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Kume, Ikuo. "The 2004 JPSA-APSA Exchange". PS: Political Science & Politics 38, n.º 1 (janeiro de 2005): 164. http://dx.doi.org/10.1017/s1049096505056210.
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In 1990, the Japanese Political Science Association (JPSA) and the APSA initiated a formal exchange program. Every year, the JPSA invites APSA representatives to attend our annual meeting—where they have a joint session with Japanese members—and sends two JPSA representatives to the APSA Annual Meeting. In 2004, APSA President Margaret Levi (University of Washington) and Ian Shapiro (Yale University) attended the JPSA meeting in Sapporo; the JPSA exchange participants in the APSA Annual Meeting in Chicago were Ryosuke Amiya (Kobe University) and Kensuke Takayasu (Hokkaido University).
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Hu, Shuli, Daniel D. Harabor, Graeme Gange, Peter J. Stuckey e Nathan R. Sturtevant. "Multi-Agent Path Finding with Temporal Jump Point Search". Proceedings of the International Conference on Automated Planning and Scheduling 32 (13 de junho de 2022): 169–73. http://dx.doi.org/10.1609/icaps.v32i1.19798.
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Temporal Jump Point Search (JPST) is a recently introduced algorithm for grid-optimal pathfinding among dynamic temporal obstacles. In this work we consider JPST as a low-level planner in Multi-Agent Path Finding (MAPF). We investigate how the canonical ordering of JPST can negatively impact MAPF performance and we consider several strategies which allow us to overcome these limitations. Experiments show our new CBS/JPST approach can substantially improve on CBS/SIPP, a contemporary and leading method from the area.
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Low, J. M. J., K. Hyrich, N. Geifman e S. Shoop-Worrall. "POS1309 THE IMPACT OF PSORIASIS ON PATIENT-REPORTED OUTCOMES IN JUVENILE PSORIATIC ARTHRITIS". Annals of the Rheumatic Diseases 81, Suppl 1 (23 de maio de 2022): 992.2–993. http://dx.doi.org/10.1136/annrheumdis-2022-eular.2715.
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BackgroundChildren with juvenile psoriatic arthritis (JPsA) are treated similarly to patients in other categories of juvenile idiopathic arthritis (JIA) despite distinctive clinical features, including either a personal or family history of psoriasis. It remains unknown whether the unique features in JPsA lead patients to experience the impact of disease differently from other JIA patients, and how the presence of psoriasis within JPsA affects patient outcomes. These gaps in our knowledge suggest there may be unmet treatment needs in these children and young people.ObjectivesTo compare patient-reported outcomes in patients with JPsA and other JIA categories. Additionally, this study explores whether the presence or absence of psoriasis in patients with JPsA is associated with different outcomes.MethodsChildren and young people with JIA were selected if recruited to the Childhood Arthritis Prospective Study (CAPS), a UK multicentre inception cohort of JIA, between January 2001 and March 2018. Detailed demographic information, clinical data and patient-reported outcomes were collected at initial presentation to paediatric rheumatology. Patient-reported outcomes included well-being as measured on the parental global evaluation (10cm), functional ability (Childhood Health Assessment Questionnaire: CHAQ), pain (10cm), health-related quality of life (Child Health Questionnaire, CHQ psychosocial score), depressive symptoms (Mood and Feelings Questionnaire, MFQ) and parent psychosocial health (General Health Questionnaire: GHQ). The