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Spekking K, Anink J, de Boer P, Bergstra SA, van den Berg JM, Schonenberg-Meinema D, van Suijlekom-Smit LWA, van Rossum MAJ, Koopman-Keemink Y, Cate RT, Allaart CF, Brinkman DMC, Muller PCEH. Significant pain decrease in children with non-systemic Juvenile Idiopathic Arthritis treated to target: results over 24 months of follow up. Pediatr Rheumatol Online J 2023; 21:90. [PMID: 37633893 PMCID: PMC10464062 DOI: 10.1186/s12969-023-00874-z] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/06/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND The aim of this study was to compare pain-scores in three targeted treatment-strategies in JIA-patients and to identify characteristics predicting persistent pain. METHODS In the BeSt-for-Kids-study 92 DMARD-naïve JIA-patients were randomized in 3 treatment-strategies: 1) initial sequential DMARD-monotherapy 2) initial methotrexate (MTX)/prednisolone-bridging or 3) initial MTX/etanercept. Potential differences in VAS pain scores (0-100 mm) over time between treatment-strategies were compared using linear mixed models with visits clustered within patients. A multivariable model was used to assess the ability of baseline characteristics to predict the chance of high pain-scores during follow-up. RESULTS Pain-scores over time reduced from mean 55.3 (SD 21.7) to 19.5 (SD 25.3) mm after 24 months. On average, pain-scores decreased significantly with β -1.37 mm (95% CI -1.726; -1.022) per month. No significant difference was found between treatment-strategies (interaction term treatment arm*time (months) β (95% CI) arm 1: 0.13 (-0.36; 0.62) and arm 2: 0.37 (-0.12; 0.86) compared to arm 3). Correction for sex and symptom duration yielded similar results. Several baseline characteristics were predictive for pain over time. Higher VAS pain [β 0.44 (95% CI 0.25; 0.65)] and higher active joint count [0.77 (0.19; 1.34)] were predictive of higher pain over time, whereas, low VAS physician [ -0.34 (-0.55; -0.06)], CHQ Physical [ -0.42 (-0.72; -0.11)] and Psychosocial summary Score [ -0.42 (-0.77; -0.06)] were predictive of lower pain. CONCLUSIONS Treatment-to-target seems effective in pain-reduction in non-systemic JIA-patients irrespective of initial treatment-strategy. Several baseline-predictors for pain over time were found, which could help to identify patients with a high risk for development of chronic pain. TRIAL REGISTRATION Dutch Trial Registry number 1574.
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Affiliation(s)
- Katinka Spekking
- Department of Pediatrics, Division of Pediatric Rheumatology, Willem-Alexander Children's Hospital, Leiden, The Netherlands.
| | - Janneke Anink
- De Kinderkliniek, Flevo Hospital, Almere, The Netherlands
| | - Piroska de Boer
- Department of Pediatrics, Division of Pediatric Rheumatology, Willem-Alexander Children's Hospital, Leiden, The Netherlands
| | - Sytske Anne Bergstra
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - J Merlijn van den Berg
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Dieneke Schonenberg-Meinema
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Lisette W A van Suijlekom-Smit
- Department of Pediatrics/Pediatric Rheumatology, Sophia Children's Hospital Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marion A J van Rossum
- Department of Pediatrics, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Department of Pediatric Rheumatology, Amsterdam Rheumatology and Immunology Center | Reade, Amsterdam, The Netherlands
| | - Yvonne Koopman-Keemink
- Department of Pediatrics, Juliana Children's Hospital, Hagaziekenhuis, the Hague, The Netherlands
| | - Rebecca Ten Cate
- Department of Pediatrics, Division of Pediatric Rheumatology, Willem-Alexander Children's Hospital, Leiden, The Netherlands
| | - Cornelia F Allaart
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Daniëlle M C Brinkman
- Department of Pediatrics, Division of Pediatric Rheumatology, Willem-Alexander Children's Hospital, Leiden, The Netherlands
| | - Petra C E Hissink Muller
- Department of Pediatrics, Division of Pediatric Rheumatology, Willem-Alexander Children's Hospital, Leiden, The Netherlands
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2
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Heckert SL, Hissink-Muller PCE, van den Berg JM, Schonenberg-Meinema D, van Suijlekom-Smit LWA, van Rossum MAJ, Koopman Y, Ten Cate R, Brinkman DMC, Huizinga TWJ, Allaart CF, Bergstra SA. Patterns of clinical joint inflammation in juvenile idiopathic arthritis. RMD Open 2023; 9:rmdopen-2022-002941. [PMID: 36927851 PMCID: PMC10030666 DOI: 10.1136/rmdopen-2022-002941] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 12/16/2022] [Accepted: 02/19/2023] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVES We studied patterns of joint inflammation in juvenile idiopathic arthritis (JIA) to assess whether joint activity recurs locally in the same joints. METHODS Joints of 91 patients of the BeSt for Kids study, a treat-to-target trial for children with recent-onset oligoarticular, rheumatoid factor-negative polyarticular and psoriatic JIA, were clinically assessed during 2 years (10 study visits). The association between joint inflammation at baseline and later inflammation in the same joint was assessed using a multilevel mixed-effects logistic regression model at joint level. With a Poisson model, the association between baseline joint inflammation and the number of study visits at which the same joint was recurrently inflamed was tested. RESULTS Of the 6097 joints studied, 15% (897) was clinically inflamed at baseline. In 42% (377/897) of those joints, inflammation recurred during follow-up. Joint inflammation at baseline was statistically significantly associated with joint inflammation during follow-up in the same joint (OR 3.9, 95% CI 3.5 to 4.4) and specifically with the number of episodes of recurrent joint inflammation (IRR 1.6, 95% CI 1.2 to 2.1). CONCLUSION In JIA, joint inflammation has the tendency to recur multiple times in joints that are clinically inflamed at disease onset. This indicates that local factors might play a role in the processes contributing to the occurrence of JIA flares.
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Affiliation(s)
- Sascha L Heckert
- Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Petra C E Hissink-Muller
- Paediatrics/Pediatric Rheumatology, Leiden University Medical Center Willem Alexander Childrens Hospital, Leiden, The Netherlands
| | - J Merlijn van den Berg
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands
| | - Dieneke Schonenberg-Meinema
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands
| | | | - Marion A J van Rossum
- Department of Pediatrics, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands
- Department of Pediatric Rheumatology, Amsterdam Rheumatology and Immunology Center, location Reade, Amsterdam, The Netherlands
| | - Yvonne Koopman
- Pediatrics, Haga Hospital Juliana Children's Hospital, Den Haag, The Netherlands
| | - Rebecca Ten Cate
- Paediatrics/Pediatric Rheumatology, Leiden University Medical Center Willem Alexander Childrens Hospital, Leiden, The Netherlands
| | - Danielle M C Brinkman
- Paediatrics/Pediatric Rheumatology, Leiden University Medical Center Willem Alexander Childrens Hospital, Leiden, The Netherlands
| | - Tom W J Huizinga
- Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
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Schonenberg-Meinema D, Bergkamp SC, Nassar-Sheikh Rashid A, van der Aa LB, de Bree GJ, Ten Cate R, Cutolo M, Hak AE, Hissink Muller PC, van Onna M, Kuijpers TW, Smith V, van den Berg JM. Nailfold capillary abnormalities in childhood-onset systemic lupus erythematosus: a cross-sectional study compared with healthy controls. Lupus 2021; 30:818-827. [PMID: 33657918 PMCID: PMC8020305 DOI: 10.1177/0961203321998750] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES For selection of high-risk systemic lupus erythematosus (SLE) patients it is necessary to obtain indicators of disease severity that predict disease damage. As in systemic sclerosis, nailfold capillary abnormalities could be such a biomarker in SLE. The primary objective of this cross-sectional study is to describe capillary abnormalities in childhood-onset SLE (cSLE) cohort (onset < 18 years) and compare them with matched healthy controls. The secondary objective is to correlate the observed capillary abnormalities with demographical variables in both cohorts and with disease-specific variables in cSLE patients. METHODS Healthy controls were matched for ethnic background, age and gender. Videocapillaroscopy was performed in eight fingers with 2-4 images per finger. Quantitative and qualitative assessments of nailfold capillaroscopy images were performed according to the definitions of the EULAR study group on microcirculation in Rheumatic Diseases. RESULTS Both groups (n = 41 cSLE-patients and n = 41 healthy controls) were comparable for ethnic background (p = 0.317). Counted per mm, cSLE-patients showed significantly more 'giants' (p = 0.032), 'abnormal capillary shapes' (p = 0.003), 'large capillary hemorrhages' (p < 0.001) and 'pericapillary extravasations' (p < 0.001). Combined 'abnormal capillary shapes and pericapillary extravasations' (in the same finger) were detected in 78% (32/41 patients). By qualitative analysis, 'microangiopathy' was detected in 68.3% (28/41) and a 'scleroderma pattern' in 17.1% (7/41) of the cSLE-patients (without scleroderma symptoms). The difference of percentage positive anti-RNP antibodies in the group with or without a scleroderma pattern was not significant (p = 0.089). The number of 'abnormal capillary shapes per mm' was significantly correlated with treatment-naivety. The number of 'large pathological hemorrhages per mm' was significantly correlated with SLEDAI score and presence of nephritis. Compared to healthy controls, 'pericapillary extravasations' were found in significantly higher numbers per mm (p < 0.001) as well as in percentage of patients (p < 0.001). CONCLUSIONS Our observations confirm that giants, abnormal capillary morphology and capillary hemorrhages are also observed in cSLE, as was already known for adults with SLE. Number of capillary hemorrhages in cSLE was significantly correlated with disease activity. A high frequency and total amount of "pericapillary extravasations" was observed in cSLE patients, possibly revealing a new subtype of capillary hemorrhage that might reflect endothelial damage in these pediatric patients.
