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Clinical and laboratory features of juvenile idiopathic arthritis with wrist involvement: Results of a retrospective cohort study. | LitMetric

AI Article Synopsis

  • Wrist inflammation in juvenile idiopathic arthritis (JIA) is linked to a more severe disease progression and increased treatment challenges, particularly in patients requiring biologic therapies.
  • The study analyzed data from 753 JIA patients, revealing that wrist involvement is common in various JIA types and is associated with more systemic inflammation markers and complications, especially in females.
  • Patients with wrist arthritis had a lower likelihood of achieving remission and a higher chance of needing biologics, highlighting the importance of early and intensive treatment strategies.

Article Abstract

Background: Previous studies in the pre-biological era showed an association of wrist inflammation in juvenile idiopathic arthritis (JIA) with progressive disease course, polyarticular involvement and failure of methotrexate treatment.

Aim: To describe features of JIA, associated with wrist arthritis.

Methods: Data from about 753 JIA patients were included in this retrospective cohort study. The clinical and laboratory features of patients with and without wrist involvement were analyzed.

Results: Wrist involvement was found in oligoarthritis (5.8%), RF(-)/RF(+) polyarthritis (44.9%/15.0%), enthesitis-related arthritis (17.7%), and systemic (58.6%) JIA categories. Unilateral wrist involvement was typical for oligoarthritis patients, bilateral involvement was either equal to that of unilateral involvement or was more frequent in other categories. Wrist arthritis was found to be associated with female sex, a low incidence of uveitis, and more indications of systemic inflammation, including elevated levels of C-reactive protein, erythrocyte sedimentation rate, and platelets, as well as involvement of the cervical spine, temporomandibular, shoulder, elbow, metacarpophalangeal, proximal interphalangeal, distal interphalangeal, hip, ankle, and tarsus arthritis. The number of patients with hip osteoarthritis and hip replacement was also higher. Wrist arthritis was associated with a lower probability of achieving remission [hazard ratio (HR) = 1.3 (95%CI: 1.0-1.7), = 0.055], and a higher probability of being treated with biologics [HR = 1.7 (95%CI: 1.3-2.10, = 0.00009)].

Conclusion: Wrist arthritis in JIA patients is a marker of a severe disease course, characterized by more intensive inflammation, unfavorable outcomes, and. requiring more intensive treatment with early administration of biologics. Close monitoring of wrist inflammation with ultrasound and MR assessment with early biological treatment might improve the outcomes.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438928PMC
http://dx.doi.org/10.5409/wjcp.v13.i3.91656DOI Listing

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