CHQ and MFQ questionnaires were completed in a subset of children recruited until 2015 and aged above 5 and 7 years old, respectively.Patient-reported outcomes in patients with JPsA versus other JIA categories, and in patients with and without psoriasis within JPsA, were tested via multivariable linear regression, adjusted for age at first presentation, gender, disease duration, ethnicity, and number of active joints.ResultsA total of 1653 patients had JIA; the majority (64.7%) were female and median age at onset was 6.5 years (IQR 2.7 - 10.8). A total of 111 (6.7%) were categorised with JPsA, of which 62 (55.9%) were female with median age at onset of 10.2 (IQR 4.3 - 12.5). In those with JPsA, 35% had psoriasis at diagnosis.There were no significant differences between JPsA and non-JPsA in terms of parental global evaluation of wellbeing (p=0.21), CHAQ (p=0.19), pain (p=0.38), CHQ psychosocial (p=0.18), GHQ (p=0.31) or MFQ (p=0.34).Within JPsA, depressive symptom score on the MFQ was higher in patients with psoriasis compared to those without (coefficient=9.8, 95% CI=0.5 to 19.0, p-value=0.04). However, there were no significant differences in parental global evaluation (p=0.4), CHAQ (p=0.3), pain (p=0. 3), CHQ psychosocial score (p=0.5) or GHQ (p=0.7) between those with and without psoriasis in JPsA (Table 1).Table 1.Patient-reported outcomes in children and young people with JPsA with and without psoriasisPatient-reported outcome at JPsA diagnosisOutcomeCoefficient95% confidence intervalp-valueReference – JPsA without psoriasisReferenceReferenceReferenceWellbeing: Parent global (0-10cm)JPsA with psoriasis0.5-0.8, 1.80.45Function: CHAQ (0-3)0.2-0.2, 0.60.28Pain (0-10cm)0.8-0.8, 2.40.34Psychosocial health: CHQ (0-100)-2.4-10.1, 5.30.52Parent psychosocial: GHQ (0-84)-1.3-8.7, 6.10.72Depressive symptoms: MFQ (0-66)9.80.5, 19.00.04ConclusionDespite the differences in clinical features present in JPsA compared to the other JIA subtypes, there were no statistically significant differences in patient-reported outcomes overall at diagnosis. However, within the JPsA group, even when adjusting for age, children with psoriasis at time of arthritis diagnosis reported higher depressive symptom scores compared to those without psoriasis. When treating children with JPsA, attention to diagnosing and treating both arthritis and psoriasis may help mood. If poor mood persists in this subtype, then further allied health care may be required.AcknowledgementsWe thank all the children and young people and their families involved in CAPS, as well as clinical staff and administrators. We also thank the data management team at the University of Manchester (UK). CAPS is funded by Versus Arthritis (UK grant 20542). This report includes independent research funded by the NIHR Biomedical Research Centre Funding Scheme. The views expressed in this publication are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health. KLH is additionally supported by the Centre for Epidemiology Versus Arthritis (UK grant 21755) at the University of Manchester, UK.Disclosure of InterestsJie Man (Jasmine) Low: None declared, Kimme Hyrich Speakers bureau: AbbVie, Grant/research support from: BMS, UCB, and Pfizer, Nophar Geifman: None declared, Stephanie Shoop-Worrall: None declared
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BUTBUL, YONATAN AVIEL, PASCAL N. TYRRELL, RAYFEL SCHNEIDER, SANDEEP DHILLON, BRIAN M. FELDMAN, RONALD M. LAXER, ROTRAUD K. SAURENMANN et al. "Comparison of Patients with Juvenile Psoriatic Arthritis and Nonpsoriatic Juvenile Idiopathic Arthritis: How Different Are They?" Journal of Rheumatology 36, n.º 9 (31 de julho de 2009): 2033–41. http://dx.doi.org/10.3899/jrheum.080674.