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Affiliation(s)
- Dieneke Schonenberg-Meinema
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam University Medical Centers (Amsterdam UMC), University of Amsterdam, Amsterdam, the Netherlands
| | - Sandy C Bergkamp
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam University Medical Centers (Amsterdam UMC), University of Amsterdam, Amsterdam, the Netherlands
| | - Amara Nassar-Sheikh Rashid
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam University Medical Centers (Amsterdam UMC), University of Amsterdam, Amsterdam, the Netherlands
| | - Leontien B van der Aa
- Department of Pediatric Rheumatology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
| | - Godelieve J de Bree
- Department of Infectious Diseases, Amsterdam University Medical Centers (Amsterdam UMC), University of Amsterdam, the Netherlands
| | - Rebecca Ten Cate
- Department of Pediatric Rheumatology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
| | - Maurizio Cutolo
- Department of Internal Medicine, Research Laboratory and Academic Division of Clinical Rheumatology, IRCCS Polyclinic San Martino Hospital, University of Genova, Genova, Italy
| | - A Elisabeth Hak
- Department of Rheumatology and Clinical Immunology, Amsterdam Rheumatology and Immunology Centre, Amsterdam University Medical Centers (Amsterdam UMC), University of Amsterdam, Amsterdam, the Netherlands
| | - Petra Ce Hissink Muller
- Department of Pediatric Rheumatology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
| | - Marieke van Onna
- Department of Rheumatology and Clinical Immunology, Amsterdam Rheumatology and Immunology Centre, Amsterdam University Medical Centers (Amsterdam UMC), University of Amsterdam, Amsterdam, the Netherlands
| | - Taco W Kuijpers
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam University Medical Centers (Amsterdam UMC), University of Amsterdam, Amsterdam, the Netherlands
| | - Vanessa Smith
- Department of Rheumatology, Ghent University Hospital, Belgium.,Faculty of Internal Medicine, Ghent University, Ghent, Belgium.,Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Centre (IRC), Ghent, Belgium
| | - J Merlijn van den Berg
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam University Medical Centers (Amsterdam UMC), University of Amsterdam, Amsterdam, the Netherlands
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Barendregt AM, Veldkamp SR, Hissink Muller PCE, van de Geer A, Aarts C, van Gulik EC, Schilham MW, Kessel C, Keizer MP, Hemke R, Nassar-Sheikh Rashid A, Dolman KM, Schonenberg-Meinema D, Ten Cate R, van den Berg JM, Maas M, Kuijpers TW. MRP8/14 and neutrophil elastase for predicting treatment response and occurrence of flare in patients with juvenile idiopathic arthritis. Rheumatology (Oxford) 2021; 59:2392-2401. [PMID: 31904851 PMCID: PMC7449815 DOI: 10.1093/rheumatology/kez590] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 10/22/2019] [Indexed: 11/25/2022] Open
Abstract
Objective To study two neutrophil activation markers, myeloid-related protein (MRP) 8/14 and neutrophil elastase (NE), for their ability to predict treatment response and flare in patients with JIA. Methods Using samples from two cohorts (I and II), we determined MRP8/14 and NE levels of 32 (I) and 81 (II) patients with new-onset, DMARD-naïve arthritis and compared patients who responded to treatment (defined as fulfilling ≥ adjusted ACRpedi50 response and/or inactive disease) with non-responders (defined as fulfilling < adjusted ACRpedi50 response and/or active disease) at 6 and 12 months. Secondly, we compared biomarker levels of 54 (I) and 34 (II) patients with clinically inactive disease who did or did not suffer from a flare of arthritis after 6 or 12 months. Receiver operating characteristic analyses were carried out to study the predictive value of MRP8/14 and NE for treatment response and flare. Results For both cohorts, baseline MRP8/14 and NE levels for patients who did or did not respond to treatment were not different. Also, MRP8/14 and NE levels were not different in patients who did or did not flare. Receiver operating characteristic analysis of MRP8/14 and NE demonstrated areas under the curve <0.7 in both cohorts. Conclusion In our cohorts, MRP8/14 and NE could not predict treatment response. Also, when patients had inactive disease, neither marker could predict flares.
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Affiliation(s)
- Anouk M Barendregt
- Department of Paediatric Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam
| | - Saskia R Veldkamp
- Department of Paediatric Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam
| | | | | | - Cathelijn Aarts
- Department of Blood Cell Research, Sanquin Research, Amsterdam, The Netherlands
| | - E Charlotte van Gulik
- Department of Paediatric Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam.,Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam
| | - Marco W Schilham
- Department of Paediatric Rheumatology, Leiden University Medical Center, Leiden
| | - Christoph Kessel
- Department of Paediatric Rheumatology and Immunology, University Children's Hospital Muenster, Muenster, Germany
| | - Mischa P Keizer
- Department of Blood Cell Research, Sanquin Research, Amsterdam, The Netherlands
| | - Robert Hemke
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam
| | - Amara Nassar-Sheikh Rashid
- Department of Paediatric Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam
| | - Koert M Dolman
- Department of Paediatric Rheumatology, Reade, Amsterdam.,Department of Paediatrics, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Dieneke Schonenberg-Meinema
- Department of Paediatric Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam
| | - Rebecca Ten Cate
- Department of Paediatric Rheumatology, Leiden University Medical Center, Leiden
| | - J Merlijn van den Berg
- Department of Paediatric Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam
| | - Mario Maas
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam
| | - Taco W Kuijpers
- Department of Paediatric Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam.,Department of Blood Cell Research, Sanquin Research, Amsterdam, The Netherlands
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5
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Luijten MAJ, Terwee CB, van Oers HA, Joosten MMH, van den Berg JM, Schonenberg-Meinema D, Dolman KM, Ten Cate R, Roorda LD, Grootenhuis MA, van Rossum MAJ, Haverman L. Psychometric Properties of the Pediatric Patient-Reported Outcomes Measurement Information System Item Banks in a Dutch Clinical Sample of Children With Juvenile Idiopathic Arthritis. Arthritis Care Res (Hoboken) 2020; 72:1780-1789. [PMID: 31628731 PMCID: PMC7756261 DOI: 10.1002/acr.24094] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 10/08/2019] [Accepted: 10/15/2019] [Indexed: 12/31/2022]
Abstract
Objective To assess the psychometric properties of 8 pediatric Patient‐Reported Outcomes Measurement Information System (PROMIS) item banks in a clinical sample of children with juvenile idiopathic arthritis (JIA). Methods A total of 154 Dutch children (mean ± SD age 14.4 ± 3.0 years; range 8–18 years) with JIA completed 8 pediatric version 1.0 PROMIS item banks (anger, anxiety, depressive symptoms, fatigue, pain interference, peer relationships, physical function mobility, physical function upper extremity) twice and the Pediatric Quality of Life Inventory (PedsQL) and the Childhood Health Assessment Questionnaire (C‐HAQ) once. Structural validity of the item banks was assessed by fitting a graded response model (GRM) and inspecting GRM fit (comparative fit index [CFI], Tucker‐Lewis index [TLI], and root mean square error of approximation [RMSEA]) and item fit (S‐X2 statistic). Convergent validity (with PedsQL/C‐HAQ subdomains) and discriminative validity (active/inactive disease) were assessed. Reliability of the item banks, short forms, and computerized adaptive testing (CAT) was expressed as the SE of theta (SE[θ]). Test–retest reliability was assessed using intraclass correlation coefficients (ICCs) and smallest detectable change. Results All item banks had sufficient overall GRM fit (CFI >0.95, TLI >0.95, RMSEA <0.08) and no item misfit (all S‐X2P > 0.001). High correlations (>0.70) were found between most PROMIS T scores and hypothesized PedsQL/C‐HAQ (sub)domains. Mobility, pain interference, and upper extremity item banks were able to discriminate between patients with active and inactive disease. Regarding reliability, PROMIS item banks outperformed legacy instruments. Post hoc CAT simulations outperformed short forms. Test–retest reliability was strong (ICC >0.70) for all full‐length item banks and short forms, except for the peer relationships item bank. Conclusion The pediatric PROMIS item banks displayed sufficient psychometric properties for Dutch children with JIA. PROMIS item banks are ready for use in clinical research and practice for children with JIA.
