Publications by authors named "Sytze de Roock"

Objectives: This study examined the comparability of venous and capillary blood samples with regard to routine chemistry analytes.

Methods: Venous and capillary blood samples were collected from adult patients to assess comparability of alanine transaminase, albumin, alkaline phosphatase, apolipoprotein B, aspartate aminotransferase, total bilirubin, calcium, chloride, creatin kinase, creatinine, C-reactive protein, ferritin, folic acid, free T4, gamma glutamyltransferase, glucose, high density lipoprotein cholesterol, iron, lipase, lipoprotein a, magnesium, phosphate, postassium, prostate specific antigen, sodium, total cholesterol, total protein, transferrin, triglycerides, thyroid stimulating hormone, urate, urea, vitamin B12 and 25-hydroxyvitamin-D3. Furthermore, hemolysis-icterus-lipemia Index (HIL-Index) was measured for all samples.

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Background: Low-dose weekly methotrexate (MTX) is the mainstay of treatment in juvenile idiopathic arthritis. Unfortunately, a substantial part of patients has insufficient efficacy of MTX. A potential cause of this inadequate response is suboptimal drug adherence.

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Objectives: To evaluate immunogenicity, effectiveness and safety of COVID-19 vaccination in patients with pediatric autoimmune inflammatory rheumatic disease (pedAIIRD).

Methods: A prospective cohort study was performed at the pediatric rheumatology department of the Wilhelmina Children's Hospital in Utrecht, the Netherlands. Vaccination dates, COVID-19 cases and vaccine-related adverse events (AEs) were registered for all pedAIIRD patients during regular clinic visits from March 2021 - August 2022.

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Objective: To quantify differences in hospital-associated costs, and accompanying travel costs and productivity losses, before and after withdrawing TNF-α inhibitors (TNFi) in JIA patients.

Methods: This was a retrospective analysis of prospectively collected data from electronic medical records of paediatric JIA patients treated with TNFi, which were immediately discontinued, spaced (increased treatment interval) or tapered (reduced subsequent doses). Costs of hospital-associated resource use (consultations, medication, radiology procedures, laboratory testing, procedures under general anaesthesia, hospitalization) and associated travel costs and productivity losses were quantified during clinically inactive disease until TNFi withdrawal (pre-withdrawal period) and compared with costs during the first and second year after withdrawal initiation (first and second year post-withdrawal).

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Introduction: Vaccines, especially live attenuated vaccines, in children with JIA pose a great challenge due to both potential lower immunogenicity and safety as a result of immunosuppressive treatment. For many years, in the Netherlands, JIA patients receive a measles-mumps-rubella (MMR) booster vaccine at the age of nine years as part of the national immunization program.

Objectives: To study long-term humoral immunoprotection in a large cohort of JIA patients who received the MMR booster vaccine while being treated with immunomodulatory therapies at the Wilhelmina Children's Hospital in Utrecht, the Netherlands.

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Objective: Human leukocyte antigen (HLA)-DRB1*15:01 has been recently associated with interstitial lung disease (LD), eosinophilia, and drug reactions in systemic juvenile idiopathic arthritis (sJIA). Additionally, genetic variants in IL1RN have been linked to poor response to anakinra. We sought to reproduce these findings in a prospective cohort study of patients with new-onset sJIA treated with anakinra as first-line therapy.

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Introduction: This study assessed the comparability of complete blood count (CBC) parameters between capillary and venous samples, and extended previous research by examining the influence of different storage temperatures on CBC stability up to 7 days after sample collection.

Methods: Venous and capillary blood samples were collected from 93 adult patients. Hemoglobin (Hb), hematocrit (Ht), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), mean platelet volume (MPV), leukocytes, lymphocytes, basophils, eosinophils, erythrocytes, red cell distribution width (RDW), immature granulocytes (IG), immature reticulocyte fraction (IRF), monocytes, neutrophils, platelets, and reticulocytes were measured.

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Objective: To study the effect of methotrexate (MTX) therapy on new-onset uveitis in patients with biological-naïve juvenile idiopathic arthritis (JIA).