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Objective.To compare the clinical features and outcome between patients with juvenile psoriatic arthritis (JPsA) and non-JPsA juvenile idiopathic arthritis (JIA).Methods.Fifty-three children with JPsA, 32 with < 5 joints in the first 6 months of disease (oligo–JPsA) and 21 (≥ 5 joints) polyarticular-onset (poly-JPsA) were compared to 53 patients with JIA who were matched by sex, age, date of diagnosis, and articular onset pattern.Results.There was no difference in the percentage of patients between the oligoarticular groups who developed extended oligoarthritis or in the percentage of patients who were positive for antinuclear antibodies. The only differences were that 25% of patients with oligo-JPsA had dactylitis compared to 0% of patients with oligo-JIA (p < 0.01) and 50% had nail pitting as compared to 18.7% (p < 0.05). In polyarticular patients the percentages with dactylitis were similar (19% vs 38%; p = 0.25). The frequency of uveitis was identical in the oligoarticular patients but a higher rate was seen in poly-JPsA compared to poly-JIA (23.8% vs 0%; p = 0.02), while contractures were more frequent in poly-JIA compared to poly-JPsA during the course of the illness (47.6% vs 14.3%; p = 0.03) but not at last followup (14.3% vs 4.7%; p = 0.6). At last followup the mean Childhood Health Assessment Questionnaire scores were similar in both the polyarticular and oligoarticular groups.Conclusion.There were only a few differences between patients with JPsA and JIA regarding disease onset, disease course, and outcome. We suggest that large, longterm prospective studies are required to accurately determine whether subdividing JIA according to psoriasis is worthwhile.
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Zisman, Devy, Dafna D. Gladman, Matthew L. Stoll, Vibeke Strand, Idit Lavi, Joyce J. Hsu e Elizabeth D. Mellins. "The Juvenile Psoriatic Arthritis Cohort in the CARRA Registry: Clinical Characteristics, Classification, and Outcomes". Journal of Rheumatology 44, n.º 3 (1 de fevereiro de 2017): 342–51. http://dx.doi.org/10.3899/jrheum.160717.
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Objective.Children with clinically diagnosed juvenile psoriatic arthritis (JPsA) who were enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry (CARRA-JPsA) were classified according to pediatric International League of Associations for Rheumatology (ILAR) and adult criteria [Classification criteria for Psoriatic Arthritis (CASPAR)]. Data on demographic and clinical features at baseline and 1-year followup were analyzed and compared.Methods.Cross-sectional analysis was performed of CARRA-JPsA patients enrolled between May 2010 and December 2013 and stratified according to age at disease onset (≤ or > 4 yrs). Features of patients fulfilling ILAR and CASPAR criteria were compared at baseline and followup using chi square, Fisher’s exact, Mann-Whitney-McNemar, Wilcoxon signed rank, and t tests, as appropriate.Results.Among 361 children enrolled as CARRA-JPsA, 72.02% had symptom onset at > 4 years of age, with a male predominance and high prevalence of enthesitis. At followup, statistically significant improvements were reported in arthritis, dactylitis, enthesitis, psoriasis, sacroiliitis, and nail pitting, but not in health questionnaire (HQ) scores. Of the patients, 80.5% fulfilled ILAR criteria for JPsA. Fifty-two patients, whose disease fulfilled CASPAR criteria but had not been included in the JPsA cohort, manifested more enthesitis, sacroiliitis, inflammatory bowel disease and uveitis and less psoriasis.Conclusion.The data support division of patients with JPsA into 2 clinical subgroups, according to age at disease onset. Improvement in objective findings did not correlate with changes in HQ scores. Pediatric rheumatologists currently do not diagnose JPsA in all children whose disease manifestations meet CASPAR criteria. Unification of adult and pediatric PsA classification criteria warrants consideration.
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Samad, Aaida, Matthew L. Stoll, Idit Lavi, Joyce J. Hsu, Vibeke Strand, Thomas N. Robinson, Elizabeth D. Mellins e Devy Zisman. "Adiposity in Juvenile Psoriatic Arthritis". Journal of Rheumatology 45, n.º 3 (15 de dezembro de 2017): 411–18. http://dx.doi.org/10.3899/jrheum.170598.