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Affiliation(s)
- Michiel A J Luijten
- Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam, Vrije Universiteit Amsterdam, and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Caroline B Terwee
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Hedy A van Oers
- Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Mala M H Joosten
- Princess Maxima Centre for Pediatric Oncology, Utrecht, The Netherlands
| | - J Merlijn van den Berg
- Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Dieneke Schonenberg-Meinema
- Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Koert M Dolman
- Amsterdam Rheumatology and Immunology Centre, Reade, and Onze Lieve Vrouwe Gasthuis West, Amsterdam, The Netherlands
| | | | - Leo D Roorda
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands
| | | | - Marion A J van Rossum
- Amsterdam Rheumatology and Immunology Centre, Reade, and Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Lotte Haverman
- Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Nordal E, Pistorio A, Rygg M, Giancane G, Maghnie M, Di Iorgi N, Flemming K, Hofer M, Melo-Gomes JA, Bica BERG, Brunner J, Dannecker G, Gerloni V, Harjacek M, Huppertz HI, Pratsidou-Gertsi P, Nielsen S, Stanevicha V, Ten Cate R, Vougiouka O, Pastore S, Simonini G, Ravelli A, Martini A, Ruperto N. Growth and Puberty in Juvenile Dermatomyositis: A Longitudinal Cohort Study. Arthritis Care Res (Hoboken) 2019; 72:265-273. [PMID: 31507092 DOI: 10.1002/acr.24065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/03/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To study growth and puberty in a multinational longitudinal prospective cohort of children with juvenile dermatomyositis (DM). METHODS Children from 31 countries who were ages <18 years and had juvenile DM in active phase were studied, and analyses of height, weight, and pubertal development were conducted in those who had follow-up visits during a 2-year period and for whom anthropometric data was available. RESULTS A total of 196 of 275 children (71%) were included. We found a significant reduction in parent-adjusted height Z score over time in female patients (P < 0.0001) and male patients (P = 0.001), but with catch-up growth at the final study visit. Median body mass index Z score peaked at 6 months (P < 0.0001) and was still significantly above baseline at the final study visit, which was at a median of 26 months after baseline (P = 0.007), with no difference between sexes. Female patients with a disease duration ≥12 months after onset had significantly lower parent-adjusted height Z score (P = 0.002) and no 2-year catch-up growth. At the final study visit, growth failure was seen in 20 of 97 female patients (21%) and in 11 of 73 male patients (15%). Height deflection (∆height Z score less than -0.25/year) was observed in 29 of 116 female patients (25%) and 25 of 80 male patients (31.3%). Delayed puberty was seen in 20 of 55 female patients (36.4%) and in 11 of 31 male patients (35.5%). Children in early pubertal stage at baseline had the highest risk of growth failure. CONCLUSION Juvenile DM in the active phase and/or its treatment has a significant impact on growth and puberty in affected children. Children with recent onset of puberty or previous growth failure have the highest risk of delayed pubertal development and further growth retardation.
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Affiliation(s)
- Ellen Nordal
- University Hospital of Northern Norway and UiT the Arctic University of Norway, Tromso, Norway
| | | | - Marite Rygg
- Norwegian University of Science and Technology and St. Olavs University Hospital of Trondheim, Trondheim, Norway
| | - Gabriella Giancane
- IRCCS Istituto Giannina Gaslini and Università degli Studi di Genova, Genoa, Italy
| | - Mohamad Maghnie
- IRCCS Istituto Giannina Gaslini and Università degli Studi di Genova, Genoa, Italy
| | - Natascia Di Iorgi
- IRCCS Istituto Giannina Gaslini and Università degli Studi di Genova, Genoa, Italy
| | | | - Michael Hofer
- University of Lausanne, Lausanne, Switzerland, and University Hospital of Geneva, Geneva, Switzerland
| | | | - Blanca E R G Bica
- Hospital Universitario Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | | | | | | | - Susan Nielsen
- Juliane Marie Centret, Rigshospitalet, Copenhagen, Denmark
| | - Valda Stanevicha
- Riga Stradins University, Children University Hospital, Riga, Latvia
| | | | - Olga Vougiouka
- Pan a Aglaia Kyriakou Children's Hospital, Athens University School of Medicine, Athens, Greece
| | - Serena Pastore
- IRCCS Burlo Garofolo, Institute for Maternal and Child Health, Trieste, Italy
| | | | - Angelo Ravelli
- IRCCS Istituto Giannina Gaslini and Università degli Studi di Genova, Genoa, Italy
| | | | - Nicolino Ruperto
- IRCCS Istituto Giannina Gaslini, Paediatric Rheumatology International Trials Organisation, Genoa, Italy
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7
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Giancane G, Lavarello C, Pistorio A, Oliveira SK, Zulian F, Cuttica R, Fischbach M, Magnusson B, Pastore S, Marini R, Martino S, Pagnier A, Soler C, Staņēvicha V, Ten Cate R, Uziel Y, Vojinovic J, Fueri E, Ravelli A, Martini A, Ruperto N. The PRINTO evidence-based proposal for glucocorticoids tapering/discontinuation in new onset juvenile dermatomyositis patients. Pediatr Rheumatol Online J 2019; 17:24. [PMID: 31118099 PMCID: PMC6530070 DOI: 10.1186/s12969-019-0326-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/02/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prednisone (PDN) in juvenile dermatomyositis (JDM), alone or in association with other immunosuppressive drugs, namely methotrexate (MTX) and cyclosporine (CSA), represents the first-line treatment option for new onset JDM patients. No clear evidence based guidelines are actually available to standardize the tapering and discontinuation of glucocorticoids (GC) in JDM. Aim of our study was to provide an evidence-based proposal for GC tapering/discontinuation in new onset juvenile dermatomyositis (JDM), and to identify predictors of clinical remission and GC discontinuation. METHODS New onset JDM children were randomized to receive either PDN alone or in combination with methotrexate (MTX) or cyclosporine (CSA). In order to derive steroid tapering indications, PRINTO/ACR/EULAR JDM core set measures (CSM) and their median absolute and relative percent changes over time were compared in 3 groups. Group 1 included those in clinical remission who discontinued PDN, with no major therapeutic changes (MTC) (reference group) and was compared with those who did not achieve clinical remission, without or with MTC (Group 2 and 3, respectively). A logistic regression model identified predictors of clinical remission with PDN discontinuation. RESULTS Based on the median change in the CSM of 30/139 children in Group 1, after 3 pulses of methyl-prednisolone, GC could be tapered from 2 to 1 mg/kg/day in the first two months from onset if any of the CSM decreased by 50-94%, and from 1 to 0.2 mg/kg/day in the following 4 months if any CSM further decreased by 8-68%, followed by discontinuation in the ensuing 18 months. The achievement of PRINTO JDM 50-70-90 response after 2 months of treatment (ORs range 4.5-6.9), an age at onset > 9 years (OR 4.6) and the combination therapy PDN + MTX (OR 3.6) increase the probability of achieving clinical remission (p < 0.05). CONCLUSIONS This is the first evidence-based proposal for glucocorticoid tapering/discontinuation based on the change in JDM CSM of disease activity. TRIAL REGISTRATION Trial full title: Five-Year Single-Blind, Phase III Effectiveness Randomized Actively Controlled Clinical Trial in New Onset Juvenile Dermatomyositis: Prednisone versus Prednisone plus Cyclosporine A versus Prednisone plus Methotrexate. EUDRACT registration number: 2005-003956-37 . CLINICAL TRIAL gov is NCT00323960 . Registered on 17 August 2005.
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Affiliation(s)
- Gabriella Giancane
- IRCCS Istituto Giannina Gaslini, Clinica Pediatrica – Reumatologia, PRINTO, Genoa, Italy
| | - Claudio Lavarello
- IRCCS Istituto Giannina Gaslini, Clinica Pediatrica – Reumatologia, PRINTO, Genoa, Italy
| | - Angela Pistorio
- IRCCS Istituto Giannina Gaslini, Servizio di Epidemiologia e Biostatistica, Genoa, Italy
| | - Sheila K. Oliveira
- 0000 0001 2294 473Xgrid.8536.8Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG), Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Francesco Zulian
- 0000 0004 1757 3470grid.5608.bDepartment of Woman and Child Health, University of Padua, Padua, Italy
| | - Ruben Cuttica
- Hospital General de Niños Pedro de Elizalde, Unidad de Reumatología, Buenos Aires, Argentina
| | - Michel Fischbach
- 0000 0004 0593 6932grid.412201.4Hôpital Universitaire Hautepierre, Pédiatrie I, Strasbourg, France
| | - Bo Magnusson
- 0000 0000 9241 5705grid.24381.3cPediatric Rheumatology Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Serena Pastore
- 0000 0004 1760 7415grid.418712.9IRCCS Burlo Garofolo, Institute for Maternal and Child Health, Trieste, Italy
| | - Roberto Marini
- 0000 0001 0723 2494grid.411087.bDepartamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brazil
| | - Silvana Martino
- 0000 0001 2336 6580grid.7605.4Clinica Pediatrica, Università degli Studi di Torino, Torino, Italy
| | - Anne Pagnier
- 0000 0001 0792 4829grid.410529.bMédecine Infantile, Centre Hospitalier Universitaire Grenoble-Alpes (CHU de Grenoble), Grenoble, France
| | - Christine Soler
- grid.413770.6Service de Pédiatrie, Hôpital de l’Archet, Nice, France
| | - Valda Staņēvicha
- Department of Pediatrics, Bērnu Klīniskā Universitātes Slimnīca, Riga, Latvia
| | - Rebecca Ten Cate
- 0000000089452978grid.10419.3dAfdelingkindergeneeskunde, Academisch Ziekenhuis Leiden, Leiden, Netherlands
| | - Yosef Uziel
- 0000 0004 1937 0546grid.12136.37Meir Medical Centre, Pediatric Rheumatology Unit, Department of Pediatrics, Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jelena Vojinovic
- 0000 0001 0942 1176grid.11374.30Department of Pediatric Immunology and Rheumatology, Faculty of Medicine, University of Nis, Nis, Serbia ,0000 0004 0517 2741grid.418653.dClinic of Pediatrics, Department of Pediatric Rheumatology, Clinical Center Nis, Nis, Serbia
| | - Elena Fueri
- IRCCS Istituto Giannina Gaslini, Clinica Pediatrica – Reumatologia, PRINTO, Genoa, Italy
| | - Angelo Ravelli
- IRCCS Istituto Giannina Gaslini, Clinica Pediatrica – Reumatologia, Genoa, Italy ,0000 0001 2151 3065grid.5606.5Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy
| | - Alberto Martini
- IRCCS Istituto Giannina Gaslini, Clinica Pediatrica – Reumatologia, Genoa, Italy ,0000 0001 2151 3065grid.5606.5Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy
| | - Nicolino Ruperto
- IRCCS Istituto Giannina Gaslini, Clinica Pediatrica - Reumatologia, PRINTO, Genoa, Italy.