Methods: In this matched case-control study, we compared MTX exposure between cases with JIA-associated chronic uveitis (JIA-U) and patients with JIA and without JIA-U at the time of matching (controls). Data were collected from electronic health records of the University Medical Centre Utrecht, the Netherlands.

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Objectives: To study short and long-term disease activity and vaccine-related adverse events in a cohort of JIA patients who received the live attenuated measles-mumps-rubella (MMR) booster vaccine while being treated with immunosuppressive and immunomodulatory therapies.

Methods: A retrospective study was performed in the UMC Utrecht, clinical and therapeutic data were collected from electronic medical records for two visits before and two visits after the MMR booster vaccine of JIA patients. Drug therapy was collected and adverse events related to the vaccine were requested from the patients during clinical visits or by short phone interviews.

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Background: Little is known about the association between juvenile idiopathic arthritis (JIA) and autoimmune thyroid disease (AITD) and therefore there are no indications for AITD screening in this population, which is possible using standard blood tests. The objective of this study is to determine the prevalence and predictors of symptomatic AITD in JIA patients from the international Pharmachild registry.

Methods: Occurrence of AITD was determined from adverse event forms and comorbidity reports.

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Objectives: The aim of this study was to identify factors associated with patients' and parents' reported satisfaction with JIA care, measured with the juvenile arthritis child and parent acceptable symptom state (JA-CASS and JA-PASS, respectively).

Methods: A prospective cohort of 239 JIA patients and 238 parents in a tertiary centre who completed the juvenile arthritis multidimensional assessment report (JAMAR) was analysed cross-sectionally. The primary outcomes were positive JA-CASS and JA-PASS, respectively.

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Article Synopsis
  • This study investigates the prevalence of autoimmune diseases (ADs) in parents of children with juvenile idiopathic arthritis (JIA) and highlights that these rates are higher compared to the general population.* -
  • Researchers analyzed data from 8,673 JIA patients and found common familial ADs like psoriasis and rheumatoid arthritis, with familial history linked to specific factors such as older age at JIA onset and certain types of arthritis.* -
  • The findings suggest that while a family history of AD increases the risk of developing JIA, it doesn't affect the severity or progression of the disease, stressing the importance of considering family health history during diagnosis.*
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  • This study aimed to compare the effects of etanercept (ETN) and adalimumab (ADA) on patient-reported well-being in juvenile idiopathic arthritis (JIA) using real-world data from the Pharmachild registry.
  • Among 158 eligible patients, 90 were matched for comparison, revealing that ETN users reported significantly better improvements in well-being scores compared to ADA users at follow-up.
  • Both treatments were effective overall; however, ETN appeared to provide a greater benefit in well-being despite similar joint count reductions and adverse events between the two groups.
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Objective: To develop and externally validate a prediction model for new-onset chronic uveitis in children with juvenile idiopathic arthritis (JIA) for clinical application.

Methods: Data from the international Pharmachild registry were used to develop a multivariable Cox proportional hazards model. Predictors were selected by backward selection, and missing values were handled by multiple imputation.

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Article Synopsis
  • The study aimed to analyze the patterns of medication prescriptions for children with Juvenile Idiopathic Arthritis (JIA), focusing on how long treatments lasted, the order they were given in, and the reasons for stopping them.
  • Conducted over 4.2 years at a single center, the research involved 236 JIA patients and looked at various medication types, finding that methotrexate (MTX) was almost universally prescribed, with significant use of biologic DMARDs among different JIA subtypes.
  • The findings showed a complex treatment landscape, with many patients switching medications frequently, often due to achieving remission, experiencing side effects, or ineffective treatments.
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Objective: To develop and validate a diagnostic prediction model that can distinguish between juvenile idiopathic arthritis (JIA) and chronic musculoskeletal pain syndrome (CMPS) based on patient-reported outcomes.

Study Design: This retrospective cohort study evaluated whether the Juvenile Arthritis Multidimensional Assessment Report (JAMAR) performs well in distinguishing JIA from CMPS. We analyzed JAMARs completed by 287 patients at their first visit to the pediatric rheumatology department of Wilhelmina Children's Hospital in Utrecht, The Netherlands.

