos F, Salgado M, Estanqueiro P, Melo-Gomes J, Martins F, Costa J, Furtado C, Figueira R, Brito I, Branco JC, Fonseca JE, Canhão H, Mourão AF, Santos MJ, Eusébio M, Lopes A, Oliveira-Ramos F, Salgado M, Estanqueiro P, Melo-Gomes J, Martins F, Costa J, Furtado C, Figueira R, Brito I, Branco JC, Fonseca JE, Canhão H, Coda A, Cassidy S, West K, Hendry G, Grech D, Jones J, Hawke F, Grewal DS, Coda A, Jones J, Grech D, Grewal DS, Foley C, Killeen O, MacDermott E, Veale D, Fearon U, Konukbay D, Demirkaya E, Tarakci E, Arman N, Barut K, Şahin S, Adrovic A, Kasapcopur O, Munro J, Consolaro A, Morgan E, Riebschleger M, Horonjeff J, Strand V, Bingham C, Collante MTM, Ganeva M, Stefanov S, Telcharova A, Mihaylova D, Saraeva R, Tzveova R, Kaneva R, Tsakova A, Temelkova K, Picarelli MMC, Danzmann LC, Barbé-Tuana F, Grun LK, Jones MH, Frković M, Ištuk K, Birkić I, Sršen S, Jelušić M, Smith N, Jandial S, Easton A, Quarmby R, Khubchandani R, Chan M, Rapley T, Foster H, Srp R, Kobrova K, Franova J, Fingerhutova S, Nemcova D, Hoza J, Uher M, Saifridova M, Linkova L, Dolezalova P, Charuvanij S, Leelayuwattanakul I, Pacharapakornpong T, Vallipakorn SAO, Lerkvaleekul B, Vilaiyuk S, Muratore V, Giancane G, Lanni S, Alongi A, Alpigiani MG, Martini A, Ravelli A, Consolaro A, Alongi A, Bovis F, Minoia F, Davì S, Martini A, Ruperto N, Cron RQ, Ravelli A, Passarelli C, Pardeo M, Pisaneschi E, Novelli A, De Benedetti F, Bracaglia C, Bracaglia C, Marafon DP, Caiello I, de Graaf K, Guilhot F, Ferlin W, Davi’ S, Schulert G, Ravelli A, Grom AA, Nelson R, de Min C, De Benedetti F, Holzinger D, Kessel C, Fall N, Grom A, de Jager W, Vastert S, Strippoli R, Bracaglia C, Sundberg E, Horne A, Ehl S, Ammann S, Lehmberg K, De Benedetti F, Beutel K, Foell D, Minoia F, Horne A, Bovis F, Davì S, Pagani L, Espada G, Gao YJ, Insalaco A, Lehmberg K, Sanner H, Shenoi S, Weitzman S, Ruperto N, Martini A, Cron RQ, Ravelli A, Prencipe G, Caiello I, Pascarella A, Bracaglia C, Ferlin WG, Chatel L, Strippoli R, de Min C, De Benedetti F, Jacqmin P, De Graaf K, Ballabio M, Nelson R, Johnson Z, Ferlin W, Lapeyre G, de Benedetti F, Cristina DM, Wakiguchi H, Hasegawa S, Hirano R, Okazaki F, Nakamura T, Kaneyasu H, Ohga S, Yamazaki K, Nozawa T, Kanetaka T, Ito S, Yokota S, McLellan K, MacGregor I, Martin N, Davidson J, Kuemmerle-Deschner J, Hansmann S, Wulffraat N, Eikelberg A, Haug I, Schuller S, Benseler SM, Nazarova LS, Danilko KV, Malievsky VA, Viktorova TV, Mauro A, Omoyinmi E, Barnicoat A, Brogan P, Foley C, Killeen O, MacDermott E, Veale D, Foley C, Killeen O, MacDermott E, Veale D, Gomes SM, Omoyinmi E, Hurst J, Canham N, Eleftheriou D, Klein N, Lacassagne S, Brogan P, Wiener A, Hügle B, Denecke B, Costa-Filho I, Haas JP, Tenbrock K, Popp D, Boltjes A, Rühle F, Herresthal S, de Jager W, van Wijk F, Schultze J, Stoll M, Klotz L, Vogl T, Roth J, Quesada-Masachs E, de la Sierra DÁ, Prat MG, Sánchez AMM, Borrell RP, Barril SM, Gallo MM, Caballero CM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Giner T, Hackl L, Albrecht J, Würzner R, Brunner J, Pastore S, Minute M, Parentin F, Tesser A, Nocerino A, Taddio A, Tommasini A, Nørgaard M, Herlin T, Alberdi-Saugstrup M, Zak MS, Nielsen SM, Herlin T, Nordal E, Berntson L, Fasth A, Rygg M, Müller KG, Avramovič MZ, Dolžan V, Toplak N, Avčin T, Ruperto N, Lovell DJ, Wallace C, Toth M. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461533 DOI: 10.1186/s12969-017-0142-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Filocamo G, Omenetti A, Frenkel J, Lachmann HJ, Ozen S, Ruperto N, Gattorno M, Insalaco A, Moneta G, Pardeo M, Passarelli C, Celani C, Messia V, De Benedetti F, Cherqaoui B, Rossi-Semerano L, Dusser P, Hentgen V, Koné-Paut I, Grimwood C, Dusser P, Rossi L, Paut IK, Hentgen V, Lasigliè D, Ferrera D, Amico G, Di Duca M, Caorsi R, Lepore L, Insalaco A, Cattalini M, Obici L, Consolini R, Ravazzolo R, Martini A, Ceccherini I, Nishikomori R, Arostegui J, Gattorno M, Borghini S, Penco F, Petretto A, Lavarello C, Inglese E, Omenetti A, Finetti M, Pastorino C, Bertoni A, Gattorno M, Vanoni F, Federici S, Ozen S, Frenkel J, Lachmann H, Martini A, Ruperto N, Gattorno M, Hofer M, Kuemmerle-Deschner JB, Hoffman HM, Hawkins PN, van der Poll T, Walker UA, Speziale A, Joubert Y, Tilson HH, Kuemmerle-Deschner J, Ozen S, Tyrrell PN, Koné-Paut I, Goldbach-Mansky R, Lachmann H, Blank N, Hoffman HM, Weissbarth-Riedel E, Huegle B, Kallinich T, Gattorno M, Gul A, ter Haar NM, Oswald M, Dedeoglu F, Benseler SM, Hanaya A, Miyamae T, Kawamoto M, Tani Y, Hara T, Kawaguchi Y, Nagata S, Yamanaka H, Ćosićkić A, Skokić F, Čolić B, Suljendić S, Kozlova A, Mersiyanova I, Panina M, Hachtryan L, Burlakov V, Raikina E, Maschan A, Shcherbina A, Acar B, Albayrak M, Sozeri B, Sahin S, Barut K, Adrovic A, Inan N, Sevgi S, Kasapcopur O, Andreasen CM, Jurik AG, Glerup MB, Høst C, Mahler BT, Hauge EM, Herlin T, Lazea C, Damian L, Lazar C, Manasia R, Stephenson CM, Prajapati V, Miettunen PM, Yılmaz D, Tokgöz Y, Bulut Y, Çakmak H, Sönmez F, Comak E, Aksoy GK, Koyun M, Akman S, Arıkan Y, Terzioğlu E, Özdeş ON, Keser İ, Koçak H, Bingöl A, Yılmaz A, Artan R, De Benedetti F, Anton J, Gattorno M, Lachmann H, Kone-Paut I, Ozen S, Frenkel J, Simon A, Zeft A, Ben-Chetrit E, Hoffman HM, Joubert Y, Lheritier K, Speziale A, Guido J, Xu X, Mehregan FF, Ziaee V, Moradinejad MH, Ferrara G, Pastore S, Insalaco A, Pardeo M, Tommasini A, La Torre F, Alizzi C, Cimaz R, Finetti M, Gattorno M, D’Adamo P, Taddio A, Lachmann H, Simon A, Anton J, Gattorno M, Kone-Paut I, Ozen S, Frenkel J, Ben-Chetrit E, Hoffman H, Zeft A, Joubert Y, Lheritier K, Speziale A, Junge G, Gregson J, De Benedetti F, Sargsyan H, Sargsyan H, Zengin H, Fidanci BE, Kaymakamgil C, Konukbay D, Simsek D, Batu ED, Yildiz D, Gok F, Ozen S, Demirkaya E, Stoler I, Freytag J, Orak B, Seib C, Esmann L, Seipelt E, Gohar F, Foell D, Wittkowski H, Kallinich T, Dursun I, Tulpar S, Yel S, Kartal D, Borlu M, Bastug F, Poyrazoglu H, Gunduz Z, Kose K, Yuksel ME, Calıskan