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Hissink Muller PCE, Yildiz B, Allaart CF, Brinkman DMC, van Rossum M, van Suijlekom-Smit LWA, van den Berg JM, Ten Cate R, de Vries MC. Participation in a single-blinded pediatric therapeutic strategy study for juvenile idiopathic arthritis: are parents and patient-participants in equipoise? BMC Med Ethics 2018; 19:96. [PMID: 30572875 PMCID: PMC6302476 DOI: 10.1186/s12910-018-0336-8] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 12/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials (RCT) need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. METHODS We compared preferences of parents/patients at enrolment, documented by a questionnaire (phase 1), with preferences developed during follow-up by an interview-study (phase 2) to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study (NTR 1574). This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug (DMARD), currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. RESULTS Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority (n = 19) stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. CONCLUSIONS Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians' research question is in line with preferences of the patient-group. By exploring so-called 'informed patient-group'-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms.
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Affiliation(s)
- Petra C E Hissink Muller
- Department of Pediatric Rheumatology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands. .,Department of Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands.
| | - Bahar Yildiz
- Department of Pediatric Rheumatology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
| | - Cornelia F Allaart
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Danielle M C Brinkman
- Department of Pediatric Rheumatology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands.,Department of Pediatrics, Alrijne Hospital, Leiderdorp, the Netherlands
| | - Marion van Rossum
- Department of Pediatric Rheumatology, Reade Amsterdam Rheumatology Center, Amsterdam, the Netherlands
| | | | - J Merlijn van den Berg
- Department of Pediatric Hematology Immunology Infectious Diseases and Rheumatology, Emma Children's Hospital/Academic Medical Center, Amsterdam, the Netherlands
| | - Rebecca Ten Cate
- Department of Pediatric Rheumatology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
| | - Martine C de Vries
- Department of Medical Ethics and Health Law, Leiden University Medical Center, Leiden, the Netherlands
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9
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Gohar F, Anink J, Moncrieffe H, Van Suijlekom-Smit LWA, Prince FHM, van Rossum MAJ, Dolman KM, Hoppenreijs EPAH, Ten Cate R, Ursu S, Wedderburn LR, Horneff G, Frosch M, Foell D, Holzinger D. S100A12 Is Associated with Response to Therapy in Juvenile Idiopathic Arthritis. J Rheumatol 2018; 45:547-554. [PMID: 29335345 DOI: 10.3899/jrheum.170438] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 09/22/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Around one-third of patients with juvenile idiopathic arthritis (JIA) fail to respond to first-line methotrexate (MTX) or anti-tumor necrosis factor (TNF) therapy, with even fewer achieving ≥ American College of Rheumatology Pediatric 70% criteria for response (ACRpedi70), though individual responses cannot yet be accurately predicted. Because change in serum S100-protein myeloid-related protein complex 8/14 (MRP8/14) is associated with therapeutic response, we tested granulocyte-specific S100-protein S100A12 as a potential biomarker for treatment response. METHODS S100A12 serum concentration was determined by ELISA in patients treated with MTX (n = 75) and anti-TNF (n = 88) at baseline and followup. Treatment response (≥ ACRpedi50 score), achievement of inactive disease, and improvement in Juvenile Arthritis Disease Activity Score (JADAS)-10 score were recorded. RESULTS Baseline S100A12 concentration was measured in patients treated with anti-TNF [etanercept n = 81, adalimumab n = 7; median 200, interquartile range (IQR) 133-440 ng/ml] and MTX (median 220, IQR 100-440 ng/ml). Of the patients in the anti-TNF therapy group, 74 (84%) were also receiving MTX. Responders to MTX (n = 57/75) and anti-TNF (n = 66/88) therapy had higher baseline S100A12 concentration compared to nonresponders: median 240 (IQR 125-615) ng/ml versus 150 (IQR 87-233) ng/ml, p = 0.021 for MTX, and median 308 (IQR 150-624) ng/ml versus 151 (IQR 83-201) ng/ml, p = 0.002, for anti-TNF therapy. Followup S100A12 could be measured in 44/75 MTX-treated patients (34/44 responders) and 39/88 anti-TNF-treated patients (26/39 responders). Responders had significantly reduced S100A12 concentration (MTX: p = 0.031, anti-TNF: p < 0.001) at followup versus baseline. Baseline serum S100A12 in both univariate and multivariate regression models for anti-TNF therapy and univariate analysis alone for MTX therapy was significantly associated with change in JADAS-10. CONCLUSION Responders to MTX or anti-TNF treatment can be identified by higher pretreatment S100A12 serum concentration levels.
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Affiliation(s)
- Faekah Gohar
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany.,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen
| | - Janneke Anink
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany.,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen
| | - Halima Moncrieffe
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany.,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen
| | - Lisette W A Van Suijlekom-Smit
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany.,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen
| | - Femke H M Prince
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany.,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen
| | - Marion A J van Rossum
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany.,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen
| | - Koert M Dolman
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany.,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen
| | - Esther P A H Hoppenreijs
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany.,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen
| | - Rebecca Ten Cate
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany.,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen
| | - Simona Ursu
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany.,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen
| | - Lucy R Wedderburn
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany.,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen
| | - Gerd Horneff
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany.,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen
| | - Michael Frosch
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany.,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen
| | - Dirk Foell
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany.,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen
| | - Dirk Holzinger
- From the Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster, Münster, Germany; Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam, Rotterdam, the Netherlands; Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA; Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam; Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre, Nijmegen; Leiden University Medical Centre, Leiden, the Netherlands; School of Biological Sciences, Royal Holloway, University of London; Infection, Immunity, Inflammation Programme, University College London (UCL) Great Ormond Street (GOS) Institute of Child Health; UK National Institute for Health Research (NIHR) GOS Hospital Biomedical Research Centre (BRC); Arthritis Research UK Centre for Adolescent Rheumatology at UCL, London, UK; Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin; German Pediatric Pain Centre, Children's and Adolescents' Hospital, Datteln; Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Essen, Germany. .,F. Gohar, MD, Department of Pediatric Rheumatology and Immunology, University Children's Hospital Münster; J. Anink, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; H. Moncrieffe, PhD, Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati; L.W. Van Suijlekom-Smit, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; F.H. Prince, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Erasmus MC Sophia Children's Hospital Rotterdam; M.A. van Rossum, MD, PhD, Emma Children's Hospital, Academic Medical Centre and Amsterdam Rheumatology and Immunology Centre, Reade location, Jan van Breemen Institute; K.M. Dolman, MD, PhD, Department of Pediatrics/Pediatric Rheumatology, Onze Lieve Vrouwe Gasthuis; E.P. Hoppenreijs, MD, Department of Pediatrics/Pediatric Rheumatology, St. Maartenskliniek and Radboud University Medical Centre; R. ten Cate, MD, PhD, Leiden University Medical Centre; S. Ursu, PhD, School of Biological Sciences, Royal Holloway, University of London; L.R. Wedderburn, MD, PhD, Infection, Immunity, Inflammation Programme, UCL GOS Institute of Child Health, UCL; G. Horneff, MD, Centre of Pediatric Rheumatology, Department of General Pediatrics, Asklepios Clinic Sankt Augustin; M. Frosch, MD, German Pediatric Pain Centre, Children's and Adolescents' Hospital; D. Foell, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster; D. Holzinger, MD, Department of Paediatric Rheumatology and Immunology, University Children's Hospital Münster, and Klinik für Kinderheilkunde III, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen.
