Effects of Biologics on Temporomandibular Joint Inflammation in Juvenile Idiopathic Arthritis.

Autor:	Stoustrup P; Peter Stoustrup, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark., Kellenberger CJ; Christian J. Kellenberger, Department of Diagnostic Imaging, and the Children's Research Center, University Children's Hospital Zürich, Zürich, Switzerland., Høst C; Christian Høst, Department of Paediatric and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark., Küseler A; Annelise Küseler,4,Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark., Pedersen TK; Thomas K. Pedersen, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark., Herlin T; Troels Herlin, Department of Paediatric and Adolescent Medicine, Aarhus University Hospital; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Glerup M; Mia Glerup, Department of Paediatric and Adolescent Medicine, Aarhus University Hospital; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Jazyk:	angličtina
Zdroj:	The Journal of rheumatology [J Rheumatol] 2024 Dec 01. Date of Electronic Publication: 2024 Dec 01.
DOI:	10.3899/jrheum.2024-0538
Abstrakt:	Objective: This prospective study investigates the efficacy of biologics in combination with methotrexate or leflunomide on juvenile idiopathic arthritis (JIA)- related temporomandibular joint (TMJ) arthritis measured by magnetic resonance imaging (MRI)-based inflammation score and deformity score. Methods: A prospective single center observational cohort study of 18 consecutive patients were performed between September 2018- April 2023. Inclusion criteria were: 1) Diagnosis of JIA, 2) MRI-verified TMJ arthritis leading to treatment with tumor necrosis factor inhibitor (TNFi), 3) MRI at 6 and 24 months after treatment initiation, 4) clinical follow-up contemporary with the MRI by a pediatric rheumatologist and an orthodontist. Results: We included 18 patients (89% females). At time of first MRI median age was 13.2 years (IQR 11.3-16.9), median disease duration was 7.8 years (IQR 3.4-11.1) and 4 received MTX/leflunomide. During the observation period, significant improvements were observed in TMJ movement pain (p=0.01), morning stiffness (p=0.004), opening capacity (p=0.03) and maximal incisal opening (p=0.006). The inflammation score decreased significantly from median 2 (IQR 1-3) at baseline to median 1(IQR 0-2) at 24 months, p=0.009. In 17 out of 36 TMJs (48%), the deformity score improved or remained stable and no significant increase in the median score was observed. Conclusion: This is the first prospective observational study with evidence to support that the orofacial signs, symptoms and MRI-derived inflammation score in TMJ arthritis can be reduced by treatment with TNFi.
Databáze:	MEDLINE
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