A, Cekgeloglu AB, Dusunsel R, Bouchalova K, Franova J, Schuller M, Macku M, Theodoropoulou K, Carlomagno R, von Scheven-Gête A, Poloni C, Hofer M, Damian LO, Cosma D, Radulescu A, Vasilescu D, Rogojan L, Lazar C, Rednic S, Lupse M, De Somer L, Moens P, Wouters C, Zavala RG, Pedraz LM, Cuadros EN, Rego GDC, Cardona ALU, Zavala RG, Pedraz LM, Cuadros EN, Rego GDC, Cardona ALU, Forno ID, Pieropan S, Viapiana O, Gatti D, Dallagiacoma G, Caramaschi P, Biasi D, Windschall D, Trauzeddel R, Lehmann H, Ganser G, Berendes R, Haller M, Krumrey-Langkammerer M, Nimtz-Talaska A, Schoof P, Trauzeddel RF, Nirschl C, Quesada-Masachs E, Blancafort CA, Barril SM, Caballero CM, Aguiar F, Fonseca R, Alves D, Vieira A, Vieira A, Dias JA, Brito I, Susic G, Milic V, Radunovic G, Boricic I, Marteau P, Adamsbaum C, Rossi-Semerano L, De Bandt M, Lemelle I, Deslandre C, Tran TA, Lohse A, Solau-Gervais E, Pillet P, Bader-Meunier B, Wipff J, Gaujoux-Viala C, Breton S, Devauchelle-Pensec V, Gran S, Fehler O, Zenker S, Schäfers M, Roth J, Vogl T, Czitrom SG, Foell D, Holzinger D, Lanni S, Van Dijkhuizen EHP, Manzoni SM, Marafon DP, Magnaguagno F, de Horatio LT, Ter Haar NM, Littooij AS, Vastert SJ, De Benedetti F, Ravelli A, Martini A, Malattia C, Teixeira VA, Campanilho-Marques R, Mourão AF, Ramos FO, Costa M, Madan WA, Killeen OG, Vidal AR, Delgado DS, Fernandez MIG, Montesinos BL, Penades IC, Kozhevnikov A, Pozdeeva N, Konev M, Melchenko E, Kenis V, Novik G, Sozeri B, Kısaarslan AP, Gunduz Z, Poyrazoglu H, Dusunsel R, Lerkvaleekul B, Jaovisidha S, Sungkarat W, Chitrapazt N, Fuangfa P, Ruangchaijatuporn T, Vilaiyuk S, Pradsgaard DØ, Hørlyck A, Spannow AH, Heuck CW, Herlin T, Diaz T, Garcia F, De La Cruz L, Rubio N, Świdrowska-Jaros J, Smolewska E, Lamot M, Lamot L, Vidovic M, Bosak EP, Rados I, Harjacek M, Tzaribachev N, Louka P, Hagoug R, Trentin C, Kubassova O, Hinton M, Boesen M, Oshlianska OA, Chaikovsky IA, Mjasnikov G, Kazmirchyk A, Garagiola U, Borzani I, Cressoni P, Corona F, Dzsida E, Farronato G, Garagiola U, Cressoni P, Corona F, Petaccia A, Dzsida E, Farronato G, Gagro A, Pasini AM, Roic G, Vrdoljak O, Lujic L, Zutelija-Fattorini M, Esser MM, Abraham DR, Kinnear C, Durrheim G, Urban M, Hoal E, Crow Y, Oshlianska OA. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part one. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461530 DOI: 10.1186/s12969-017-0141-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Ruperto N, Lovell DJ, Tzaribachev N, Vega-Cornejo G, Louw I, Berman A, Calvo I, Cuttica R, Horneff G, Avila-Zapata F, Anton J, Cimaz R, Solau-Gervais E, Joos R, Espada G, Li X, Nys M, Wong R, Banerjee S, Brunner HI, Martini A. O28. SUBCUTANEOUS ABATACEPT IN PATIENTS WITH POLYARTICULAR-COURSE JUVENILE IDIOPATHIC ARTHRITIS AND INADEQUATE RESPONSE TO BIOLOGIC OR NON-BIOLOGIC DISEASE-MODIFYING ANTI-RHEUMATIC DRUGS: PHARMACOKINETICS, EFFICACY AND SAFETY. Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex061.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Daniel J. Lovell
- Rheumatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Nikolay Tzaribachev
- Pediatric Rheumatology, Pediatric Rheumatology Research Institute, Bad Bramstedt, GERMANY
| | - Gabriel Vega-Cornejo
- Clinica de Reumatología y Enfermedades Autoinmunes, Hospital México Americano, Guadalajara, MEXICO
| | - Ingrid Louw
- Rheumatology, Panorama Medical Centre, Cape Town, SOUTH AFRICA
| | - Alberto Berman
- Universidad Nacional de Tucuman, Centro Médico Privado de Reumatología, Tucuman, ARGENTINA
| | - Inmaculada Calvo
- Department of Paediatric Rheumatology, Hospital Universitario La Fe, Valencia, SPAIN
| | - Ruben Cuttica
- Department of Paediatric Rheumatology, Hospital General de Niños Pedro de Elizalde, Buenos Aires, ARGENTINA
| | - Gerd Horneff
- Department of Paediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin, GERMANY
| | | | - Jordi Anton
- Paediatric Rheumatology, Hospital Sant Joan de Déu, Barcelona, SPAIN
| | - Rolando Cimaz
- Department of Paediatric Rheumatology, Ospedale Pediatrico Anna Meyer, Firenze, ITALY
| | | | - Rik Joos
- Centre for Paediatric Rheumatology, University Hospital Gent, Gent, BELGIUM
| | - Graciela Espada
- Rheumatology Section, Hospital De Ninos Dr. Ricardo Gutierrez, Buenos Aires, ARGENTINA
| | - Xiaohui Li
- Clinical Pharmacology, Bristol-Myers Squibb, Princeton, NJ, USA
| | - Marleen Nys
- Global Biometric Sciences, Bristol-Myers Squibb, Braine L'Alleud, BELGIUM
| | - Robert Wong
- Immunoscience Global Clinical Research, Bristol-Myers Squibb, Princeton, NJ
| | - Subhashis Banerjee
- Immunoscience Global Clinical Research, Bristol-Myers Squibb, Princeton, NJ
| | - Hermine I. Brunner
- Division of Rheumatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Alberto Martini
- Pediatria II, Istituto G. Gaslini Pediatria II Reumatologia and University of Genova, Genova, ITALY
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Affiliation(s)
- Cristóbal Couto
- Uveitis Clinics, Department of Ophthalmology, University of Buenos Aires, Buenos Aires, Argentina
| | - Mercedes M. Frick
- Uveitis Clinics, Department of Ophthalmology, University of Buenos Aires, Buenos Aires, Argentina
| | - Kara LaMattina
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Ariel Schlaen
- Uveitis Clinics, Department of Ophthalmology, University of Buenos Aires, Buenos Aires, Argentina
| | - Marina Khoury
- Epidemiology Department, University of Buenos Aires, Buenos Aires, Argentina
| | - Matilde María Lopez
- Uveitis Clinics, Department of Ophthalmology, University of Buenos Aires, Buenos Aires, Argentina
| | - Erika Hurtado
- Uveitis Clinics, Department of Ophthalmology, University of Buenos Aires, Buenos Aires, Argentina
| | - Graciela Espada
- Division of Rheumatology, Hospital de Niños “Ricardo Gutiérrez,”, Buenos Aires, Argentina