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Objective.Adult patients with psoriatic arthritis are at increased risk for obesity and metabolic syndrome, but data regarding adiposity in children with juvenile psoriatic arthritis (JPsA) are limited. Our study assessed adiposity in children with JPsA in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry.Methods.Patients with JPsA in the CARRA registry were divided into nonoverweight and overweight groups using recommendations from the US Centers for Disease Control, and differences in demographic and clinical characteristics between groups at baseline and after 1-year followup were assessed using chi-square test, Fisher’s exact test, T test, or Mann-Whitney U test, as appropriate. The prevalence of overweight status in the JPsA registry patients was compared to rheumatoid factor–positive and −negative polyarticular juvenile idiopathic arthritis (RF+polyJIA; RF−polyJIA) registry cohorts and the US pediatric population, using a chi-square goodness-of-fit test.Results.Overweight children represented 36.3% of this JPsA cohort (n = 320). Compared to nonoverweight children, they were significantly older at symptom onset and rheumatologist’s first assessment, and scored significantly worse on patient/physician outcome measures. At 1-year followup, changes in body mass index were not associated with changes in clinical features or outcome measures. The prevalence of overweight and obesity in patients with JPsA was significantly higher than in RF+polyJIA patients, RF−polyJIA patients, and the US pediatric population.Conclusion.In this registry, almost 1 in 5 patients with JPsA were obese and more than one-third were overweight. This is significantly more than expected compared to the US pediatric population, and appropriate longterm followup of this JPsA subgroup is warranted.
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Butbul, Y. "OP0305 VALIDATION OF THE PSORIASIS EPIDEMIOLOGY SCREENING TOOL (PEST) AND THE NEW EARLY ARTHRITIS FOR PSORIATIC PATIENTS (EARP) IN PEDIATRIC POPULATION - PILOT STUDY". Annals of the Rheumatic Diseases 80, Suppl 1 (19 de maio de 2021): 187.2–187. http://dx.doi.org/10.1136/annrheumdis-2021-eular.4165.
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Background:Juvenile Psoriatic Arthritis (JPsA) is an inflammatory arthritis associated with irreversible joint damage among the pediatric population, which is associated with psoriasis in most cases.While there are few validated screening tools for diagnosis of arthritis for adult patients with psoriasis, those screening tools were never evaluated in children.Objectives:The aims of this study were to evaluate two screening tools among pediatric patients with psoriasis.Methods:Thirty-nine patients with the diagnosis of psoriasis were administered two screening questionnaires: the new Early Arthritis for Psoriatic Patients (EARP) questionnaire and the Psoriatic Arthritis Screening and Evaluation (PASE) questionnaire.All patients were evaluated by a rheumatologist for the diagnosis of JPsA, and the accuracy of the two questionnaires compared.Results:The 4/39 (10.1%) patients diagnosed with JPsA had a PEST questionnaire score of ≥ 3, compared to a median PEST score of the patients without the diagnosis of JPsA of 0 (0-2). Thus both the sensitivity and specificity of the PEST in diagnosing JPsA were 100%.For the EARP questionnaire, 8/39 patients had a screening questionnaire score of ≥ 3, suggestive of JPsA, four were true positive, and four false positive. Thus, the sensitivity and specificity of EARP in diagnosing JPsA were 100% and 89%, respectively.Conclusion:Both the PEST and EARP questionnaires were easy to use and had high sensitivity for pediatric population with psoriasis, however the PEST questionnaire had a higher specificity than the EARP.Disclosure of Interests:None declared.
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Naddei, Roberta, Ana Rebollo-Giménez, Marco Burrone, Valentina Natoli, Silvia Rosina, Alessandro Consolaro e Angelo Ravelli. "Juvenile Psoriatic Arthritis: Myth or Reality? An Unending Debate". Journal of Clinical Medicine 12, n.º 1 (3 de janeiro de 2023): 367. http://dx.doi.org/10.3390/jcm12010367.
