How common is remission in rheumatoid factor-positive juvenile idiopathic arthritis patients? The multicenter Pediatric Rheumatology Academy (PeRA) research group experience
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Published:2023-07-20
Issue:1
Volume:21
Page:
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ISSN:1546-0096
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Container-title:Pediatric Rheumatology
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language:en
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Short-container-title:Pediatr Rheumatol
Author:
Ozdel SemanurORCID, Sönmez Hafize Emine, Çağlayan Şengül, Akgün Özlem, Aydın Tuncay, Baba Özge, Bağrul İlknur, Yener Gülçin Otar, Öztürk Kübra, Demir Ferhat, Yıldırım Deniz Gezgin, Karadağ Şerife Gül, Bağlan Esra, Çakan Mustafa, Kalyoncu Mukaddes, Makay Balahan Bora, Ünsal Şevket Erbil, Bakkaloğlu Sevcan, Bülbül Mehmet, Sözeri Betül, Ayaz Nuray Aktay
Abstract
Abstract
Objective
Rheumatoid factor (RF)-positive polyarthritis is the least common type of juvenile idiopathic arthritis (JIA). Functional disability in RF-positive polyarthritis patients is much more severe than in patients with other subtypes; but data on this subtype alone is limited. This study aimed to analyze clinical features, long-term follow-up, treatment response, and remission status in a large multicenter cohort of RF-positive polyarthritis patients.
Methods
This retrospective study included RF-positive polyarthritis patients that were followed up for ≥ 6 months between 2017 and 2022 by the Pediatric Rheumatology Academy (PeRA)-Research Group (RG). Data on patient demographics, clinical and laboratory characteristics were obtained from medical charts. JIA treatments and duration of treatment were also recorded. The patients were divided into 2 groups based on methotrexate (MTX) response, as follows: group 1: MTX responsive, group 2: MTX unresponsive. Clinical and laboratory findings were compared between the 2 groups.
Results
The study included 56 (45 female and 11 male) patients. The median age at onset of RF-positive polyarthritis was 13.2 years [(interquartile range) (IQR): 9.0–15.0 years] and the median duration of follow-up was 41.5 months (IQR: 19.5–75.7 months). Symmetrical arthritis affecting the metacarpophalangeal and proximal interphalangeal joints of the hands was commonly observed. Subcutaneous MTX was the preferred initial treatment; however, it was ineffective in 39 (69.6%) of the patients. Of 25 patients followed for 24 months, 56% still had active disease at 24 months.
Conclusion
During 2 years of treatment, 44% of RF-positive polyarthritis patients have inactive disease, and they should be considered as a distinct and important clinical entity requiring aggressive and early treatment.
Publisher
Springer Science and Business Media LLC
Subject
Immunology and Allergy,Rheumatology,Pediatrics, Perinatology and Child Health
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