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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, Caorsi R, Penco F, Grossi A, Insalaco A, Alessio M, Conti G, Marchetti F, Tommasini A, Martino S, Gallizzi R, Salis A, Schena F, Caroli F, Martini A, Damonte G, Ceccherini I, Gattorno M, Frémond ML, Uggenti C, Van Eyck L, Melki I, Duffy D, Bondet V, Rose Y, Neven B, Crow Y, Rodero MP, Kusche Y, Roth J, Barczyk-Kahlert K, Ferrara G, Chiocchetti A, Polizzi S, Vuch J, Vozzi D, Mondino A, Valencic E, Pastore S, Taddio A, Faletra F, Dianzani U, Ramenghi U, Tommasini A, Zhou Q, Yu X, Demirkaya E, Deuitch N, Stone D, Tsai W, Ombrello A, Romeo T, Remmers EF, Chae J, Gadina M, Welch S, Ozen S, Topaloglu R, Abinun M, Kastner DL, Aksentijevich I, Vairo D, Ferraro RM, Zani G, Galli J, De Simone M, Cattalini M, Fazzi E, Giliani S, Omoyinmi E, Standing A, Rowczenio D, Keylock A, Gomes SM, Price-Kuehne F, Nanthapisal S, Murphy C, Cullup T, Jenkins L, Gilmour K, Eleftheriou D, Lachmann H, Hawkins P, Klein N, Brogan P, Nikolayenko VB, Şahin K, Karaaslan Y, Civino A, Alighieri G, Davì S, Rondelli R, Martino S, Filocamo G, Magnolato A, Dhanrajani A, Ricci F, Gallizzi R, Olivieri A, Gerloni V, Lattanzi B, Soscia F, De Fanti A, Manzoni SM, Citiso S, Quartulli L, Chan M, La Torre F, Rigante D, Maggio MC, Marsili M, Pelagatti MA, Conter V, Fagioli F, Lepore L, Pession A, Ravelli A, Pau S, Consolaro A, Ruperto N, Garrone M, Rinaldi M, De Inocencio J, Demirkaya E, Garay S, Foell D, Lovell DJ, Lazar C, Ellsworth J, Nielsen S, Flato B, Martini A, Ravelli A, Marasco E, Aquilani A, Cascioli S, Caiello I, Moneta GM, Pires-Marafón D, Guzman J, Magni-Manzoni S, Carsetti R, De Benedetti F, Robinson E, Albani S, Beresford MW, de Jager W, de Roock S, Duong T, Ellis J, Aeschlimann FA, Hyrich K, Jervis L, Lovell D, Marshall L, Mellins ED, Minden K, Munro J, Nigrovic PA, Palman J, Roth J, Twilt M, Ruperto N, Sampath S, Schanberg LE, Thompson SD, Thomson W, Vesely R, Wallace C, Williams C, Wu Q, Wulffraat N, Eng SW, Yeung RSM, Prakken B, Wedderburn LR, Horneff G, Seyger MB, Arikan D, Kalabic J, Anderson JK, Lazar A, Williams DA, Sheikh S, Wang C, Tarzynski-Potempa R, Hymans JS, Simonini G, Scoccimarro E, Pontikaki I, Ferrara G, Giani T, Ventura A, Meroni PL, Laxer RM, Cimaz R, Minnone G, Soligo M, Caiello I, Prencipe G, Marafon DP, Magni-Manzoni S, Manni L, De Benedetti F, Laudiero LB, Hebert D, Groot N, Grein I, Wulffraat NM, Schepp R, Berbers G, de Souza CCBS, Ferriani VPL, Pileggi G, de Roock S, Grein IHR, Noone D, Scala S, Patrone E, Schoemaker C, Costello W, Wulffraat N, Parsons S, McDonagh J, Thomson W, Cohen JD, Bentayou D, Pagnoux C, Brunel MAB, Trope S, Klotsche J, Listing M, Niewerth M, Horneff G, Thon A, Huppertz HI, Mönkemöller K, Foeldvari I, Benseler SM, Föll D, Minden K, Marino A, Stagi S, Carli N, Bertini F, Giani T, Simonini G, Cimaz R, Díaz-Maldonado AS, Yeung RS, Pino S, Guarnizo P, Torres-Jimenez AR, Sanchez-Jara B, Solis-Vallejo E, Cespedes-Cruz AI, Zeferino-Cruz M, Ramirez-Miramontes JV, Kumar A, Gupta A, Kessel C, Suri D, Rawat A, Kakkar N, Singh S, Makay B, Gücenmez ÖA, Ünsal E, Magnusson B, Mördrup K, Vermé A, Lippitz K, Peterson C, Freychet C, Stephan JL, Hofer M, Belot A, Harkness CE, Rooney M, Foster L, Henry E, Taggart P, Weinhage T, Simsek D, Ozkececi CF, Kurt E, Basbozkurt G, Gok F, Demirkaya E, Gorczyca D, Postępski J, Czajkowska A, Szponar B, Hinze C, Paściak M, Gruenpeter A, Lachór-Motyka I, Augustyniak D, Olesińska E, Asuka ES, Golovko T, Aliejim SU, Clemente EI, Jimenez EI, Wittkowski H, Hernandez JC, Fernandez SB, Roca CG, Romo DM, Nieva NR, Angarita JMM, Lopez JA, Nuñez-Cuadros E, Diaz-Cordovés G, Galindo-Zavala R, Holzinger D, Urda-Cardona A, Fernández-Nebro A, Quesada-Masachs E, de la Sierra DÁ, Prat MG, Gallo MM, Borrell RP, Barril SM, Sánchez AMM, Caballero CM, Grün N, Merlin E, Breton S, Fraitag S, Stephan JL, Wouters C, Bodemer C, Bader-Meunier B, Baldo F, Annoni F, Di Landro G, Föll D, Torreggiani S, Torcoletti M, Petaccia A, Corona F, Filocamo G, Tiller G, Buckle J, Munro J, Cox A, Gowdie P, Van Dijkhuizen P, Allen RC, Akikusa JD, Hernández-Huirache HG, Rodea-Montero ER, Cohen JD, Belot A, Fahy W, Quartier P, Sordet C, Trope S, Del Chierico F, Berggren KB, Kembe JT, Bos J, Armbrust W, Wulffraat N, van Brussel M, Cappon J, Dijkstra P, Geertzen J, Legger E, Malattia C, van Rossum M, Sauer P, Lelieveld O, Ozturk K, Buluc L, Akansel G, Muezzinoglu B, Ekinci Z, Rychkova L, Knyazeva T, Russo A, Pogodina A, Belova T, Mandzyak T, Kulesh E, Cafarotti A, Marsili M, Giannini C, Salvatore R, Lapergola G, Di Battista C, Marafon DP, Marcovecchio ML, Basilico R, Pelliccia P, Chiarelli F, Breda L, Almeida B, Tansley S, Simou S, Gunawardena H, McHugh N, ter Haar NM, Wedderburn L, Aouizerate J, Bader-Meunier B, De Antonio M, Bodemer C, Barnerias C, Bassez G, Desguerre I, Quartier P, Gherardi R, Magni-Manzoni S, Charuel JL, Authier FJ, Gitiaux C, Spencer CH, Aziz RA, Yu CY, Adler B, Bout-Tabaku S, Lintner K, Moore-Clingenpeel M, Vastert SJ, Boros C, McCann L, Ambrose N, Cortina-Borja M, Simou S, Pilkington C, Wedderburn L, Hinze C, Oommen PT, Speth F, Dallapiccola B, Haas JP, Hinze C, Oommen PT, Speth F, Haas JP, Speth F, Haas JP, Hinze C, Lavarello C, Giancane G, Prakken B, Pistorio A, Rider L, Aggarwal R, Oliveira SK, Cuttica R, Fischbach M, Sterba G, Brochard K, Dressler F, Barone P, Martini A, Burgos-Vargas R, Chalom EC, Desjonqueres M, Espada G, Fasth A, Garay SM, Herbigneaux RM, Hoyoux C, Deslandre CJ, Miller FW, De Benedetti F, Vencovsky J, Ravelli A, Martini A, Ruperto N, Sag E, Ozen S, Kale G, Topaloglu H, Talim B, Giancane G, Putignani L, Lavarello C, Pistorio A, Zulian F, Magnusson B, Avcin T, Corona F, Gerloni V, Pastore S, Marini R, Martino S, Fidanci BE, Pagnier A, Rodiere M, Soler C, Stanevicha V, Ten Cate R, Uziel Y, Vojinovic J, Ravelli A, Martini A, Ruperto N, Barut K, Villarreal AV, Acevedo N, Diaz T, Ramirez Y, Faugier E, Maldonado R, Arabshahi B, Lee JH, Leibowitz I, Okong’o LO, Arıcı S, Wilmshurst J, Esser M, Scott C, Batu ED, Emiroglu N, Sonmez HE, Tugcu GD, Arici ZS, Yalcin E, Dogru D, Simsek D, Ozcelik U, Bilginer Y, Haliloglu M, Kiper N, Ozen S, Yashiro M, Yamada M, Yabuuchi T, Kikkawa T, Nosaka N, Cakan M, Fujii Y, Saito Y, Tsukahara H, Al-Mayouf SM, AlMutiari N, Muzaffer M, shehata R, Al-Wahadneh A, Abdwani R, Al-Abrawi S, Batu ED, Abu-shukair M, El-Habahbeh Z, Alsonbul A, Szabat A, Chęć M, Opoka-Winiarska V, Kumar A, Gupta A, Rawat A, Saikia B, Şahin S, Minz RW, Suri D, Singh S, Arango C, Malagon C, Gomez MDP, Mosquera AC, Yepez R, Gonzalez T, Vargas C, Kısaarslan A, Zulian F, Balzarin M, Castaldi B, Reffo E, Sperotto F, Martini G, Meneghel A, Milanesi O, Foeldvari I, Klotsche J, Yilmaz E, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Sifuentes-Giraldo WA, Basaran Ö, Smith V, Sztajnbok F, Avcin T, Santos MJ, Nemcova D, Battagliotti C, Eleftheriou D, Harel L, Janarthanan M, Kallinich T, Demir F, Lopez JA, Minden K, Nielsen S, Torok K, Uziel Y, Helmus N, Foeldvari I, Baildem E, Blakley M, Boros C, Ozturk K, Fligelstone K, Kienast A, Nemcova D, Pain C, Saracino A, Simoni G, Torok K, Weibel