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Juvenile psoriatic arthritis (JPsA) accounts for 1–7% of all cases of juvenile idiopathic arthritis (JIA) and its definition has been a matter of controversy among pediatric rheumatologists for many years. The traditional attribution of JPsA to the spondyloarthropathy group was challenged in the early 1990s, whereas the recent demonstrations of its heterogenous nature have led to questions about its identification as a distinct category in JIA classification. It has been shown that children with the phenotype of JPsA can be divided in two subgroups, one presenting with the features of early-onset ANA-positive JIA, and another that belongs to the spectrum of spondyloarthropathies. The few studies that have compared the clinical characteristics and genetic determinants of JPsA with those of the other JIA categories have obtained contrasting findings. The debate on the categorization of JPsA as a distinct entity within JIA classification is still ongoing and has prompted the revision of its current classification.
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Morris, Walter. "PDA JPST Online Reboot". PDA Journal of Pharmaceutical Science and Technology 73, n.º 5 (2019): 417. http://dx.doi.org/10.5731/pdajpst.2019.001115.
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Shoop-Worrall, S., C. Ciurtin, G. Cleary, F. Mcerlane, L. Coates, N. Geifman e K. Hyrich. "POS0742 CLUSTERS OF JUVENILE PSORIATIC ARTHRITIS IDENTIFIED AT INITIAL PRESENTATION TO PAEDIATRIC RHEUMATOLOGY IN A NATIONWIDE UK COHORT". Annals of the Rheumatic Diseases 82, Suppl 1 (30 de maio de 2023): 661.1–661. http://dx.doi.org/10.1136/annrheumdis-2023-eular.2282.
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BackgroundThe heterogenous presentation and variable clinical response of juvenile psoriatic arthritis (JPsA) to disease-modifying therapies suggests undiscovered subgroups within this disease. Nevertheless, JPsA is often studied under the umbrella of juvenile idiopathic arthritis (JIA), with few studies interrogating JPsA separately. To improve stratified treatment of this rare disease, such subgroups must be uncovered.ObjectivesTo identify novel, phenotypically consistent subgroups of children and young people (CYP) with JPsA at the point of first contact with paediatric rheumatology.MethodsCYP were initially selected if enrolled between January 2001 and December 2019 to the Childhood Arthritis Prospective Study, a UK, multicentre, prospective inception cohort of JIA. Those who had a physician’s diagnosis of JPsA at any time point through the 10-year follow-up were included, to allow for onset of psoriatic signs after initial diagnosis. At initial presentation to paediatric rheumatology, clinical features within the ILAR classification criteria for JPsA were collected: an active joint count and the presence or absence of psoriasis, dactylitis and nail abnormalities. Latent class analysis used these features to identify clusters of disease. Between one and ten clusters were tested and an optimal model selected based on statistical fit.ResultsOf 1,753 CYP with JIA recruited to CAPS within the study period, a total of 161 CYP had ever had a diagnosis of JPsA (n=97 diagnosed as JPsA at initial presentation to paediatric rheumatology). The majority were female (61%), of white ethnicity (94%) and the median age at initial presentation was 10 years (IQR 6, 13).The optimal latent class model identified two clusters of JPsA. An oligoarticular cluster (90%, median active joint count (IQR): 2 (1,5)) had a higher proportion of CYP affected by psoriasis (Cluster 1: 29%, Cluster 2: 14%). A polyarticular cluster (10%, median active joint count (IQR): 20 (16, 27)) had a higher proportion with nail abnormalities (Cluster 1: 8%, Cluster 2: 27%). There were similar proportions of dactylitis among the clusters (Cluster 1: 18%, Cluster 2: 15%) (Figure 1).ConclusionThis study identifies two clusters of JPsA at initial presentation to paediatric rheumatology with differences in key features used to classify this disease. Such subgroups may have different experiences of disease, and future analysis will explore characteristics, alongside disease impact and response to therapy for these groups.Figure 1.Characteristics of two JPsA clusters identified at initial presentation to paediatric rheumatologyAcknowledgementsWe thank all the children and young people and their families involved in CAPS as well as clinical staff and administrators. We also thank the data management team at the University of Manchester (UK). This work is funded by the Medical Research Council (MR/W027151/1), and is also supported by Versus Arthritis (UK grant numbers 20542 & 21755) and the NIHR Manchester Biomedical Research Centre (NIHR203308).Disclosure of InterestsStephanie Shoop-Worrall: None declared, Coziana Ciurtin: None declared, Gavin Cleary: None declared, Flora McErlane: None declared, Laura Coates: None declared, Nophar Geifman: None declared, Kimme Hyrich Speakers bureau: AbbVie, Grant/research support from: BMS and Pfizer.