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Varnier G, Consolaro A, Pilkington C, Ferrari C, Civino A, de Inocencio J, Jelusic Drazic M, Tsitsamis E, Vojinovic J, Espada G, Makay B, Martini A, Ravelli A. OP0270 Further Validation of the Hybrid MMT/CMAS (HMC), A New Measure of Muscle Disease Activity in Juvenile Dermatomyositis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Consolaro A, Varnier G, Ferrari C, de Inocencio J, Civino A, Jeluzic-Drazic M, Tsitsamis E, Vojinovic J, Makay B, Espada G, Malattia C, Maillard S, Martini A, Pilkington C, Ravelli A, Nistala K. OP0150 Development and Preliminary Validation of a New Composite Disease Activity Measure for Juvenile Dermatomyositis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Horne A, Minoia F, Davì S, Bovis F, Rosina S, Lehmberg K, Weitzman S, Insalaco A, Wouters C, Shenoi S, Espada G, Ozen S, Anton J, Khubchandani R, Russo R, Ruperto N, Martini A, Cron R, Ravelli A. SAT0486 Macrophage Activation Syndrome and Familial Hemophagocytic Lymphohistiocytosis: Is Their Clinical Phenotype Really Similar? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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De Benedetti F, Brunner H, Ruperto N, Schneider R, Xavier R, Allen R, Brown DE, Chaitow J, Pardeo M, Espada G, Gerloni V, Myones BL, Frane JW, Wang J, Lipman TH, Bharucha KN, Martini A, Lovell D. Catch-up growth during tocilizumab therapy for systemic juvenile idiopathic arthritis: results from a phase III trial. Arthritis Rheumatol 2015; 67:840-8. [PMID: 25504861 DOI: 10.1002/art.38984] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 12/02/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the impact of tocilizumab treatment on growth and growth-related laboratory parameters in patients with systemic juvenile idiopathic arthritis (JIA) enrolled in a phase III clinical trial. METHODS Patients with systemic JIA ages 2-17 years (n = 112) received tocilizumab in a 12-week, randomized, placebo-controlled period and a long-term open-label extension. Height velocity and standard deviation (SD) score; levels of insulin-like growth factor 1 (IGF-1), osteocalcin (OC), and C-telopeptide of type I collagen (CTX-I); and Juvenile Arthritis Disease Activity Score in 71 joints (JADAS-71) were measured in a post hoc analysis of 83 patients who never received growth hormone and did not reach Tanner stage 5 by the end of the first year of treatment. RESULTS Patients had stunted growth at baseline (mean height SD score -2.2). During tocilizumab treatment, males (73%) and females (83%) experienced above-normal mean height velocities of 6.6 cm/year (P < 0.0001 versus World Health Organization norms). Mean height SD score increases during year 1 (0.29) and year 2 (0.31) were significant (both P < 0.0001). The mean SD score for IGF-1 levels increased significantly (-0.2 for year 1 and -0.1 for year 2 versus -1.0 at baseline; both P < 0.0001). Mean OC and CTX-I levels (both P < 0.0001) and the OC:CTX-I ratio (P = 0.014) significantly increased from baseline to year 2. In multiple regression analysis, first-year height velocity had a significant inverse relationship to JADAS-71 at year 1, age, mean glucocorticoid dosage during the year, and height SD score at baseline. CONCLUSION Our findings indicate that during treatment with tocilizumab, patients with systemic JIA experience significant catch-up growth, normalization of IGF-1 levels, and bone balance improvement favoring bone formation.
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Minoia F, Davì S, Horne A, Demirkaya E, Bovis F, Li C, Lehmberg K, Weitzman S, Insalaco A, Wouters C, Shenoi S, Espada G, Ozen S, Anton J, Khubchandani R, Russo R, Pal P, Kasapcopur O, Miettunen P, Maritsi D, Merino R, Shakoory B, Alessio M, Chasnyk V, Sanner H, Gao YJ, Huasong Z, Kitoh T, Avcin T, Fischbach M, Frosch M, Grom A, Huber A, Jelusic M, Sawhney S, Uziel Y, Ruperto N, Martini A, Cron RQ, Ravelli A. Clinical features, treatment, and outcome of macrophage activation syndrome complicating systemic juvenile idiopathic arthritis: a multinational, multicenter study of 362 patients. Arthritis Rheumatol 2015; 66:3160-9. [PMID: 25077692 DOI: 10.1002/art.38802] [Citation(s) in RCA: 261] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 07/24/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To describe the clinical, laboratory, and histopathologic features, current treatment, and outcome of patients with macrophage activation syndrome (MAS) complicating systemic juvenile idiopathic arthritis (JIA). METHODS In this multinational, multicenter study, pediatric rheumatologists and hemato-oncologists entered patient data collected retrospectively into a web-based database. RESULTS A total of 362 patients, 22% of whom had MAS at the onset of systemic JIA, were included in the study by 95 investigators from 33 countries. The most frequent clinical manifestations were fever (96%), hepatomegaly (70%), and splenomegaly (58%). Central nervous system dysfunction and hemorrhages were recorded in 35% and 20% of the patients, respectively. Platelet count and liver transaminase, ferritin, lactate dehydrogenase, triglyceride, and d-dimer levels were the sole laboratory biomarkers showing a percentage change of >50% between the pre-MAS visit and MAS onset. Evidence of macrophage hemophagocytosis was found in 60% of the patients who underwent bone marrow aspiration. MAS occurred most frequently in the setting of active underlying disease, in the absence of a specific trigger. Nearly all patients were given corticosteroids, and 61% received cyclosporine. Biologic medications and etoposide were given to 15% and 12% of the patients, respectively. Approximately one-third of the patients required admission to the intensive care unit (ICU), and the mortality rate was 8%. CONCLUSION This study provides information on the clinical spectrum and current management of systemic JIA-associated MAS through the analysis of a very large patient sample. MAS remains a serious condition, as a sizeable proportion of patients required admission to the ICU or died.