L, Helmus N, Foeldvari I, Gunduz Z, Klotsche J, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Sozeri B, Sifuentes-Giraldo WA, Smith V, Sztajnbok F, Avcin T, Santos MJ, Nemcova D, Battagliotti C, Eleftheriou D, Harel L, Janarthanan M, Makay B, Kallinich T, Lopez JA, Minden K, Nielsen S, Torok K, Uziel Y, Helmus N, Osminina MK, Geppe NA, Niconorova OV, Ayaz N, Karashtina OV, Abbyasova OV, Shpitonkova OV, Adrovic A, Sahin S, Barut K, Durmus S, Uzun H, Kasapcopur O, Foeldvari I, Yavascan O, Klotsche J, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Aydog O, Sifuentes-Giraldo WA, Smith V, Sztajnbok F, Avcin T, Santos MJ, Nemcova D, Battagliotti C, Eleftheriou D, Harel L, Janarthanan M, Bilginer Y, Kallinich T, Lopez JA, Minden K, Nielsen S, Torok K, Uziel Y, Helmus N, Mauro A, Fanti E, Voller F, Ekinci Z, Rusconi F, Cimaz R, Garcia-Rodriguez F, Villarreal-Treviño AV, Flores-Pineda AJ, Lara-Herrea PB, Salinas-Encinas DR, Diaz-Prieto T, Maldonado-Velazquez MR, Moreno-Espinosa S, Yıldız D, Faugier-Fuentes E, Gallizzi R, Finetti M, Crapanzano M, Cantarini L, Cattalini M, Filocamo G, Insalaco A, Mauro A, Rigante D, Gök F, Zulian F, Alessio M, Parissenti I, Ruperto N, Gattorno M, Cimaz R, Parihar MS, Singh S, Vignesh P, Gupta A, Erguven M, Rohit M, Gopalan K, Singh S, Vignesh P, Gupta A, Rohit M, Attri SV, Hong Y, Eleftheriou D, Nanthapisal S, Unsal E, Salama A, Jayne D, Little M, Brogan P, Kostina Y, Lyskina G, Shpitonkova O, Torbyak A, Lyskina G, Shirinsky O, Kasapcopur O, Mauro A, Gicchino MF, Smaldone MC, Diplomatico M, Olivieri AN, Spencer CH, Aziz RA, McClead R, Bout-Tabaku S, Patel H, Ozen S, Yu CY, Ozkececi CF, Basbozkurt G, Simsek D, Kurt E, Gok F, Demirkaya E, Cebecauerová D, Dallos T, Kabíčková E, Demirkaya E, Kynčl M, Chroustová D, Hoza J, Němcová D, Tesař V, Doležalová P, Batu ED, Sonmez HE, Hazirolan T, Ozaltin F, Sönmez HE, Bilginer Y, Ozen S, Almeida F, de Paula IHF, Sampaio MM, Arita FN, Alves AG, Santos MC, Okuda EM, Sacchetti SB, Batu ED, Falcini F, Francesca M, Stagi S, Rigante D, Lepri G, Matucci-Cerinic M, Brandi ML, Di Landro G, Torreggiani S, Petaccia A, Sözeri B, Torcoletti M, Corona F, Filocamo G, Kisaoglu H, Misir S, Demir S, Aliyazicioglu Y, Kalyoncu M, de Paula IHF, Ramalho CE, Butbul Y, Almeida FD, Alves AG, Santos MC, Sacchetti SB, Okuda EM, Calzada-Hernández J, Bou R, Iglesias E, Sánchez-Manubens J, Martínez FHP, Bilginer Y, Roca CG, Fernández SB, Angarita JMM, Anton J, Bohm M, Mahmood K, Leone V, Wood M, Yamaguchi KI, Fujikawa S, Özen S, Kim KY, Kim DY, Kim DS, Ioseliani M, Chkhaidze I, Lekishvili M, Tskhakaia N, Tvalabeishvili S, Kajrishvili A, Takakura M, Bracaglia C, Shimizu M, Inoue N, Mizuta M, Yachie A, Alizzi C, Corsello G, Maggio MC, Piram M, Maldini C, Biscardi S, Prencipe G, Desuremain N, Orzechowski C, Georget E, Regnard D, Kone-Paut I, Mahr A, Sparchez M, Damian L, Sparchez Z, Silva NA, Pardeo M, Treviño AVV, Loyola YR, Prieto TD, Fuentes EF, Velazquez MDRM, Perez P, Mosquera AC, Malagon C, Bhattad S, Rawat A, Lapeyre G, Saikia B, Minz R, Shandilya J, Singh S, Parihar MS, Singh S, Vignesh P, Gupta A, Rohit M, Maldonado R, Marasco E, Faugier E, Villarreal A, Acevedo N, Ramírez Y, Diaz T, Kostina Y, Lyskina G, Shpitonkova O, Ozturk K, Ekinci Z, Insalaco A, Özçakar ZB, Fitoz S, Yalcinkaya F, Horne A, Minoia F, Bovis F, Davi S, Pal P, Anton J, Stein K, Ferlin W, Enciso S, Kasapcopur O, Jeng M, Maritsi D, Cron RC, Ravelli A, Thorwarth A, von Stuckrad SL, Rösen-Wolff A, Luksch H, Nelson R, Hundsdoerfer P, Minden K, Krawitz P, Kallinich T, Sozeri B, Ayaz NA, Batu ED, Makay B, Şahin S, Simsek D, de Min C, Kılıc ŞS, Ozturk K, Sonmez E, Kisaarslan AP, Gucenmez OA, Cakan M, Arıcı ZS, Adrovic A, Kelesoglu F, Bilginer Y, De Benedetti F, Demirkaya E, Ekinci ZE, Dusunsel R, Unsal E, Kasapcopur O, Ozen S, Lerkvaleekul B, Vilaiyuk S, Miranda-Garcia M, Pretzer C, Ruperto N, Huppertz HI, Horneff G, Haas JP, Ganser G, Kuemmerle-Deschner J, Wittkowski H, Frosch M, Roth J, Foell D, Holzinger D, Brunner HI, Gohar F, McArdle A, Callan N, Hernandez B, Lavric M, Kessel C, Holzinger D, FitzGerald O, Pennington SR, Foell D, Quartier P, Horneff G, Peitz J, Kekow J, Klein A, Horneff G, Schulz AC, Minden K, Weller-Heinemann F, Hospach A, Haas JP, Constantin T, Put K, Vandenhaute J, Avau A, van Nieuwenhuijze A, Brisse E, Dierckx T, Rutgeerts O, Garcia-Perez JE, Toelen J, Waer M, Alexeeva E, Leclercq G, Goris A, Van Weyenbergh J, Liston A, De Somer L, Matthys P, Wouters CH, Mizuta M, Shimizu M, Inoue N, Kone-Paut I, Nakagishi Y, Yachie A, Shimizu M, Inoue N, Mizuta M, Yachie A, Ombrello MJ, Arthur V, Remmers EF, Hinks A, Marzan K, Kastner DL, Woo P, Thomson W, Stanimirovic B, Djurdjevic-Banjac B, Ljuboja O, Hugle B, Speth F, Haas JP, Maritsi D, Wulffraat N, Onoufriou MA, Vougiouka O, Eleftheriou D, Horneff G, Peitz J, Kekow J, Foell D, Bouayed K, El Hani S, Hafid I, Schneider R, Mikou N, Ioseliani M, Lekishvili M, Shelia N, Tvalabeishvili S, Kajrishvili A, Laan M, Ilisson J, Pruunsild C, Padeh S, Chasnyk V, Wouters C, Kuemmerle-Deschner JB, Kallinich T, Lauwerys B, Haddad E, Nasonov E, Trachana M, Vougiouka O, Leon K, Vritzali E, Lheritier K, Martini A, Lovell D, Schena F, Volpi S, Caorsi R, Penco F, Pastorino C, Kalli F, Omenetti A, Chiesa S, Bertoni A, Picco P, Filaci G, Aksentijevich I, Grossi A, Ceccherini I, Martini A, Traggiai E, Gattorno M, Melki I, Rose Y, Uggenti C, Fremond ML, Van Eyck L, Kitabayashi N, Gattorno M, Volpi S, Sacco O, Meyts I, Morren MA, Wouters C, Legius E, Callebaut I, Bodemer C, Rieux-Laucat F, Rodero M, Crow Y, Frémond ML, Rodero MP, Jeremiah N, Belot A, Jeziorski E, Duffy D, Bessis D, Cros G, Rice GI, Charbit B, Hulin A, Khoudour N, Caballero CM, Bodemer C, Fabre M, Berteloot L, Le Bourgeois M, Reix P, Walzer T, Moshous D, Blanche S, Fischer A, Bader-Meunier B, Rieux-Laucat F, Crow Y, Neven B, Annink K, ter Haar N, Al-Mayouf S, Amaryan G, Anton J, Barron K, Benseler S, Brogan P, Cantarini L, Cattalini M, Cochino A, De Benedetti F, Dedeoglu F, De Jesus A, Dellacasa O, Demirkaya E, Dolezalova P, Durrant K, Fabio G, Gallizzi R, Goldbach-Mansky R, Hachulla E, Hentgen V, Herlin T, Hofer M, Hoffman H, Insalaco A, Jansson A, Kallinich T, Koné-Paut I, Kozlova A, Kuemmerle-Deschner J, Lachmann H, Laxer R, Martini A, Nielsen S, Nikishina I, Ombrello A, Ozen S, Papadopoulou-Alataki E, Quartier P, Ravelli A, Rigante D, Russo R, Simon A, Trachana M, Uziel Y, Gattorno M, Frenkel J, ter Haar N, Jeyaratnam J, Lachmann H, Simon A, Brogan P, Doglio M, Cattalini M, Anton J, Modesto C, Quartier P, Hoppenreijs E, Martino S, Insalaco A, Cantarini L, Lepore L, Alessio M, Penades IC, Boros C, Consolini R, Rigante D, Russo R, Schmid JP, Lane T, Martini A, Ruperto N, Frenkel J, Gattorno M, Passarelli C, Pisaneschi E, Messia V, Pardeo M, Novelli A, Debenedetti F, Insalaco A, Brogan PA, Hofer M, Kuemmerle-Deschner JB, Lauwerys B, Speziale A, Wei X, Laxer R, Insalaco A, Marafon DP, Finetti M, Pardeo M, Martino S, Cattalini M, Alessio M, Orlando F, Taddio A, Pastore S, Cortis E, Miniaci A, Ruperto N, Martini A, De Benedetti F, Gattorno M, Eijkelboom C, ter Haar N, Cantarini L, Finetti M, Brogan P, Dolezalova