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Aleksanyan, K., S. Chebysheva, O. Sukhovyova e E. Zholobova. "OP0306 ETANERCEPT AND ADALIMUMAB IN THE TREATMENT OF JUVENILE PSORIATIC ARTHRITIS". Annals of the Rheumatic Diseases 80, Suppl 1 (19 de maio de 2021): 187.1–188. http://dx.doi.org/10.1136/annrheumdis-2021-eular.2827.
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Background:Juvenile psoriatic arthritis (JPsA) accounts for 4 to 9% of children with juvenile arthritis (1). Biologics, particularly TNF-α inhibitors, have proved to be effective and safe for treatment of psoriatic arthritis in adults (2). However, no comprehensive evidence exists on the comparative effectiveness and safety of TNF-α inhibitors in the treatment of JPsA, which challenges a decision of what biologic should be prescribed to children with JPsA.Objectives:To study the comparative effectiveness of etanercept and adalimumab in patients with JPsA with respect to both the articular and skin manifestations.Methods:Our observational (2012-2019), parallel-group, open-label, single-centre cohort clinical study involved 34 patients (2-13 y/o) with JPsA who met Vancouver and I/E criteria and received etanercept SC (0.8 mg/kg QW, max 50 mg per week) or adalimumab SC (max 40 mg Q2W), both in combination with methotrexate (10-15 mg/m2 QW). Intention-to-treat analysis was used to evaluate treatment efficacy at months 6, 12, and 18 after biologic therapy initiation. To assess articular manifestations of JPsA, we applied ACRpedi criteria; to estimate the surface area of involved skin and severity of psoriasis – the PASI score.Results:We observed 34 patients with JPsA (2 to 13 y/o), who were initiated by biological therapy (etanercept [n=18 - group 1] and adalimumab [n=16 - group 2]) (Table 1, Figure 1).Table 1.Clinical and demographic characteristics of patients with JPsA before biologic therapy initiation (n=34)clinical and demographic indicatorsGroup 1(Etanercept)M±δ / Me (Q1-Q3)Group 2(Adalimumab)M±δ / Me (Q1-Q3)Girl/Boy Ratio12:6 (2:1)10:6 (1,7:1)Average age, years7,58 ± 3,75,8 ± 3Duration of the disease, years3,0 (1,4-6,6)3,5 ± 2Uveitis (n, %)05 (31,3%)ANA positivity (n, %)2 (11%)8 (50%)RF positivity (%)00No. active joints8,0 (5-16,5)5,5 (3-8,5)No. joints with LOM9(5,75-18,25)6 (3,5-10,5)PGA of disease activity, mm70 ± 1565,9 ± 12,7Parent’s global assessment of the child’s pain, VAS71,5 (65-90)72,5 ± 14СНАQ1,34 (1,1-1,68)1,25 (0,93-1,44)Psoriasis BSA, %7,0 (4-13)8 (3-13) PASI score5,7 (3-8,2)9 (5-19)ESR, mm/h28 (20,75-40)24,5 (21-32)ANA - antinuclear antibodies, RF - rheumatoid factor, LOM - limitation of motion, PGA - physician’s global assessment; VAS - visual analog scale, CHAQ - Childhood Health Assessment Questionnaire; BSA - body surface area; PASI - Psoriasis Area Severity Index, ESR - erythrocyte sedimentation rate; CRP - C-reactive protein.Figure 1.Comparative efficacy of etanercept and adalimumab in children with JPsA, according to the ACRpedi criteria at months 6, 12, and 18 after treatment initiation. No statistically significant difference in the efficacy of etanercept and adalimumab in patients with juvenile psoriatic arthritis was obtained, according to the ACRpedi criteria. The efficacy of biologic treatment on skin manifestations of JPsA was also evaluated (Figure 2).Figure 2.Comparative efficacy of etanercept and adalimumab in children with JPsA by PASI score at months 