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Rose CD, Pans S, Casteels I, Anton J, Bader-Meunier B, Brissaud P, Cimaz R, Espada G, Fernandez-Martin J, Hachulla E, Harjacek M, Khubchandani R, Mackensen F, Merino R, Naranjo A, Oliveira-Knupp S, Pajot C, Russo R, Thomee C, Vastert S, Wulffraat N, Arostegui JI, Foley KP, Bertin J, Wouters CH. Blau syndrome: cross-sectional data from a multicentre study of clinical, radiological and functional outcomes. Rheumatology (Oxford) 2014; 54:1008-16. [DOI: 10.1093/rheumatology/keu437] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Indexed: 11/12/2022] Open
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Meiorin S, Barzola ML, Espada G, Blumenthal L. Value of ultrasound in detecting subclinical synovitis in polyarticular juvenile idiophatic arthritis (PJIA) in clinical remission (CR). Pediatr Rheumatol Online J 2014. [PMCID: PMC4191132 DOI: 10.1186/1546-0096-12-s1-p165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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De Benedetti F, Ruperto N, Espada G, Gerloni V, Flato B, Horneff G, Myones BL, Onel K, Frane J, Wang J, Lipman TH, Bharucha KN, Martini A. Catch-up growth during tocilizumab therapy for systemic juvenile idiopathic arthritis: 2-year data from a phase 3 clinical trial. Rheumatology (Oxford) 2014. [DOI: 10.1093/rheumatology/keu268.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Minoia F, Davì S, Horne A, Consolaro A, Rosina S, Davidsone Z, De Cunto C, De Inocencio J, Eisenstein E, Espada G, Fishbach M, Frosch M, Gallizzi R, Gamir ML, Griffin T, Grom A, Hennon T, Horneff G, Huasong Z, Ruperto N, Martini A, Cron RQ, Ravelli A. PReS-FINAL-2141: Clinical features, therapeutic interventions and outcome of 362 patients with macrophage activation syndrome enrolled in a multinational survey. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044446 DOI: 10.1186/1546-0096-11-s2-p153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Rose CD, Cimaz R, Thomee C, Khubchandani R, Espada G, Russo R, Harjacek M, Bader-Meunier B, Brissaud P, Wulffraat N, Vastert S, Merino R, Naranjo-Hernandez A, Oliveira-Knupp S, Mackensen F, Arostegui J, Anton J, Fernandez-Martin J, Wouters C. PW03-016 – Blau prospective cohort study: articular outcomes. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952171 DOI: 10.1186/1546-0096-11-s1-a242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Rose CD, Cimaz R, Thomee C, Khubchandani R, Espada G, Russo R, Harjacek M, Bader-Meunier B, Brissaud P, Wulffraat N, Vastert S, Merino R, Naranjo-Hernandez A, Knupp SO, Mackenson F, Arostegui J, Lopez JA, Fernandez-Martin J, Wouters C. OR3-002 – Blau Syndrome cohort study: ocular outcome. Pediatr Rheumatol Online J 2013. [PMCID: PMC3953341 DOI: 10.1186/1546-0096-11-s1-a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Hollander MC, Sage JM, Greenler AJ, Pendl J, Avcin T, Espada G, Beresford MW, Henrickson M, Lee TL, Punaro M, Huggins J, Stevens AM, Klein-Gitelman MS, Brunner HI. International Consensus for Provisions of Quality-Driven Care in Childhood-Onset Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken) 2013; 65:1416-23. [DOI: 10.1002/acr.21998] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 02/21/2013] [Indexed: 01/22/2023]
Affiliation(s)
| | - Jessica M. Sage
- Cincinnati Children's Hospital Medical Center; Cincinnati; Ohio
| | | | - Joshua Pendl
- Cincinnati Children's Hospital Medical Center; Cincinnati; Ohio
| | - Tadej Avcin
- University Children's Hospital; Ljubljana; Slovenia
| | - Graciela Espada
- Hospital de Niños Ricardo Gutierrez; Buenos Aires; Argentina
| | - Michael W. Beresford
- University of Liverpool, Alder Hey Children's NHS Foundation Trust; Liverpool; UK
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Abstract
Monogenic autoinflammatory syndromes are caused by mutations in protein-coding genes that have a pivotal role in the regulation of the inflammatory response. Due to their genetic nature, most of these syndromes usually begin during childhood. They are clinically characterized by recurrent episodes of systemic inflammation (fever with different clinical manifestations, such as skin rash, serositis or arthritis) associated with elevation of acute phase reactants. During symptom-free intervals, patients achieve clinical well-being and normalize infammatory parameters. Amyloidosis is a serious long-term complication. In this update we will discuss the clinical presentation and therapeutic strategies for these diseases in pediatrics.
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Affiliation(s)
- Silvia M Meiorin
- Servicio de Reumatología, Hospital de Niños Ricardo Gutiérrez, Argentina.
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De Benedetti F, Ruperto N, Espada G, Gerloni V, Flato B, Horneff G, Myones B, Onel K, Frane J, Wang J, Lipman T, Bharucha K, Martini A, Lovell D. SAT0438 Catch-Up Growth During Tocilizumab Therapy for Systemic Juvenile Idiopathic Arthritis: 2-Year Data from a Phase 3 Clinical Trial. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Demirkaya E, Turker T, Ruperto N, Cuttica R, Brogan P, Quartier P, Anton J, Ayaz N, Garay S, Espada G, Khubchandani R, Zulian F, Bagga A, Belot A, Silva C, Al-Mayouf S, Estrella A, Oliveira S, Magalhães C, Martini A, Ozen S. THU0210 The comparison of childhood polyarteritis nodosa and cutaneous polyarteritis NODOSA. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Tobias J, Deere K, Palmer S, Clark E, Clinch J, Fikree A, Aktar R, Wellstead G, Knowles C, Grahame R, Aziz Q, Amaral B, Murphy G, Ioannou Y, Isenberg DA, Tansley SL, Betteridge ZE, Gunawardena H, Shaddick G, Varsani H, Wedderburn L, McHugh N, De Benedetti F, Ruperto N, Espada G, Gerloni V, Flato B, Horneff G, Myones BL, Onel K, Frane J, Kenwright A, Lipman TH, Bharucha KN, Martini A, Lovell DJ, Baildam E, Ruperto N, Brunner H, Zuber Z, Keane C, Harari O, Kenwright A, Cuttica RJ, Keltsev V, Xavier R, Penades IC, Nikishina I, Rubio-Perez N, Alekseeva E, Chasnyk V, Chavez J, Horneff G, Opoka-Winiarska V, Quartier P, Silva CA, Silverman ED, Spindler A, Lovell DJ, Martini A, De Benedetti F, Hendry GJ, Watt GF, Brandon M, Friel L, Turner D, Lorgelly PK, Gardner-Medwin J, Sturrock RD, Woodburn J, Firth J, Waxman R, Law G, Siddle H, Nelson AE, Helliwell P, Otter S, Butters V, Loughrey L, Alcacer-Pitarch B, Tranter J, Davies S, Hryniw R, Lewis S, Baker L, Dures E, Hewlett S, Ambler N, Clarke J, Gooberman-Hill R, Jenkins R, Wilkie R, Bucknall M, Jordan K, McBeth J, Norton S, Walsh D, Kiely P, Williams R, Young A, Harkess JE, McAlarey K, Chesterton L, van der Windt DA, Sim J, Lewis M, Mallen CD, Mason E, Hay E, Clarson LE, Hider