Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
Paediatrics/Pediatric Rheumatology, Leiden University Medical Center Willem Alexander Childrens Hospital, Leiden, The Netherlands.
RMD Open. 2023 Mar;9(1). doi: 10.1136/rmdopen-2022-002941.
We studied patterns of joint inflammation in juvenile idiopathic arthritis (JIA) to assess whether joint activity recurs locally in the same joints.
Joints of 91 patients of the BeSt for Kids study, a treat-to-target trial for children with recent-onset oligoarticular, rheumatoid factor-negative polyarticular and psoriatic JIA, were clinically assessed during 2 years (10 study visits). The association between joint inflammation at baseline and later inflammation in the same joint was assessed using a multilevel mixed-effects logistic regression model at joint level. With a Poisson model, the association between baseline joint inflammation and the number of study visits at which the same joint was recurrently inflamed was tested.
Of the 6097 joints studied, 15% (897) was clinically inflamed at baseline. In 42% (377/897) of those joints, inflammation recurred during follow-up. Joint inflammation at baseline was statistically significantly associated with joint inflammation during follow-up in the same joint (OR 3.9, 95% CI 3.5 to 4.4) and specifically with the number of episodes of recurrent joint inflammation (IRR 1.6, 95% CI 1.2 to 2.1).
In JIA, joint inflammation has the tendency to recur multiple times in joints that are clinically inflamed at disease onset. This indicates that local factors might play a role in the processes contributing to the occurrence of JIA flares.
我们研究了幼年特发性关节炎（JIA）的关节炎症模式，以评估关节活动是否会在同一关节局部复发。
我们对 BeSt for Kids 研究中的 91 例患者的关节进行了研究，该研究是一项针对近期发病的少关节型、类风湿因子阴性多关节型和银屑病性 JIA 患儿的靶向治疗试验。在 2 年内（10 次研究访视）对这些患者的关节进行了临床评估。使用关节水平的多级混合效应逻辑回归模型评估基线时的关节炎症与同一关节随后发生炎症之间的关联。使用泊松模型测试基线时的关节炎症与同一关节出现反复炎症的研究访视次数之间的关联。
在研究的 6097 个关节中，15%（897 个）在基线时出现临床炎症。在这些关节中，有 42%（377/897）在随访期间出现炎症复发。基线时的关节炎症与同一关节在随访期间的炎症显著相关（OR 3.9，95%CI 3.5 至 4.4），特别是与复发性关节炎症的发作次数相关（IRR 1.6，95%CI 1.2 至 2.1）。
在 JIA 中，在疾病发病时出现临床炎症的关节有多次复发的趋势。这表明局部因素可能在导致 JIA 发作的发生过程中发挥作用。
