How common is remission in rheumatoid factor-positive juvenile idiopathic arthritis patients? The multicenter Pediatric Rheumatology Academy (PeRA) research group experience.

Autor: Ozdel S; Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey. semanurozdel@gmail.com.; Department of Pediatric Rheumatology, Etlik City Hospital, Ankara, Turkey. semanurozdel@gmail.com., Sönmez HE; Department of Pediatric Rheumatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey., Çağlayan Ş; Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey., Akgün Ö; Department of Pediatric Rheumatology, Faculty of Medicine, Istanbul University, Istanbul, Turkey., Aydın T; Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey., Baba Ö; Department of Pediatric Rheumatology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey., Bağrul İ; Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey., Yener GO; Department of Pediatric Rheumatology, Medicalpark Hospital, Gaziantep, Turkey., Öztürk K; Department of Pediatric Rheumatology, Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey., Demir F; Department of Pediatric Rheumatology, Acıbadem Healthcare Group, Istanbul, Turkey., Yıldırım DG; Department of Pediatric Rheumatology, Gazi University Faculty of Medicine, Ankara, Turkey., Karadağ ŞG; Department of Pediatric Rheumatology, Faculty of Medicine, Istanbul University, Istanbul, Turkey., Bağlan E; Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey., Çakan M; Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey., Kalyoncu M; Department of Pediatric Rheumatology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey., Makay BB; Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey., Ünsal ŞE; Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey., Bakkaloğlu S; Department of Pediatric Rheumatology, Gazi University Faculty of Medicine, Ankara, Turkey., Bülbül M; Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey., Sözeri B; Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey., Ayaz NA; Department of Pediatric Rheumatology, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Pediatric rheumatology online journal [Pediatr Rheumatol Online J] 2023 Jul 20; Vol. 21 (1), pp. 72. Date of Electronic Publication: 2023 Jul 20.
DOI: 10.1186/s12969-023-00860-5
Abstrakt: Objective: Rheumatoid factor (RF)-positive polyarthritis is the least common type of juvenile idiopathic arthritis (JIA). Functional disability in RF-positive polyarthritis patients is much more severe than in patients with other subtypes; but data on this subtype alone is limited. This study aimed to analyze clinical features, long-term follow-up, treatment response, and remission status in a large multicenter cohort of RF-positive polyarthritis patients.
Methods: This retrospective study included RF-positive polyarthritis patients that were followed up for ≥ 6 months between 2017 and 2022 by the Pediatric Rheumatology Academy (PeRA)-Research Group (RG). Data on patient demographics, clinical and laboratory characteristics were obtained from medical charts. JIA treatments and duration of treatment were also recorded. The patients were divided into 2 groups based on methotrexate (MTX) response, as follows: group 1: MTX responsive, group 2: MTX unresponsive. Clinical and laboratory findings were compared between the 2 groups.
Results: The study included 56 (45 female and 11 male) patients. The median age at onset of RF-positive polyarthritis was 13.2 years [(interquartile range) (IQR): 9.0-15.0 years] and the median duration of follow-up was 41.5 months (IQR: 19.5-75.7 months). Symmetrical arthritis affecting the metacarpophalangeal and proximal interphalangeal joints of the hands was commonly observed. Subcutaneous MTX was the preferred initial treatment; however, it was ineffective in 39 (69.6%) of the patients. Of 25 patients followed for 24 months, 56% still had active disease at 24 months.
Conclusion: During 2 years of treatment, 44% of RF-positive polyarthritis patients have inactive disease, and they should be considered as a distinct and important clinical entity requiring aggressive and early treatment.
(© 2023. The Author(s).)
Databáze: MEDLINE
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