SL, Belcher J, Heneghan C, Roddy E, Mallen CD, Gibson J, Whiteford S, Williamson E, Beatty S, Hamilton-Dyer N, Healey EL, Ryan S, McHugh GA, Main CJ, Porcheret M, Nio Ong B, Pushpa-Rajah A, Dziedzic KS, MacRae CS, Shortland A, Lewis J, Morrissey M, Critchley D, Muller S, Mallen CD, Belcher J, Helliwell T, Hider SL, Cole Z, Parsons C, Crozier S, Robinson S, Taylor P, Inskip H, Godfrey K, Dennison E, Harvey NC, Cooper C, Prieto Alhambra D, Lalmohamed A, Abrahamsen B, Arden N, de Boer A, Vestergaard P, de Vries F, Kendal A, Carr A, Prieto-Alhambra D, Judge A, Cooper C, Chapurlat R, Bellamy N, Czerwinski E, Pierre Devogelaer J, March L, Pavelka K, Reginster JY, Kiran A, Judge A, Javaid MK, Arden N, Cooper C, Sundy JS, Baraf HS, Becker M, Treadwell EL, Yood R, Ottery FD. Oral Abstracts 3: Adolescent and Young Adult * O13. Hypermobility is a Risk Factor for Musculoskeletal Pain in Adolescence: Findings From a Prospective Cohort Study. Rheumatology (Oxford) 2013. [DOI: 10.1093/rheumatology/ket200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Miettunen PM, Pistorio A, Palmisani E, Ravelli A, Silverman E, Oliveira S, Alessio M, Cuttica R, Mihaylova D, Espada G, Pasic S, Insalaco A, Ozen S, Porras O, Sztajnbok F, Lazarevic D, Martini A, Ruperto N. Therapeutic approaches for the treatment of renal disease in juvenile systemic lupus erythematosus: an international multicentre PRINTO study. Ann Rheum Dis 2012; 72:1503-9. [PMID: 23100607 DOI: 10.1136/annrheumdis-2012-201937] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To evaluate therapeutic approaches and response to therapy in juvenile systemic lupus erythematosus (SLE) with renal involvement in a large prospective international cohort from four geographic areas. METHODS New onset and flared patients with active renal disease (proteinuria ≥0.5 g/24 h) were enrolled in 2001-2004. Therapeutic approaches and disease activity parameters were analysed at baseline, 6, 12 and 24 months. Response was assessed by the PRINTO/ACR criteria. RESULTS 218/557 (79.8% female subjects, 117 new onset and 101 flared) patients with active renal disease were identified; 66 patients were lost to follow-up and 11 died. Mean age at disease onset for new onset group was higher than for flared group (13.1 vs 10.2 years, p<0.0001). At baseline, both groups had similar renal activity with similar median doses of corticosteroids (1.0-0.76 mg/kg/day). Cyclophosphamide (43.1%) and azathioprine (22%) were the most common immunosuppressive drugs. At baseline, South American patients received higher doses of corticosteroids than in other areas in new onset (median 1.16 vs 0.8-1 mg/kg/day) while cyclophosphamide use was similar in all four regions in the new onset group. There were no differences regarding the use of azathioprine or mycophenolate mofetil worldwide. PRINTO 70 response was reached in a greater percentage of new onset versus flared patients (74.8% vs 53.3%; p=0.005) at 6 months while at 24 months ACR 90 was reached by 69.9% and 56.1%, respectively. CONCLUSIONS New onset and flared juvenile SLE improved similarly over 24 months with minimal differences in therapeutic approaches worldwide.
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Affiliation(s)
- Paivi M Miettunen
- Division of Pediatric Rheumatology, University of Calgary, Alberta Children's Hospital, Calgary, Canada
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Mina R, Klein-Gitelman MS, Ravelli A, Beresford MW, Avcin T, Espada G, Eberhard BA, Schanberg LE, O'Neil KM, Silva CA, Higgins GC, Onel K, Singer NG, von Scheven E, Imundo LF, Nelson S, Giannini EH, Brunner HI. Inactive disease and remission in childhood-onset systemic lupus erythematosus. Arthritis Care Res (Hoboken) 2012; 64:683-93. [PMID: 22238253 DOI: 10.1002/acr.21612] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To define inactive disease (ID) and clinical remission (CR) and to delineate variables that can be used to measure ID/CR in childhood-onset systemic lupus erythematosus (cSLE). METHODS Delphi questionnaires were sent to an international group of pediatric rheumatologists. Respondents provided information about variables to be used in future algorithms to measure ID/CR. The usefulness of these variables was assessed in 35 children with ID and 31 children with minimally active lupus (MAL). RESULTS While ID reflects cSLE status at a specific point in time, CR requires the presence of ID for >6 months and considers treatment. There was consensus that patients in ID/CR can have <2 mild nonlimiting symptoms (i.e., fatigue, arthralgia, headaches, or myalgia) but not Raynaud's phenomenon, chest pain, or objective physical signs of cSLE; antinuclear antibody positivity and erythrocyte sedimentation rate elevation can be present. Complete blood count, renal function testing, and complement C3 all must be within the normal range. Based on consensus, only damage-related laboratory or clinical findings of cSLE are permissible with ID. The above parameters were suitable to differentiate children with ID/CR from those with MAL (area under the receiver operating characteristic curve >0.85). Disease activity scores with or without the physician global assessment of disease activity and patient symptoms were well suited to differentiate children with ID from those with MAL. CONCLUSION Consensus has been reached on common definitions of ID/CR with cSLE and relevant patient characteristics with ID/CR. Further studies must assess the usefulness of the data-driven candidate criteria for ID in cSLE.
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Affiliation(s)
- Rina Mina
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, William S. Rowe Division of Rheumatology, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA
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Backhouse MR, Vinall KA, Redmond A, Helliwell P, Keenan AM, Dale RM, Thomas A, Aronson D, Turner-Cobb J, Sengupta R, France B, Hill I, Flurey CA, Morris M, Pollock J, Hughes R, Richards P, Hewlett S, Ryan S, Lille K, Adams J, Haq I, McArthur M, Goodacre L, Birt L, Wilson O, Kirwan J, Dures E, Quest E, Hewlett S, Rajak R, Thomas T, Lawson T, Petford S, Hale E, Kitas GD, Ryan S, Gooberman-Hill R, Jinks C, Dziedzic K, Boucas SB, Hislop K, Rhodes C, Adams J, Ali F, Jinks C, Ong BN, Backhouse MR, White D, Hensor E, Keenan AM, Helliwell P, Redmond A, Ferguson AM, Douiri A, Scott DL, Lempp H, Halls S, Law RJ, Jones J, Markland D, Maddison P, Thom J, Law RJ, Thom JM, Maddison P, Breslin A, Kraus A, Gordhan C, Dennis S, Connor J, Chowdhary B, Lottay N, Juneja P, Bacon PA, Isaacs D, Jack J, Keller M, Tibble J, Haq I, Hammond A, Gill R, Tyson S, Tennant A, Nordenskiold U, Pease EE, Pease CT, Trehane A, Rahmeh F, Cornell P, Westlake SL, Rose K, Alber CF, Watson L, Stratton R, Lazarus M, McNeilly NE, Waterfield J, Hurley M, Greenwood J, Clayton AM, Lynch M, Clewes A, Dawson J, Abernethy V, Griffiths AE, Chamberlain VA, McLoughlin Y, Campbell S, Hayes J, Moffat C, McKenna F, Shah P, Rajak R, Williams A, Rhys-Dillon C, Goodfellow R, Martin JC, Rajak R, Bari F, Hughes G, Thomas E, Baker S, Collins D, Price E, Williamson L, Dunkley L, Youll MJ, Rodziewicz M, Reynolds JA, Berry J, Pavey C, Hyrich K, Gorodkin R, Wilkinson K, Bruce I, Barton A, Silman A, Ho P, Cornell T, Westlake SL, Richards S, Holmes A, Parker S, Smith H, Briggs N, Arthanari S, Nisar M, Thwaites C, Ryan S, Kamath S, Price S, Robinson SM, Walker D, Coop H, Al-Allaf W, Baker S, Williamson L, Price E, Collins D, Charleton RC, Griffiths B, Edwards EA, Partlett R, Martin K, Tarzi M, Panthakalam S, Freeman T, Ainley L, Turner M, Hughes L, Russell B, Jenkins S, Done J, Young A, Jones T, Gaywood IC, Pande I, Pradere MJ, Bhaduri M, Smith A, Cook H, Abraham S, Ngcozana T, Denton CP, Parker L, Black CM, Ong V, Thompson N, White C, Duddy M, Jobanputra P, Bacon P, Smith J, Richardson A, Giancola G, Soh V, Spencer S, Greenhalgh A, Hanson M, De Lord D, Lloyd M, Wong H, Wren D, Grover B, Hall J, Neville C, Alton P, Kelly S, Bombardieri M, Humby F, Ng N, Di Cicco M, Hands R, Epis O, Filer A, Buckley C, McInnes I, Taylor P, Pitzalis C, Freeston J, Conaghan P, Grainger A, O'Connor PJ, Evans R, Emery P, Hodgson R, Emery P, Fleischmann R, Han C, van der Heijde D, Conaghan P, Xu W, Hsia E, Kavanaugh A, Gladman D, Chattopadhyay C, Beutler A, Han C, Zayat AS, Conaghan P, Freeston J, Hensor E, Ellegard K, Terslev L, Emery P, Wakefield RJ, Ciurtin C, Leandro M, Dey D, Nandagudi A, Giles I, Shipley M, Morris V, Ioannou J, Ehrenstein M, Sen D, Chan M, Quinlan TM, Brophy R, Mewar D, Patel D, Wilby MJ, Pellegrini V, Eyes B, Crooks D, Anderson M, Ball E, McKeeman H, Burns J, Yau WH, Moore O, Foo J, Benson C, Patterson C, Wright G, Taggart A, Drew S, Tanner L, Sanyal K, Bourke BE, Lloyd M, Alston C, Baqai C, Chard M, Sandhu V, Neville C, Jordan K, Munns C, Zouita L, Shattles W, Davies U, Makadsi R, Griffith S, Kiely PD, Ciurtin C, Dimofte I, Dabu M, Dabu B, Dobarro D, Schreiber BE, Warrell C, Handler C, Coghlan G, Denton C, Ishorari J, Bunn C, Beynon H, Denton CP, Stratton R, George Malal JJ, Boton-Maggs B, Leung A, Farewell D, Choy E, Gullick NJ, Young A, Choy EH, Scott DL, Wincup C, Fisher B, Charles P, Taylor P, Gullick NJ, Pollard LC, Kirkham BW, Scott DL, Ma MH, Ramanujan S, Cavet G, Haney D, Kingsley GH, Scott D, Cope A, Singh A, Wilson J, Isaacs A, Wing C, McLaughlin M, Penn H, Genovese MC, Sebba A, Rubbert-Roth A, Scali J, Zilberstein M, Thompson L, Van Vollenhoven R, De Benedetti F, Brunner H, Allen R, Brown D, Chaitow J, Pardeo M, Espada G, Flato B, Horneff G, Devlin C, Kenwright A, Schneider R, Woo P, Martini A, Lovell D, Ruperto N, John H, Hale ED, Treharne GJ, Kitas GD, Carroll D, Mercer L, Low A, Galloway J, Watson K, Lunt M, Symmons D, Hyrich K, Low A, Mercer L, Galloway J, Davies R, Watson K, Lunt M, Dixon W, Hyrich K, Symmons D, Balarajah S, Sandhu A, Ariyo M, Rankin E, Sandoo A, van Zanten JJV, Toms TE, Carroll D, Kitas GD, Sandoo A, Smith JP, Kitas GD, Malik S, Toberty E, Thalayasingam N, Hamilton J, Kelly C, Puntis D, Malik S, Hamilton J, Saravanan V, Rynne M, Heycock C, Kelly C, Rajak R, Goodfellow R, Rhys-Dillon C, Winter R, Wardle P, Martin JC, Toms T, Sandoo A, Smith J, Cadman S, Nightingale P, Kitas G, Alhusain AZ, Verstappen SM, Mirjafari H, Lunt M, Charlton-Menys V, Bunn D, Symmons D, Durrington P, Bruce I, Cooney JK, Thom JM, Moore JP, Lemmey A, Jones JG, Maddison PJ, Ahmad YA, Ahmed TJ, Leone F, Kiely PD, Browne HK, Rhys-Dillon C, Wig S, Chevance A, Moore T, Manning J, Vail A, Herrick AL, Derrett-Smith E, Hoyles R, Moinzadeh P, Chighizola C, Khan K, Ong V, Abraham D, Denton CP, Schreiber BE, Dobarro D, Warrell CE, Handler C, Denton CP, Coghlan G, Sykes R, Muir L, Ennis H, Herrick AL, Shiwen X, Thompson K, Khan K, Liu S, Denton CP, Leask A, Abraham DJ, Strickland G, Pauling J, Betteridge Z, Dunphy J, Owen P, McHugh N, Abignano G, Cuomo G, Buch MH, Rosenberg WM, Valentini G, Emery P, Del Galdo F, Jenkins J, Pauling JD, McHugh N, Khan K, Shiwen X, Abraham D, Denton CP, Ong V, Moinzadeh P, Howell K, Ong V, Nihtyanova S, Denton CP, Moinzadeh P, Fonseca C, Khan K, Abraham D, Ong V, Denton CP, Malaviya AP, Hadjinicolaou AV, Nisar MK, Ruddlesden M, Furlong A, Baker S, Hall FC, Hadjinicolaou AV, Malaviya AP, Nisar MK, Ruddlesden M, Raut-Roy D, Furlong A, Baker S, Hall FC, Peluso R, Dario Di Minno MN, Iervolino S, Costa L, Atteno M, Lofrano M, Soscia E, Castiglione F, Foglia F, Scarpa R, Wallis D, Thomas A, Hill I, France B, Sengupta R, Dougados M, Keystone E, Heckaman M, Mease P, Landewe R, Nguyen D, Heckaman M, Mease P, Winfield RA, Dyke C, Clemence M, Mackay K, Haywood KL, Packham J, Jordan KP, Davies H, Brophy S, Irvine E, Cooksey R, Dennis MS, Siebert S, Kingsley GH, Ibrahim F, Scott DL, Kavanaugh A, McInnes I, Chattopadhyay C, Krueger G, Gladman D, Beutler A, Gathany T, Mudivarthy S, Mack M, Tandon N, Han C, Mease P, McInnes I, Sieper J, Braun J, Emery P, van der Heijde D, Isaacs J, Dahmen G, Wollenhaupt J, Schulze-Koops H, Gsteiger S, Bertolino A, Hueber W, Tak PP, Cohen CJ, Karaderi T, Pointon JJ, Wordsworth BP, Cooksey R, Davies H, Dennis MS, Siebert S, Brophy S, Keidel S, Pointon JJ, Farrar C, Karaderi T, Appleton LH, Wordsworth BP, Adshead R, Tahir H, Greenwood M, Donnelly SP, Wajed J, Kirkham B. BHPR research: qualitative * 1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Miettunen P, Pistorio A, Ravelli A, Oliveira S, Alessio M, Cuttica R, Mihaylova D, Espada G, Pasic S, Cortis E, Ozen S, Porras O, Sztajnbok F, Palmisani E, Martini A, Ruperto N. Therapeutic approaches for the treatment of new onset and flared juvenile systemic lupus erythematosus with active renal disease: an international multicenter PRINTO study. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194622 DOI: 10.1186/1546-0096-9-s1-p258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Espada G, Giupponi J, Cerqueiro C. Tuberculosis in Juvenile Idiopathic arthritis under Anti-TNF therapy. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194733 DOI: 10.1186/1546-0096-9-s1-p72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Pendl J, Hollander M, Nelson S, Yousaf W, Ruperto N, Beresford M, Klein-Gitelman M, Punaro M, Stevens A, Avcin T, Espada G, Lee TL, Lau YL, Huggins J, Morgan-DeWitt E, Brunner HI. Achieving consensus on quality indicators (QI) for pediatric Systemic Lupus Erythematosus (pSLE). Pediatr Rheumatol Online J 2011. [PMCID: PMC3194610 DOI: 10.1186/1546-0096-9-s1-p247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Mina R, Schanberg L, Eberhard AB, Klein–Gitelman M, Higgins G, Onel K, Singer NG, O’Neil K, Tucker L, Levy D, Yousaf W, Nelson S, Beresford M, Cuttica R, Espada G, Ravelli A, Martini A, Giannini E, Brunner HI. Defining clinical remission and clinically inactive disease in juvenile systemic lupus erythematosus (jSLE). Pediatr Rheumatol Online J 2011. [PMCID: PMC3194411 DOI: 10.1186/1546-0096-9-s1-o17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Visvanathan S, Wagner C, Marini JC, Lovell DJ, Martini A, Petty R, Cuttica R, Woo P, Espada G, Gattorno M, Apaz MT, Baildam E, Fasth A, Gerloni V, Lahdenne P, Quartier P, Saurenmann R, Travers S, Mendelsohn A, Xu S, Giannini EH, Ruperto N. The effect of infliximab plus methotrexate on the modulation of inflammatory disease markers in juvenile idiopathic arthritis: analyses from a randomized, placebo-controlled trial. Pediatr Rheumatol Online J 2010; 8:24. [PMID: 20822542 PMCID: PMC2949752 DOI: 10.1186/1546-0096-8-24] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 09/07/2010] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We evaluated the effect of infliximab on markers of inflammation in patients with juvenile idiopathic arthritis (JIA). METHODS In this randomized, placebo-controlled substudy, 122 patients with JIA received infliximab 3 mg/kg + methotrexate (MTX)(n = 60) or placebo + MTX (n = 62) at weeks 0, 2, and 6. At week 14, patients receiving placebo + MTX crossed over to infliximab 6 mg/kg + MTX; patients receiving infliximab 3 mg/kg + MTX continued treatment through week 44. Sera and plasma from eligible patients receiving infliximab 3 mg/kg + MTX (n = 34) and receiving placebo→infliximab 6 mg/kg +MTX (n = 38) were collected at weeks 0, 2, 14, 16, 28, and 52 and analyzed for inflammatory markers (IL-6, IL-12p40, ICAM-1, MMP-3, VEGF, TNF-α, and CRP). RESULTS At week 2, decreases from baseline in IL-6, ICAM-1, MMP-3, TNF-α, and CRP were greater with infliximab versus placebo treatment, and with the exception of CRP, these differences were generally maintained through week 14. The decreases from baseline to week 52 in IL-6, ICAM-1, VEGF, MMP-3, and CRP and increases in IL-12p40 levels were larger in patients receiving placebo→infliximab 6 mg/kg +MTX versus infliximab 3 mg/kg + MTX treatment. Patients receiving infliximab 3 mg/kg+MTX who achieved an American College of Rheumatology Pediatric 30 (ACR-Pedi-30) response had significantly larger decreases from baseline in ICAM-1 (p = 0.0105) and MMP-3 (p = 0.0253) at week 2 and in ICAM-1 (p = 0.0304), MMP-3 (p = 0.0091), and CRP (p = 0.0011) at week 14 versus ACR-Pedi-30 nonresponders. CONCLUSION Infliximab + MTX attenuated several inflammatory markers in patients with JIA; larger decreases in ICAM-1, MMP-3, and CRP levels were observed in ACR-Pedi-30 responders versus nonresponders. TRIAL REGISTRATION NCT00036374.
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Affiliation(s)
| | - Carrie Wagner
- Centocor Research & Development, Inc., Malvern, PA, USA
| | | | - Daniel J Lovell
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | | | - Ross Petty
- British Columbia's Children's Hospital and the University of British Columbia, British Columbia, Canada
| | - Ruben Cuttica
- Hospital General de Niños Pedro de Elizalde, Buenos Aires, Argentina
| | - Patricia Woo
- Great Ormond St Hospital for Children, London, UK
| | - Graciela Espada
- Hospital de Ninos Ricardo Gutierrez, Buenos Aires, Argentina
| | | | | | | | - Anders Fasth
- University of Gothenberg and The Queen Silvia Children's Hospital, Götenborg, Sweden
| | | | - Pekka Lahdenne
- Hospital for Children and Adolescents, Helsinki, Finland
| | - Pierre Quartier
- Hopital Necker Enfants Malades, Assistance Publique Hopitaux de Paris and Universite Paris-Descartes, Paris, France
| | | | | | | | - Stephen Xu
- Centocor Research & Development, Inc., Malvern, PA, USA
| | - Edward H Giannini
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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Ruperto N, Pistorio A, Ravelli A, Rider LG, Pilkington C, Oliveira S, Wulffraat N, Espada G, Garay S, Cuttica R, Hofer M, Quartier P, Melo-Gomes J, Reed AM, Wierzbowska M, Feldman BM, Harjacek M, Huppertz HI, Nielsen S, Flato B, Lahdenne P, Michels H, Murray KJ, Punaro L, Rennebohm R, Russo R, Balogh Z, Rooney M, Pachman LM, Wallace C, Hashkes P, Lovell DJ, Giannini EH, Gare BA, Martini A. The Paediatric Rheumatology International Trials Organisation provisional criteria for the evaluation of response to therapy in juvenile dermatomyositis. Arthritis Care Res (Hoboken) 2010; 62:1533-41. [PMID: 20583105 DOI: 10.1002/acr.20280] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Accepted: 06/17/2010] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To develop a provisional definition for the evaluation of response to therapy in juvenile dermatomyositis (DM) based on the Paediatric Rheumatology International Trials Organisation juvenile DM core set of variables. METHODS Thirty-seven experienced pediatric rheumatologists from 27 countries achieved consensus on 128 difficult patient profiles as clinically improved or not improved using a stepwise approach (patient's rating, statistical analysis, definition selection). Using the physicians' consensus ratings as the "gold standard measure," chi-square, sensitivity, specificity, false-positive and-negative rates, area under the receiver operating characteristic curve, and kappa agreement for candidate definitions of improvement were calculated. Definitions with kappa values >0.8 were multiplied by the face validity score to select the top definitions. RESULTS The top definition of improvement was at least 20% improvement from baseline in 3 of 6 core set variables with no more than 1 of the remaining worsening by more than 30%, which cannot be muscle strength. The second-highest scoring definition was at least 20% improvement from baseline in 3 of 6 core set variables with no more than 2 of the remaining worsening by more than 25%, which cannot be muscle strength (definition P1 selected by the International Myositis Assessment and Clinical Studies group). The third is similar to the second with the maximum amount of worsening set to 30%. This indicates convergent validity of the process. CONCLUSION We propose a provisional data-driven definition of improvement that reflects well the consensus rating of experienced clinicians, which incorporates clinically meaningful change in core set variables in a composite end point for the evaluation of global response to therapy in juvenile DM.
