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Artrite idiopatica giovanile
Juvenile idiopathic arthritis: a disease that changed its clinical picture
Loredana Lepore, Serena Pastore, Andrea Taddio
SS di Reumatologia pediatrica, IRCCS Materno-Infantile “Burlo Garofolo”, Trieste
Giugno 2020 - pagg. 357 -364
Abstract
Juvenile idiopathic arthritis is the most frequent rheumatic disease in childhood. Its diagnosis
is still clinical and recently new classification criteria have been proposed. Over
the past twenty years, there have been significant improvement in understanding the
pathogenetic mechanisms leading to the implementation of targeted therapies. Indeed,
the introduction of biological drugs has changed the quality of life of these children,
with a rapid control of the disease activity and a reduction in the complications related
to the disease and to the use of steroids, which is today very limited. The way of evaluating
patients has also changed: joint ultrasound has become a fundamental tool of the
daily practice of the paediatric rheumatologists. This article aims to highlight the new
discoveries that have changed the management and prognosis of patients affected by
juvenile idiopathic arthritis.
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Bibliografia
Bibliogra!a
1. Ravelli A, Martini A. Juvenile idiopathic
arthritis. Lancet 2007;369(9563):767.
2. Martini A, Ravelli A, Avcin T, et al. Toward
new classification criteria for juvenile idiopathic
arthritis: first step, Pediatric Rheumatology
International trial Organization Consensus.
J Rheumatol 2018;46(2):190-7.
3. Ombrello MJ, Arthur VL, Remmers EF, et
al. Genetic architecture distinguishes systemic
juvenile idiopathic arthritis from other
forms of juvenile idiopathic arthritis: clinical
and therapeutic implications. Ann Rheum
Dis 2017;76(5):906-13.
4. Stock CJ, Ogilvie EM, Samuel JM, Fife M,
Lewis CM, Woo P. Comprehensive association
study of genetic variants in the IL-1 gene
family in systemic juvenile idiopathic arthritis.
Genes and Immunity 2008;9:349-57.
5. Pardeo M, Pires Marafon D, Insalaco A, et
al. Anakinra in systemic juvenile idiopathic
arthritis: a single Center experience. J Rheumatol
2015;42(8):1523-7.
6. De Benedetti F, Martini A. Targeting the
interleukin-6 receptor: a new treatment for
systemic juvenile idiopathic arthritis? Arthritis
Rheum 2005;52:687-93.
7. De Benedetti F. Tocilizumab for systemic
juvenile idiopathic arthritis. N Engl J Med
2013;368(13):1256-7.
8. Jing Yao L, Guan Y G, Albani S, Arkachaisri
T. Recent advances in our understanding
of the pathogenesis of juvenile idiopathic
arthritis and their potential clinical implications.
Expert Review of Clinical Immunology
2018;14(11)933-44.
9. Hinks A, Cobb J, Marion MC, et al. Dense
genotyping of immune-related disease regions
identifies 14 new susceptibility loci for
juvenile idiopathic arthritis. Nat Genet 2013;
45:664.
10. Prahalad S, Glass DN. A comprehensive
review of the genetic of juvenile idiopathic
arthritis. J Pediatr Rheumatol Online 2008;6:
11.
11. Spreafico R, Rossetti M, van Loosdregt J,
et al. A circulating reservoir of pathogeniclikeCD4+
T cells shares a genetic and phenotypic
signature with the inflamed synovial
microenvironment. Ann Rheum Dis 2016;75
(2):459-65.
12. Rossetti M, Spreafico R, Consolaro A, et
al. TCR repertoire sequencing identifies synovial
T-reg cell clonotypes in the bloodstream
during active inflammation in human
arthritis. Ann Rheum Dis 2017;76(2):435-41.
13. Kamada N, Su S, Gy C, et al. Role of the
gut microbiota in immunity and inflammatory
disease. Nat Rev Immunol 2013;13:321.
14. Verwoerd A, Ter Haar NM, de Roock S,
et al. The human microbiome and juvenile
idiopathic arthritis. Pediatric Rheumatol
2016;14:55.
15. Nistala K, Moncrieffe H, Newton KR, et
al. Interleukin-17-producing T cells are enriched
in the joints of children with arthritis,
but have a reciprocal relationship to regulatory
T cell number. Arthritis Rheum 2008;58:
875.
16. Basra HAS, Humpries PD. Juvenile idiopathic
arthritis: what is the utility of ultrasound?
Br J Radiol 2017;90(1073):20160920.
17. Malattia C, Rinaldi M, Martini A. The role
of imaging in juvenile idiopathic arthritis. Expert
Rev Clin Immunol 2018;14(8):681-94.
18. Malattia C, Tzaribachev N, van den Berg
JM, Magni-Manzoni S. Juvenile idiopathic
arthritis - the role of imaging from rheumatologist’s
perspective Pediatr Radiol 2018;48
(6):785-91.
19. Rebollo-Polo M, Koujok K, Weisser C. Ultrasound
findings on patients with juvenile
idiopathic arthritis in clinical remission. Arthritis
Care Res (Hoboken) 2011;63(7):1013-9.
