Balay-Dustrude Erin, Weiss Jennifer E, Goh Y Ingrid, Rubin Nathan, Bullock Danielle R
Pediatric Rheumatology, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, United States.
Seattle Children's Hospital and Research Center, Seattle, WA, United States.
Front Pediatr. 2024 Jul 23;12:1423362. doi: 10.3389/fped.2024.1423362. eCollection 2024.
Intra-articular corticosteroid injections (IACI) have been shown to be effective at improving arthritis across juvenile idiopathic arthritis (JIA) categories. The American College of Rheumatology (ACR) recommends IACI use as primary and adjunctive therapy for JIA patients. However, there remains minimal data describing actual IACI use in North America. The objective of this study was to describe and to evaluate IACI use in JIA, utilizing the Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) registry.
Study participants from 13 sites were enrolled in the PR-COIN registry from 2011 to 2015. Demographic and clinical variables were summarized and Chi-squared and -tests were used to evaluate differences between participants who did or did not receive IACI. Multiple logistic regression models were used to evaluate characteristics associated with IACI treatment.
Our study included 3,241 participants, the majority of whom were white (85%), female (71%) and had oligoarticular JIA (39%). IACI was administered at least once in 23% of participants, the majority of whom had oligoarticular disease (52.5%), but overall use in oligoarticular participants was low at 30.8%. IACI use varied significantly between treatment centers and use was associated with oligoarticular disease, ANA positivity, and use of other systemic medications.
This study demonstrates that participants with JIA enrolled in the PR-COIN registry between 2011 and 2015 with persistent oligoarticular disease, ANA positivity, and use of other systemic medications were more likely to receive IACI. However, IACI use was lower than expected for oligoarticular participants.
关节内注射皮质类固醇（IACI）已被证明对改善各类幼年特发性关节炎（JIA）有效。美国风湿病学会（ACR）建议将IACI用作JIA患者的主要和辅助治疗方法。然而，在北美，关于IACI实际使用情况的数据仍然很少。本研究的目的是利用儿科风湿病护理与结局改善网络（PR-COIN）登记处的数据，描述和评估JIA患者中IACI的使用情况。
2011年至2015年期间，来自13个地点的研究参与者被纳入PR-COIN登记处。对人口统计学和临床变量进行了总结，并使用卡方检验和t检验来评估接受或未接受IACI的参与者之间的差异。使用多重逻辑回归模型来评估与IACI治疗相关的特征。
我们的研究包括3241名参与者，其中大多数是白人（85%）、女性（71%），患有少关节型JIA（39%）。23%的参与者至少接受过一次IACI治疗，其中大多数患有少关节型疾病（52.5%），但少关节型参与者的总体使用率较低，为30.8%。IACI的使用在各治疗中心之间存在显著差异，且使用情况与少关节型疾病、抗核抗体阳性以及其他全身用药有关。
本研究表明，2011年至2015年期间纳入PR-COIN登记处的JIA参与者，若患有持续性少关节型疾病、抗核抗体阳性且使用其他全身用药，则更有可能接受IACI治疗。然而，少关节型参与者的IACI使用率低于预期。