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Affiliation(s)
- Nicolino Ruperto
- Paediatric Rheumatology International Trials Organisation, Genoa, Italy.
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Ruperto N, Ozen S, Pistorio A, Dolezalova P, Brogan P, Cabral DA, Cuttica R, Khubchandani R, Lovell DJ, O'Neil KM, Quartier P, Ravelli A, Iusan SM, Filocamo G, Magalhaes CS, Unsal E, Oliveira S, Bracaglia C, Bagga A, Stanevicha V, Manzoni SM, Pratsidou P, Lepore L, Espada G, Paut IK, Zulian F, Barone P, Bircan Z, Maldonado MDR, Russo R, Vilca I, Tullus K, Cimaz R, Horneff G, Anton J, Garay S, Nielsen S, Barbano G, Martini A. EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part I: Overall methodology and clinical characterisation. Ann Rheum Dis 2010; 69:790-7. [DOI: 10.1136/ard.2009.116624] [Citation(s) in RCA: 146] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Parodi A, Davì S, Pringe AB, Pistorio A, Ruperto N, Magni-Manzoni S, Miettunen P, Bader-Meunier B, Espada G, Sterba G, Ozen S, Wright D, Magalhães CS, Khubchandani R, Michels H, Woo P, Iglesias A, Guseinova D, Bracaglia C, Hayward K, Wouters C, Grom A, Vivarelli M, Fischer A, Breda L, Martini A, Ravelli A. Macrophage activation syndrome in juvenile systemic lupus erythematosus: a multinational multicenter study of thirty-eight patients. ACTA ACUST UNITED AC 2010; 60:3388-99. [PMID: 19877067 DOI: 10.1002/art.24883] [Citation(s) in RCA: 166] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To describe the clinical and laboratory features of macrophage activation syndrome as a complication of juvenile systemic lupus erythematosus (SLE). METHODS Cases of juvenile SLE-associated macrophage activation syndrome were provided by investigators belonging to 3 pediatric rheumatology networks or were found in the literature. Patients who had evidence of macrophage hemophagocytosis on bone marrow aspiration were considered to have definite macrophage activation syndrome, and those who did not have such evidence were considered to have probable macrophage activation syndrome. Clinical and laboratory findings in patients with macrophage activation syndrome were contrasted with those of 2 control groups composed of patients with active juvenile SLE without macrophage activation syndrome. The ability of each feature to discriminate macrophage activation syndrome from active disease was evaluated by calculating sensitivity, specificity, and area under the receiver operating characteristic curve. RESULTS The study included 38 patients (20 with definite macrophage activation syndrome and 18 with probable macrophage activation syndrome). Patients with definite and probable macrophage activation syndrome were comparable with regard to all clinical and laboratory features of the syndrome, except for a greater frequency of lymphadenopathy, leukopenia, and thrombocytopenia in patients with definite macrophage activation syndrome. Overall, clinical features had better specificity than sensitivity, except for fever, which was highly sensitive but had low specificity. Among laboratory features, the best sensitivity and specificity was achieved using hyperferritinemia, followed by increased levels of lactate dehydrogenase, hypertriglyceridemia, and hypofibrinogenemia. Based on the results of statistical analysis, preliminary diagnostic guidelines for macrophage activation syndrome in juvenile SLE were developed. CONCLUSION Our findings indicate that the occurrence of unexplained fever and cytopenia, when associated with hyperferritinemia, in a patient with juvenile SLE should raise the suspicion of macrophage activation syndrome. We propose preliminary guidelines for this syndrome in juvenile SLE to facilitate timely diagnosis and correct classification of patients.
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Affiliation(s)
- Alessandro Parodi
- Istituto di Ricovero e Cura a Carattere Scientifico G. Gaslini, Genoa, Italy
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Espada G. [Juvenile idiopathic arthritis: Part 2. Prognosis and current therapeutic approach]. ARCH ARGENT PEDIATR 2009; 107:536-541. [PMID: 20049399 DOI: 10.1590/s0325-00752009000600011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2009] [Accepted: 07/01/2009] [Indexed: 05/28/2023]
Abstract
The prognosis of juvenile idiopathic arthritis has improved substantially during the last decade, due to an earlier recognition of the disease, its predictors of outcome and the approach to treatment. The introduction of biological agents, constitutes a valuable treatment option for children who are resistant or refractory to conventional antirheumatic drugs. Disease outcome regarding different categories, predictors associated to poor prognosis and the current approach to treatment are reviewed in this article.
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Affiliation(s)
- Graciela Espada
- Sección de Reumatología Hospital de Niños Dr. Ricardo Gutiérrez.
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Espada G. [Juvenil idiopathic arthritis. Part 1: diagnosis, pathogenesis and clinical manifestations]. ARCH ARGENT PEDIATR 2009; 107:441-8. [PMID: 19809766 DOI: 10.1590/s0325-00752009000500012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2009] [Accepted: 07/01/2009] [Indexed: 11/21/2022]
Abstract
Juvenile idiopathic arthritis is not a single disease and constitutes an heterogeneous group of illnesses or inflammatory disorders. This new nomenclature encompasses different disease categories, each of which has different presentation, clinical signs, symptoms, and outcome. The cause of the disease is still unknown but both environmental and genetic factors seem to be related to its pathogenesis. Is the most common chronic rheumatic disease in children and an important cause of short-term and long-term disability. In this article, clinical manifestation, new classification and approach to diagnosis are reviewed.
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Affiliation(s)
- Graciela Espada
- Sección de Reumatología, Hospital de Niños Dr. Ricardo Gutiérrez.
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Rosé CD, Aróstegui JI, Martin TM, Espada G, Scalzi L, Yagüe J, Rosenbaum JT, Modesto C, Cristina Arnal M, Merino R, García-Consuegra J, Carballo Silva MA, Wouters CH. NOD2-associated pediatric granulomatous arthritis, an expanding phenotype: study of an international registry and a national cohort in Spain. ACTA ACUST UNITED AC 2009; 60:1797-803. [PMID: 19479837 DOI: 10.1002/art.24533] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To study the phenotype characteristics of the largest to date cohort of patients with pediatric granulomatous arthritis (PGA) and documented mutations in the NOD2 gene. METHODS We analyzed merged data from 2 prospective cohorts of PGA patients, the International PGA Registry and a Spanish cohort. A systematic review of the medical records of interest was performed to identify phenotype characteristics. RESULTS Forty-five patients with PGA (23 sporadic cases and 22 from familial pedigrees) and documented NOD2 mutations were identified and formed the basis of the study. Of these 45 patients, 18 had the R334W-encoding mutation, 18 had R334Q, 4 had E383K, 3 had R587C, 1 had C495Y, and 1 had W490L. The majority of patients manifested the typical triad of dermatitis, uveitis, and arthritis. In contrast, in 13 patients, the following "atypical" manifestations were noted: fever, sialadenitis, lymphadenopathy, erythema nodosum, leukocytoclastic vasculitis, transient neuropathy, granulomatous glomerular and interstitial nephritis, interstitial lung disease, arterial hypertension, hypertrophic cardiomyopathy, pericarditis, pulmonary embolism, hepatic granulomatous infiltration, splenic involvement, and chronic renal failure. In addition, 4 individuals who were asymptomatic carriers of a disease-causing mutation were documented. CONCLUSION NOD2-associated PGA can be a multisystem disorder with significant visceral involvement. Treating physicians should be aware of the systemic nature of this condition, since some of these manifestations may entail long-term morbidity.
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Affiliation(s)
- Carlos D Rosé
- Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
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