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.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10464062 | PMC |
| http://dx.doi.org/10.1186/s12969-023-00874-z | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Stone-event-free survival after retrograde intrarenal surgery: is the stone-free-status so relevant for the future outcomes?
Int Urol Nephrol
December 2024
Department of Urology, Unidade Local de Saúde de Santo António, Centro Hospitalar Universitário Do Porto, 8th floor, Largo Do Prof. Abel Salazar, 4099-001, Porto, Portugal.
Introduction: The primary aim of stone treatment is to achieve stone-free status. Residual fragments can cause stone growth, recurrence, urinary tract infections, and ureteric obstruction. Our goal was to describe the natural history of stone burden after retrograde intrarenal surgery (RIRS) based on stone-free status (SFS), evaluating stone growth and stone-events.
View Article and Find Full Text PDFPotential role of electroencephalographic monitoring for diagnosis and treatment of local anesthetic systemic toxicity during general anesthesia: a case report.
JA Clin Rep
December 2024
Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Background: Local anesthetic systemic toxicity (LAST) is a rare but potentially life-threatening complication. Under general anesthesia, neurological signs are often masked, delaying diagnosis and increasing the risk of sudden cardiovascular collapse. Therefore, early detection methods are critically needed.
View Article and Find Full Text PDF[Safety and efficacy of Relatox in comparison with Dysport in the treatment of focal spasticity of the upper limb in patients after stroke and traumatic brain injury (results of a prospective simple blind randomized comparative study in parallel groups)].
Zh Nevrol Psikhiatr Im S S Korsakova
December 2024
GUTA-CLINIC LLC, Moscow, Russia.
Objective: Evaluation of the safety and effectiveness of Relatox, botulinum toxin type A in patients with focal spasticity (FS) of the upper limb as a result of a cerebrovascular accident (CVA) or traumatic brain injury (TBI).
Material And Methods: A multicenter, prospective, single-blinded, randomized, comparative clinical study included 210 patients of both sexes aged 18-75 years after moderate to severe TBI and CVA in seven sites in the Russian Federation. The patients were randomized into two groups.
Pterygium extended removal followed by minor ipsilateral simple limbal epithelial transplantation (PERMISLET): An innovative technique for recurrent pterygium.
Indian J Ophthalmol
December 2024
Department of Ophthalmology, Military Hospital, Panagarh, West Bengal, India.
We describe a novel technique for recurrent pterygium and assess the advantage of properties of extended tenonectomy, amniotic membrane transplantation, and limbal epithelial transplantation in terms of recurrence rate, postoperative symptoms, postoperative orthoptics, and other complications. A total of nine eyes with recurrent pterygium underwent PERMISLET, i.e.
View Article and Find Full Text PDFThe necessity of validity diagnostics when drawing causal inferences from observational data: lessons from a multi-database evaluation of the risk of non-infectious uveitis among patients exposed to Remicade.
BMC Med Res Methodol
December 2024
Janssen Research & Development LLC, Global Epidemiology Organization, Raritan, NJ, USA.
Background: Autoimmune disorders have primary manifestations such as joint pain and bowel inflammation but can also have secondary manifestations such as non-infectious uveitis (NIU). A regulatory health authority raised concerns after receiving spontaneous reports for NIU following exposure to Remicade, a biologic therapy with multiple indications for which alternative therapies are available. In assessment of this clinical question, we applied validity diagnostics to support observational data causal inferences.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!