20. Magni-Manzoni S, Scirè CA, Ravelli A, et
al. Ultrasound-detected synovial abnormalities
are frequent in clinically inactive juvenile
idiopathic arthritis, but do not predict a flare
of synovitis. Ann Rheum Dis 2013;72(2):223-
8.
21. Zulian F, Martini G, Gobber D, et al. Comparison
of intra-articular triamcinolone hexacetonide
and triamcinolone acetonide in oligoarticular
juvenile idiopathic arthritis. Rheumatology
2003;42(10):1254.
22. Padeh S, Passwell JH. Intraarticular corticosteroid
injections in the management of
children with chronic arthritis. Arthritis
Rheum 1998;41:1210.
23. Lepore L, Del Santo M, Malorgio C, et al.
Treatment of juvenile idiopathic arthritis with
intra-articular triamcinolone hexacetonide:
evaluation of clinical effectiveness correlated
with circulating ANA and T gamma/delta +
and B CD5+ lymphocyte populations of synovial
fluid. Clin Exp Rheumatol 2002;20(5):
719.
24. Uziel Y, Chapnick G, Rothschild M, et al.
Nitrous Oxide sedation for intra-articular
injection in juvenile idiopathic arthritis. Pediatr
Rheumatol Online J 2008;15:6.
25. Ruperto N, Murray KJ, Gerloni V, et al.;
Pediatric Rheumatology International Trials
Organization. A randomized trial of parenteral
methotrexate comparing an intermediate
dose with a higher dose in children with juvenile
idiopathic arthritis who failed to respond
to standard doses of methotrexate.
Arthritis Rheum 2004 ;50(7):2191-201.
26. Foell D, Wulffraat N, Wedderburn LR,
Wittkowski H. Methotrexate withdrawal at 6
vs 12 months in juvenile idiopathic arthritis
in remission: a randomized clinical trial. JAMA
2010;303(13):1266-73.
27. Lovell DJ, Giannini EH, Reiff A, et al. Etanercept
in children with polyarticular juvenile
rheumatoid arthritis. Pediatric Rheumatology
Collaborative Study Group. N Engl J
Med 2000;342(11):763-9.
28. Lovell DJ, Reiff A, Ilowite NT, et al. Safety
and efficacy of up to eight years of continuous
etanercept therapy in patients with juvenile
rheumatoid arthritis. Arthritis Rheum
2008;58(5):1496.
29. Nielsen S, Ruperto N, Gerloni V, et al.
Preliminary evidence that etanercept may reduce
radiographic progression in juvenile
idiopathic arthritis. Clin Exp Rheumatol
2008;26(4):688.
30. Horneff G, De Bock F, Foeldvari I, et al.
German and Austrian Paediatric Rheumatology
Collaborative Study Group. Safety and
efficacy of combination of etanercept and
methotrexate compared to treatment with
etanercept only in patients with juvenile idiopathic
arthritis (JIA): preliminary data from
the German JIA Registry. Ann Rheum Dis
2009;68(4):519-25.
31. Ruperto N, Lovell DJ, Cuttica R, et al.
Paediatric Rheumatology International Trials
Organization (PRINTO); Pediatric Rheumatology
Collaborative Study Group (PRCSG).
Long-term efficacy and safety of infliximab
plus methotrexate for the treatment of
polyarticular-course juvenile rheumatoid
arthritis: findings from an open-label treatment
extension. Ann Rheum Dis 2010;69(4):
718-22.
32. Ruperto N, Lovell DJ, Cuttica R, et al.
Paediatric Rheumatology International Trials
Organisation; Pediatric Rheumatology Collaborative
Study Group. A randomized, placebo-
controlled trial of infliximab plus methotrexate
for the treatment of polyarticularcourse
juvenile rheumatoid arthritis. Arthritis
Rheum 2007;56(9):3096-106.
33. Lovell DJ, Ruperto N, Goodman S, et al.
Pediatric Rheumatology Collaborative Study
Group; Pediatric Rheumatology International
Trials Organisation. Adalimumab with or
without methotrexate in juvenile rheumatoid
arthritis. N Engl J Med 2008;359(8):810-20.
34. Simonini G, Taddio A, Cattalini M, et al.
Prevention of flare recurrences in childhoodrefractory
chronic uveitis: an open-label comparative
study of adalimumab versus infliximab.
Arthr Care Res (Hoboken) 2011;63(4):
612.
35. Lovell DJ , Ruperto N, Mouy R, et al.
Long-term safety, efficacy, and quality of life
in patients with juvenile idiopathic arthritis
treated with intravenous abatacept for up to
seven years. Arthritis Rheumatol 2015;67
(10):2759-70.
36. Birolo C, Zannin ME, Arsenyeva S, et al.
Comparable efficacy of abatacept used as first-
line or second-line biological agent for severe
juvenile idiopathic arthritis-related uveitis.
J Rheumatol 2016;43(11):2068-73.
