Health-related quality of life in children with rheumatic diseases.

Purpose Of Review: The effects of therapies on the physical function and health-related quality of life of patients are increasingly considered when treatment decisions are made. For the interpretation of the values of the physical function and health-related quality of life measures, their measurement properties have to be studied.

Recent Findings: Recent advantages include the determination of the minimal clinically important difference of Child Health Assessment Questionnaire, the cross-cultural adaptation of the Child Health Assessment Questionnaire and the Child Health Questionnaire, as well as the development of the Pediatric Quality of Life Inventory.

European Consensus Lupus Activity Measurement is sensitive to change in disease activity in childhood-onset systemic lupus erythematosus.

Objectives: To evaluate the European Consensus Lupus Activity Measurement (ECLAM) for responsiveness to change in disease activity when used in childhood-onset systemic lupus erythematosus (cSLE). To confirm the construct validity and to characterize the measurement properties of the ECLAM by assessing its ability to predict damage and steroid requirements.

Methods: The disease courses of 66 newly diagnosed cSLE patients were reviewed.

Item weightings for the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Disease Damage Index using Rasch analysis do not lead to an important improvement.

Objective: To develop Systemic Lupus International Collaborating Clinics/American College of Rheumatology Disease Damage Index (SLICC/ACR-DI) item weightings that improve the ability of the measure to predict patient mortality in systemic lupus erythematosus (SLE).

Methods: Disease damage was measured for 738 patients followed at the University of Toronto Lupus Clinic since diagnosis. Using Rasch analysis, item weightings were determined and tested for their ability to predict death in a logistic regression model.

DNA microarray analysis reveals novel gene expression profiles in collagen-induced arthritis.

Global gene expression was analyzed in early and late collagen-induced arthritis (CIA). Of 8734 cDNAs analyzed, 330 were induced and 55 downregulated greater than twofold in early or late disease. Hierarchical clustering of these 385 cDNAs demonstrated five distinct expression patterns differentiating early from late disease and correlating with histopathologic changes in the paw.

Preliminary definition of disease flare in juvenile rheumatoid arthritis.

Objective: To develop preliminary criteria for defining disease flare in patients with polyarticular-course juvenile rheumatoid arthritis (JRA).

Methods: Data from a randomized clinical trial of etanercept in JRA (51 patients) and the 6 core response variables (CRV) for JRA were used to derive flare definitions. The criterion standard of flare was treatment with placebo.

Longterm anticoagulation is preferable for patients with antiphospholipid antibody syndrome. result of a decision analysis.

Objective: Patients with antiphospholipid antibody syndrome (APS) have a high risk for rethrombosis. Anticoagulation with warfarin and aspirin reduces the frequency of recurrences. No universally accepted approach regarding the duration and intensity of antithrombotic therapy exists.

Risk factors for damage in childhood-onset systemic lupus erythematosus: cumulative disease activity and medication use predict disease damage.

Objective: The Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index measures damage in adult patients with systemic lupus erythematosus (SLE), but its usefulness in patients with childhood-onset SLE has not been examined. This study was conducted to evaluate the sensibility of the SLICC/ACR Damage Index, to investigate how cumulative disease activity is related to damage in childhood-onset SLE, and to identify other risk factors for damage in childhood-onset SLE.

Methods: Disease activity and damage in 66 patients with newly diagnosed childhood-onset SLE were assessed retrospectively, and information on potential risk factors for damage (age, race, sex, medications, duration of disease, hypertension, body mass index, antiphospholipid antibodies, kidney disease, acute thrombocytopenia) was obtained.

Interferon-gamma:interleukin 4 ratios and associated type 1 cytokine expression in juvenile rheumatoid arthritis synovial tissue.

Objective: To compare synovial tissue cytokine mRNA expression between patients with juvenile rheumatoid arthritis (JRA) and a heterogeneous group of non-autoimmune arthropathies (controls) with respect to type 1/type 2 balance.

Methods: Thirty-five JRA (average 9.1 years' disease duration) and 13 control synovial tissues were studied.