Treatment for juvenile idiopathic arthritis has undergone substantial changes in recent decades. These changes are partly due to the availability of new treatments, mainly biological agents, as well as developments in treatment strategies, including a focus on concepts such as treat-to-target. In addition, the creation of large paediatric research networks has improved patient access to, and design of, clinical trials for rare paediatric diseases. Although these advances have resulted in improvements in care for most patients with juvenile idiopathic arthritis, certain subgroups of patients continue to have a poor prognosis. Further research aims to identify patients in these subgroups early, to personalise their care, improve functional outcomes, and minimise long-term damage and harm. Optimising the duration of therapy for those individuals who require systemic immunosuppression is also of importance. Incorporation of novel biomarkers in combination with validated clinical measures in an effort to predict outcomes and target therapy accordingly is an exciting development.
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African guidelines for diagnosis and management of polyarticular juvenile idiopathic arthritis: PAFLAR initiative.
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Faculty of Medicine, Batna 2 University, Batna, Algeria.
Background: Juvenile idiopathic arthritis (JIA) is the most common rheumatologic disease of childhood. The Existing guidelines for polyarticular JIA are typically based on data from non-African populations and may not fully address the unique challenges faced in African settings. We aimed to produce updated African guidelines for the diagnosis and treatment of children and adolescents with polyarticular juvenile idiopathic arthritis (poly-JIA).
View Article and Find Full Text PDFMethotrexate resistance and its regulatory mechanisms in pediatric tumors and beyond.
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Department of Pharmacy, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang 310052, China; Research Center for Clinical Pharmacy, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China. Electronic address:
Methotrexate (MTX) is a critical antimetabolite drug in treating various pediatric diseases, including acute lymphoblastic leukemia (ALL), non-Hodgkin lymphoma (NHL), brain tumors, osteosarcoma, inflammatory myofibroblastic tumor (IMT), juvenile scleroderma (JS), and juvenile idiopathic arthritis (JIA). MTX acts as a folate antagonist by inhibiting dihydrofolate reductase (DHFR), an enzyme essential for the synthesis of tetrahydrofolate. This disruption impairs DNA synthesis, repair, and cellular replication, particularly affecting rapidly dividing cells.
View Article and Find Full Text PDFVisceral adipose tissue is related to interleukin 6 and resistin in juvenile idiopathic arthritis - a case-control study.
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Section for Rheumatology, Oslo University Hospital, Oslo, Norway.
To compare visceral adipose tissue (VAT) mass, lipid profile, and selected adipokines/cytokines in patients with juvenile idiopathic arthritis (JIA) with controls, and to explore associations between these markers and VAT. We included 60 JIA patients (30 oligoarticular,30 polyarticular), aged 10-16 years, and 60 age-and sex-matched controls. VAT (g) was estimated by dual-energy x-ray absorptiometry.
View Article and Find Full Text PDFTreatment of systemic juvenile idiopathic arthritis: conventional treatment versus biologics.
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Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Türkiye.
Objective: We aimed to identify and compare systemic juvenile idiopathic arthritis (sJIA) patients receiving treatment with either glucocorticoids and/or conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) or biologic drugs.
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Using Genetics, Genomics, and Transcriptomics to Identify Therapeutic Targets in Juvenile Idiopathic Arthritis.
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Department of Pediatrics, University of Washington School of Medicine, Seattle, WA; Enhanced Pharmacodynamics, LLC, Buffalo, NY. Electronic address:
Despite progress in improving outcomes for oligoarticular and polyarticular juvenile idiopathic arthritis (JIA), the field still faces considerable challenges. More than half of adults who had JIA continue to have active disease and have developed functional limitations. Medication side-effects are common and intrusive.
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