P, Koné-Paut I, Insalaco A, Jelusic-Drazic M, Bezrodnik L, Pinedo MC, Stanevicha V, van Gijn M, Federici S, Ruperto N, Frenkel J, Gattorno M, Girschick H, Finetti M, Orlando F, Insalaco A, Ganser G, Nielsen S, Herlin T, Koné-Paut I, Martino S, Cattalini M, Anton J, Al-Mayouf SM, Hofer M, Quartier P, Boros C, Kuemmerle-Deschner J, Schalm S, Alessio M, Ruperto N, Martini A, Jansson A, Gattorno M, Finetti M, Marchi M, Marini C, Doglio M, Malattia C, Ravelli A, Martini A, Garaventa A, Gattorno M, Bertoni A, Carta S, Balza E, Castellani P, Pellecchia C, Penco F, Schena F, Borghini S, Trotta ML, Pastorino C, Ceccherini I, Martini A, Gattorno M, Rubartelli A, Chiesa S, Guzman J, Henrey A, Loughin T, Berard R, Shiff N, Jurencak R, Benseler S, Tucker L, Papadopoulou C, Hong Y, Krol P, Ioannou Y, Pilkington C, Chaplin H, Simou S, Charakida M, Wedderburn L, Brogan P, Eleftheriou D, Spiegel LR, Kohut SA, Stinson J, Forgeron P, Kaufman M, Luca N, Amaria K, Bell M, Swart J, Boris F, Castagnola E, Groll A, Giancane G, Horneff G, Huppertz HI, Lovell D, Wolfs T, Hofer M, Alekseeva E, Panaviene V, Nielsen S, Anton J, Uettwiller F, Stanevicha V, Trachana M, De Benedetti F, Ailioaie LM, Tsitami E, Kamphuis S, Herlin T, Dolezalova P, Susic G, Sztajnbok F, Flato B, Pistorio A, Martini A, Wulffraat N, Ruperto N, Shoop SJW, Verstappen SMM, McDonagh JE, Thomson W, Hyrich KL, Tarkiainen M, Tynjala P, Lahdenne P, Martikainen J, Wilkinson M, Piper C, Otto G, Deakin CT, Dowle S, Simou S, Kelberman D, Ioannou Y, Mauri C, Jury E, Isenberg D, Wedderburn LR, Nistala K, Foeldvari I, Ruperto N, Lovell DJ, Horneff G, Huppertz HI, Quartier P, Simonini G, Bereswill M, Kalabic J, Martini A, Brunner HI, Oen K, Guzman J, Feldman BM, Dufault B, Lee J, Shiff N, Duffy KW, Tucker L, Duffy C, 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, Martini A, Brunner HI, Nicolai R, Marafon DP, Verardo M, D’Amico A, Bracci-Laudiero L, De Benedetti F, Moneta GM, Belot A, Rice G, Mathieu AL, Omarjee SO, Bader-Meunier B, Walzer T, Briggs TA, O’Sullivan J, Williams S, Cimaz R, Smith E, Beresford MW, Crow YJ, Rooney M, Bishop N, davidson J, pilkington C, Beresford M, Clinch J, Satyapal R, Foster H, Medwin JG, McDonagh J, Wyatt S, Modignani VL, Baldo F, Lanni S, Consolaro A, Ravelli A, 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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Ciullini Mannurita S, Vignoli M, Bianchi L, Kondi A, Gerloni V, Breda L, Ten Cate R, Alessio M, Ravelli A, Falcini F, Gambineri E. CACP syndrome: identification of five novel mutations and of the first case of UPD in the largest European cohort. Eur J Hum Genet 2013; 22:197-201. [PMID: 23756439 DOI: 10.1038/ejhg.2013.123] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 04/29/2013] [Accepted: 05/08/2013] [Indexed: 11/09/2022] Open
Abstract
Camptodactyly-Arthropathy-Coxa vara-Pericarditis (CACP) syndrome is a rare autosomal recessive disorder caused by mutations in PRG4 gene that encodes for proteoglycan 4, a mucin-like glycoprotein that is the major lubricant for joints and tendon surfaces. The molecular studies reported so far have described the identification of 15 mutations associated with this syndrome and the majority of them were found in families of Arabian origin. Here we report the molecular investigation of the largest European cohort that comprises 13 patients, and allowed the identification of 5 novel mutations and of the first case of CACP syndrome resulting from uniparental disomy of chromosome 1.
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Affiliation(s)
- Sara Ciullini Mannurita
- Department of 'NEUROFARBA', Section of Child's Health, University of Florence and Anna Meyer Children's Hospital, Florence, Italy
| | - Marina Vignoli
- Department of 'NEUROFARBA', Section of Child's Health, University of Florence and Anna Meyer Children's Hospital, Florence, Italy
| | - Lucia Bianchi
- Unit of Hematology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Anuela Kondi
- Pediatrics, Centro Ospedaliero-Universitario 'Madre Teresa', Tirana, Albania
| | | | - Luciana Breda
- Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Rebecca Ten Cate
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Maria Alessio
- Department of Pediatrics, University Federico II of Naples, Naples, Italy
| | - Angelo Ravelli
- Istituto Giannina Gaslini and University of Genoa, Genoa, Italy
| | - Fernanda Falcini
- Department of Internal Medicine, Section of Rheumatology, Transition Clinic, University of Florence, Florence, Italy
| | - Eleonora Gambineri
- Department of 'NEUROFARBA', Section of Child's Health, University of Florence and Anna Meyer Children's Hospital, Florence, Italy
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Otten MH, Prince FHM, Anink J, Ten Cate R, Hoppenreijs EPAH, Armbrust W, Koopman-Keemink Y, van Pelt PA, Kamphuis S, Gorter SL, Dolman KM, Swart JF, van den Berg JM, Wulffraat NM, van Rossum MAJ, van Suijlekom-Smit LWA. Effectiveness and safety of a second and third biological agent after failing etanercept in juvenile idiopathic arthritis: results from the Dutch National ABC Register. Ann Rheum Dis 2012; 72:721-7. [PMID: 22730374 DOI: 10.1136/annrheumdis-2011-201060] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the effectiveness and safety of switching to a second or third biological agent in juvenile idiopathic arthritis (JIA) after etanercept failure. METHODS The Arthritis and Biologicals in Children Register aims to include all Dutch JIA patients who have used biological agents. Data on the disease course were used to estimate drug survival with Kaplan-Meier and calculate adverse event (AE) rates. RESULTS Of 307 biologically naive JIA patients who started etanercept, 80 (26%) switched to a second and 22 (7%) to a third biological agent. During 1030 patient-years of follow-up after the introduction of etanercept, 49 switches to adalimumab, 28 infliximab, 17 anakinra, four abatacept and four trial drugs were evaluated. 84% (95% CI 80% to 88%) of patients who started etanercept as a first biological agent were, after 12 months, still on the drug, compared with 47% (95% CI 35% to 60%) who started a second and 51% (95% CI 26% to 76%) who started a third biological agent. Patients who switched because of primary ineffectiveness continued the second agent less often (32%, 95% CI 12% to 53%). After etanercept failure, drug continuation of adalimumab was similar to infliximab for patients with non-systemic JIA; anakinra was superior to a second TNF-blocker for systemic JIA. AE rates within first 12 months after initiation were comparable for each course and each biological agent. CONCLUSIONS Switching to another biological agent is common, especially for systemic JIA patients. A second (and third) agent was less effective than the first. The choice of second biological agent by the physician mainly depends on availability and JIA category.
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Affiliation(s)
- Marieke H Otten
- Department of Paediatrics, Sp 1546, Erasmus MC Sophia Children's Hospital, PO Box 2060, Rotterdam 3000 CB, The Netherlands.