37. De Benedetti F, Brunner HI, Ruperto N,
et al. Randomized trial of tocilizumab in systemic
juvenile idiopathic arthritis. N Engl J
Med 2012;367(25):2385.
38. Brunner HI, Ruperto N, Zuber Z, et al;
Paediatric Rheumatology International Trials
Organisation PRINTO; Pediatric Rheumatology
Collaborative Study Group (PRCSG). Efficacy and safety of tocilizumab in patients
with polyarticular-course juvenile idiopathic
arthritis: results from a phase 3, randomised,
double-blind withdrawal trial. Ann Rheum
Dis 2015;74(6):1110-7.
39. Pastore S, Naviglio S, Canuto A, Lepore
L, et al. Serious adverse events associated
with anti-tumor necrosis factor alpha agents
in pediatric-onset inflammatory bowel disease
and juvenile idiopathic arthritis in a real-life
setting. Paediatr Drugs 2018;20(2):165-
171.
40. Furst DE, Keystone EC, So A, et al. Updated
consensus statement on biological agents
for the treatment of rheumatic diseases,
2012. Ann Rheum Dis 2013;72:ii2-34.
41. Lahdenne P, Wikström AM, Aalto K,
Kolho KL. Prevention of acute adverse
events related to infliximab infusions in pediatric
patients. Arthr Care Res (Hoboken)
2010;62:785-90.
42. Jacobstein DA, Markowitz JE, Kirschner
BS, et al. Premedication and infusion reactions
with infliximab: results from a pediatric
inflammatory bowel disease consortium. Inflamm
Bowel Dis 2005;11:442.
43. Pastore S, Londero M, Gortani G, et al.
Infliximab-related vasculitis in patients affected
by ulcerative colitis. J Pediatr Gastroenterol
Nutr 2010;51:226.
44. Lepore L, Marchetti F, Facchini S. Druginduced
systemic lupus erythematosus associated
with etanercept therapy in a child with
juvenile idiopathic arthritis. Clin Exp Rheumatol
2003;21(2):276.
45. Oikonomou KA, Kapsoritakis AN, Tsiopoulos
FD, et al. Emergence of Crohn’s disease
in juvenile idiopathic arthritis during
treatment with etanercept: a causal link or a
mere coincidence? J Gastrointestin Liver Dis
2010;19:342.
46. McCroskery P, Wallace CA, Lovell DJ, et
al. Summary of worldwide pediatric malignancies
reported after exposure to etanercept.
Pediatr Rheumatol Online J 2010;8:18.
47. Rosh JR, Gross T, Mamula P, et al. Hepatosplenic
T-cell lymphoma in adolescents and
young adults with Crohn’s disease: a cautionary
tale? Inflamm Bowel Dis 2007;13:1024.
48. Heijstek MW, Ott de Bruin LM, Bijl M, et
al. EULAR recommendations for vaccination
in paediatric patients with rheumatic diseases.
Ann Rheum Dis 2011;70:1704.
49. Felis-Giemza A, Chmurzyńska K, Nałęcz-
Janik J. Observational study of inflammatory
arthritis treatment by etanercept originator
switched to an etanercept biosimilar. Reumatologia
2019;57(5):257-63.
50. Simonini G, Ferrara G, Pontikaki I, et al.
Flares after withdrawal of biologic therapies
in juvenile idiopathic arthritis: clinical and laboratory
correlates of remission duration.
Arthr Care Res 2018;70(7):1046-51.
51. Aquilani A, Marafon DP, Marasco E, et al.
Predictors of flare following etanercept withdrawal
in patients with rheumatoid factor-negative
juvenile idiopathic arthritis who reached
remission while taking medication. J
Rheumatol 2018;45(7):956-61.
52. Horton DB, Onel KB, Beukelman T, Ringold
S. Attitudes and approaches for withdrawing
drugs for children with clinically
inactive nonsystemic JIA: a survey of the
Childhood Arthritis and Rheumatology Research
Alliance. J Rheumatol 2017;44(3):352-
360.
53. Ruperto N, Brunner HI, Zuber Z et al.
Pharmacokinetic and safety profile of tofacitinib
in children with polyarticular course juvenile
idiopathic arthritis: results of a phase 1,
open-label, multicenter study. Pediatr Rheumatol
Online J 2017;15:86.
54. Kremer JM, Emery P, Camp HS, et al. A
Phase IIb study of ABT-494, a selective JAK-1
inhibitor, in patients with rheumatoid arthritis
and an inadequate response to anti-tumor
necrosis factor therapy. Arthr Rheumatol
2016;68(12):2867-77.
55. Ravelli A, Consolaro A, Horneff G, et al.
Treating juvenile idiopathic arthritis to target:
recommendations of an international task
force. Ann Rheum Dis 2018;77(6):819-28.
56. Consolaro A Giancane G, Schiappapietra
B, et al. Clinical outcome measures in juvenile
idiopathic arthritis. Pediatr Rheumatol Online
J 2016;14(1):23.
Corrispondenza: andrea.taddio@burlo.trieste.it