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Objectives: Burden of comorbidities are largely unknown in JIA. From 2000, national and international patient registries were established to monitor biologic treatment, disease activity and adverse events in patients with JIA. The aim of this analysis was to investigate in parallel, for the first time, three of the largest JIA registries in Europe/internationally-UK JIA Biologic Registers (BCRD/BSPAR-ETN), German biologic registers (BiKeR/JuMBO), multinational Pharmachild-to quantify the occurrence of selected comorbidities in patients with JIA.

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Article Synopsis
  • - The study aimed to identify risk factors for Inflammatory Bowel Disease (IBD) in children with Juvenile Idiopathic Arthritis (JIA) by analyzing data from the Pharmachild register and comparing characteristics of patients with and without IBD.
  • - Out of 8,942 JIA patients, only 48 (0.54%) developed IBD, with notable differences in demographics such as being predominantly male, older at diagnosis, more likely to have a family history of autoimmune conditions, and more often associated with enthesitis-related arthritis.
  • - Key predictors for developing IBD included having enthesitis-related arthritis and a family history of autoimmune disease, while certain therapies like etanercept were linked to significantly higher rates
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Objective: To identify serum protein biomarkers that might distinguish patients with early inflammatory arthritis (IA) with psoriatic arthritis (PsA) from those with rheumatoid arthritis (RA) and may be used to support appropriate early intervention.

Methods: The serum proteome of patients with PsA and patients with RA was interrogated using nano-liquid chromatography mass spectrometry (nano-LC-MS/MS) (n = 64 patients), an aptamer-based assay (SomaScan) targeting 1,129 proteins (n = 36 patients), and a multiplexed antibody assay (Luminex) for 48 proteins (n = 64 patients). Multiple reaction monitoring (MRM) assays were developed to evaluate the performance of putative markers using the discovery cohort (n = 60 patients) and subsequently an independent cohort of PsA and RA patients (n = 167).

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Article Synopsis
  • Treg cells play a key role in maintaining immune balance, and their transition into effector Treg (eTreg) cells is essential for immune function, particularly during inflammation.
  • The study uses transcriptional and epigenetic analysis to reveal a distinct eTreg cell signature in humans, highlighting increased expression of specific markers (like FOXP3 and GITR) during inflammatory responses.
  • It finds that the vitamin D receptor (VDR) is a significant regulator in eTreg differentiation, and the altered epigenetic landscape suggests a connection between inflammation-derived Treg cells and those found in tumors.
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Objective: The aim of this study was to quantify costs of hospital-associated care for juvenile idiopathic arthritis (JIA), provide insights in patient-level variation in costs, and investigate costs over time from the moment of JIA diagnosis. Results were reported for all JIA patients in general and by subtype.  METHODS: This study was a single-center, retrospective analysis of prospective data from electronic medical records of children with JIA, ages 0-18 years, between April 1, 2011 and March 31, 2019.

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Article Synopsis
  • - The study aimed to evaluate how adalimumab trough concentrations relate to treatment responses in children with Juvenile Idiopathic Arthritis (JIA).
  • - Researchers analyzed clinical data and measured adalimumab levels in blood samples from 34 pediatric patients, finding that those with secondary treatment failure had significantly lower drug concentrations compared to those with primary failure or who responded well.
  • - The findings indicate that measuring adalimumab trough levels could help identify JIA patients needing higher doses of the medication to ensure effective treatment.
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Crohn's disease (CD) and ulcerative colitis (UC) have a chronic-remittent course. Optimal management of inflammatory bowel diseases (IBD) relies on early intervention, treat-to-target strategies and a tight disease control. However, it is challenging to assess the risk of relapses in individual patients.

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Background: Pediatric patients with juvenile idiopathic arthritis (JIA) are at risk for a lower health-related quality of life compared to their healthy peers. Remote monitoring of health-related quality of life using electronic patient-reported outcomes could provide important information to treating physicians. The aim of this study was to investigate if self-assessment with the EuroQol five-dimensional 'youth' questionnaire with five levels (EQ-5D-Y-5 L) inside a mobile E-health application could identify JIA patients in need of possible treatment adjustments.

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