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Janssen CE, Rose CD, De Hertogh G, Martin TM, Bader Meunier B, Cimaz R, Harjacek M, Quartier P, Ten Cate R, Thomee C, Desmet VJ, Fischer A, Roskams T, Wouters CH. Morphologic and immunohistochemical characterization of granulomas in the nucleotide oligomerization domain 2–related disorders Blau syndrome and Crohn disease. J Allergy Clin Immunol 2012; 129:1076-84. [DOI: 10.1016/j.jaci.2012.02.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 01/20/2012] [Accepted: 02/07/2012] [Indexed: 02/06/2023]
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Otten MH, Prince FHM, Twilt M, Ten Cate R, Armbrust W, Hoppenreijs EPAH, Koopman-Keemink Y, Wulffraat NM, Gorter SL, Dolman KM, Swart JF, van den Berg JM, van Rossum MAJ, van Suijlekom-Smit LWA. Tumor necrosis factor-blocking agents for children with enthesitis-related arthritis--data from the dutch arthritis and biologicals in children register, 1999-2010. J Rheumatol 2011; 38:2258-63. [PMID: 21844151 DOI: 10.3899/jrheum.110145] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To evaluate the effectiveness and safety of biological agents in children with enthesitis-related arthritis (ERA). METHODS All patients with ERA in whom a biological agent was initiated between 1999 and 2010 were selected from the Dutch Arthritis and Biologicals in Children (ABC) register. In this ongoing multicenter observational register, data on the course of the disease and medication use are retrieved prospectively at the start of the biological agent, after 3 months, and yearly thereafter. Inactive disease was assessed in accordance with the Wallace criteria. RESULTS Twenty-two patients with ERA started taking 1 or more biological agents: 20 took etanercept, 2 took adalimumab (1 switched from etanercept to adalimumab), and 2 took infliximab (1 switched from etanercept to infliximab). Characteristics: 77% were male, 77% had enthesitis, 68% were HLA-B27-positive. The median age of onset was 10.4 (IQR 9.4-12.0) years; median followup from the start of the biological agent was 1.2 (IQR 0.5-2.4) years. Intention-to-treat analysis shows that inactive disease was achieved in 7 of 22 patients (32%) after 3 months, 5 of 13 patients (38%) after 15 months, and 5 of 8 patients (63%) after 27 months of treatment. Two patients discontinued etanercept because of ineffectiveness, and switched to adalimumab (inactive disease achieved) or infliximab (decline in joints with arthritis after 3 months of treatment). One patient discontinued etanercept because of remission, but had flare and restarted treatment, with good clinical response. No serious adverse events occurred. CONCLUSION Tumor necrosis factor (TNF)-blocking agents seem effective and safe for patients with ERA that was previously unresponsive to 1 or more DMARD. However, a sustained disease-free state could not be achieved, and none discontinued TNF-blocking agents successfully.
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Affiliation(s)
- Marieke H Otten
- Department of Pediatrics, Sp 1546, Erasmus MC Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands.
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Otten MH, Prince FHM, Ten Cate R, van Rossum MAJ, Twilt M, Hoppenreijs EPAH, Koopman-Keemink Y, Oranje AP, de Waard-van der Spek FB, Gorter SL, Armbrust W, Dolman KM, Wulffraat NM, van Suijlekom-Smit LWA. Tumour necrosis factor (TNF)-blocking agents in juvenile psoriatic arthritis: are they effective? Ann Rheum Dis 2010; 70:337-40. [PMID: 21068101 DOI: 10.1136/ard.2010.135731] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of tumour necrosis factor (TNF) blockers in juvenile psoriatic arthritis (JPsA). METHODS The study was a prospective ongoing multicentre, observational study of all Dutch juvenile idiopathic arthritis (JIA) patients using biologicals. The response of arthritis was assessed by American College of Rheumatology (ACR) paediatric response and Wallace inactive disease criteria. The response of psoriatic skin lesions was scored by a 5-point scale. RESULTS Eighteen JPsA patients (72% female, median age onset 11.1 (range 3.3-14.6) years, 50% psoriatic skin lesions, 39% nail pitting, 22% dactylitis) were studied. The median follow-up time since starting anti-TNFα was 26 (range 3-62) months. Seventeen patients started on etanercept and one started on adalimumab. After 3 months of treatment 83% of the patients achieved ACR30 response, increasing to 100% after 15 months. Inactive disease reached in 67% after 39 months. There was no discontinuation because of inefficacy. Six patients discontinued treatment after a good clinical response. However, five patients flared and restarted treatment, all with a good response. During treatment four patients (two JPsA and two JIA patients with other subtypes) developed de novo psoriasis. In four of the nine patients the pre-existing psoriatic skin lesions improved. CONCLUSION Anti-TNFα therapy in JPsA seems effective in treating arthritis. However, in most patients the arthritis flared up after treatment discontinuation, emphasising the need to investigate optimal therapy duration. The psoriatic skin lesions did not respond well and four patients developed de novo psoriasis.
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Affiliation(s)
- Marieke H Otten
- Department of Paediatrics, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.
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Otten MH, Prince FHM, Twilt M, van Rossum MAJ, Armbrust W, Hoppenreijs EPAH, Kamphuis S, Koopman-Keemink Y, Wulffraat NM, Gorter SL, Ten Cate R, van Suijlekom-Smit LWA. Delayed clinical response in patients with juvenile idiopathic arthritis treated with etanercept. J Rheumatol 2010; 37:665-7. [PMID: 20080910 DOI: 10.3899/jrheum.090550] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate response in patients with juvenile idiopathic arthritis (JIA) who failed to meet response criteria after 3 months of etanercept treatment. METHODS This was a prospective ongoing multicenter observational study of all Dutch patients with JIA using etanercept. Response according to American College of Rheumatology Pediatric 30 criteria was assessed at study start and at 3 and 15 months. RESULTS In total we studied 179 patients of median age 5.8 years at disease onset; 70% were female. Thirty-four patients did not respond after 3 months, of which 20 continued etanercept and 11 achieved response thereafter. CONCLUSION The delayed clinically relevant response in a substantial proportion of patients who initially did not respond justifies the consideration of continuing therapy to at least 6 months.
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Affiliation(s)
- Marieke H Otten
- Department of Paediatrics, Sp 1547, Erasmus MC Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands.
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Ruperto N, Ravelli A, Pistorio A, Ferriani V, Calvo I, Ganser G, Brunner J, Dannecker G, Silva CA, Stanevicha V, Cate RT, van Suijlekom-Smit LWA, Voygioyka OLGA, Fischbach M, Foeldvari I, Hilario O, Modesto C, Saurenmann RK, Sauvain MJ, Scheibel I, Sommelet D, Tambic-Bukovac L, Barcellona R, Brik R, Ehl S, Jovanovic M, Rovensky J, Bagnasco F, Lovell DJ, Martini A. The provisional Paediatric Rheumatology International Trials Organisation/American College of Rheumatology/european League Against Rheumatism Disease activity core set for the evaluation of response to therapy in juvenile dermatomyositis: A prospective validation study. ACTA ACUST UNITED AC 2007; 59:4-13. [DOI: 10.1002/art.23248] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Janssen R, Verhard E, Lankester A, Ten Cate R, van Dissel JT. Enhanced interleukin-1beta and interleukin-18 release in a patient with chronic infantile neurologic, cutaneous, articular syndrome. ACTA ACUST UNITED AC 2004; 50:3329-33. [PMID: 15476236 DOI: 10.1002/art.20494] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Chronic infantile neurologic, cutaneous, articular (CINCA) syndrome is a severe inflammatory disease that recently was associated with mutations in CIAS1. It was hypothesized that these mutations may lead to enhanced inflammatory responses. Herein, we provide evidence that inflammation in the CINCA syndrome is characterized by enhanced interleukin-1beta (IL-1beta) and IL-18 release upon stimulation of blood cells and show that this release is caspase 1 dependent.
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Affiliation(s)
- Riny Janssen
- Leiden University Medical Center, Leiden, The Netherlands
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Cimaz R, Casadei A, Rose C, Bartunkova J, Sediva A, Falcini F, Picco P, Taglietti M, Zulian F, Ten Cate R, Sztajnbok FR, Voulgari PV, Drosos AA. Primary Sjögren syndrome in the paediatric age: a multicentre survey. Eur J Pediatr 2003; 162:661-5. [PMID: 12898241 DOI: 10.1007/s00431-003-1277-9] [Citation(s) in RCA: 96] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2003] [Revised: 06/02/2003] [Accepted: 06/03/2003] [Indexed: 11/24/2022]
Abstract
UNLABELLED Primary Sjögren syndrome (SS) is very rare in childhood. We collected a series of primary paediatric SS cases from different centres. A data collection form was prepared and sent to rheumatologists who were willing to participate. Data on 40 cases of primary SS with onset before the 16th birthday were collected. Almost all patients (35/40) were females, age at onset varied from 9.3 to 12.4 years (mean 10.7 years). Signs and symptoms at disease onset were mainly recurrent parotid swelling followed by sicca symptoms. Abnormal laboratory tests were found in the majority of cases. Regarding treatment, 22 patients were treated at some time with oral corticosteroids, seven with non-steroidal anti-inflammatory drugs, and five with hydroxychloroquine; two patients needed cyclosporine and one cyclophosphamide. Follow-up varied from 0 to 7.5 years from onset, without major complications in the majority of patients. CONCLUSION recurrent parotid swelling is a common feature of primary Sjögren syndrome in childhood and often occurs as a presenting feature. Sicca symptoms may be rarer.
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Affiliation(s)
- Rolando Cimaz
- Clinica Pediatrica, Istituti Clinici di Perfezionamento, Via Commenda 9, 20122 Milano, Italy.
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