6, 12, and 18 after treatment initiation. Both TNF-α blockers (etanercept, adalimumab) showed similar efficacy for psoriasis in patients with JPsA, though response rate for psoriasis in adalimumab group was higher than in etanercept group.Conclusion:Both TNF-α inhibitors (etanercept and adalimumab) proved to be effective in the treatment of arthritis and psoriasis in JPsA. There was no statistically significant difference in the effectiveness of etanercept and adalimumab in the treatment of JPsA in our cohort. Both biological agents can be successfully used to treat JPsA.References:[1]Beukelman T., et al. The new Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry: design, rationale, and characteristics of patients enrolled in the first 12 months. PediatrRheumatol Online J. 2017;15(1):30[2]Ruyssen-Witrand A., et al. Efficacy and safety of biologics in psoriatic arthritis: a systematic literature review and network meta-analysis. RMD Open. 2020;6(1):е001117Disclosure of Interests:Karina Aleksanyan: None declared, Svetlana Chebysheva: None declared, Olga Sukhovyova: None declared, Elena Zholobova Speakers bureau: Pfizer, AbbVie, Novartis, Roche.
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Correll, Colleen K., Scott Stryker, David Collier, Thomas A. Phillips, Anne C. Dennos, Stephen J. Balevic e Timothy Beukelman. "Occurrence of adverse events and change in disease activity after initiation of etanercept in paediatric patients with juvenile psoriatic arthritis in the CARRA Registry". RMD Open 9, n.º 2 (maio de 2023): e002943. http://dx.doi.org/10.1136/rmdopen-2022-002943.
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ObjectiveEtanercept is commonly used to treat juvenile idiopathic arthritis, including juvenile psoriatic arthritis (JPsA); however, information on etanercept’s safety and effectiveness in clinical practice is limited. We used data from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry to evaluate etanercept’s safety and effectiveness in JPsA in clinical practice.MethodsWe analysed safety and effectiveness data for paediatric patients enrolled in the CARRA Registry who had a JPsA diagnosis and had used etanercept. Safety was assessed by calculating rates of prespecified adverse events of special interest (AESIs) and serious adverse events (SAEs). Effectiveness was assessed by a variety of disease activity measures.ResultsOverall, 226 patients had JPsA and received etanercept; 191 met criteria for safety analysis and 43 met criteria for effectiveness analysis. AESI and SAE incidence rates were low. There were five events: three uveitis, one new-onset neuropathy and one malignancy. Incidence rates were 0.55 (95% CI: 0.18, 1.69), 0.18 (95% CI: 0.03, 1.29) and 0.13 (95% CI: 0.02, 0.09) per 100 patient-years for uveitis, neuropathy and malignancy, respectively. Etanercept showed effectiveness for JPsA treatment; 7 of 15 (46.7%) had an American College of Rheumatology-Pediatric Response 90, 9 of 25 (36.0%) had a clinical Juvenile Arthritis Disease Activity Score 10-joint ≤1.1 and 14 of 27 (51.9%) had clinically inactive disease at the 6-month follow-up.ConclusionData in the CARRA Registry showed that etanercept treatment was safe in treating children with JPsA, with low AESIs and SAEs. Etanercept was also effective, even when assessed in a small sample size.
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Chen, Xin, Lisi Cha, Zhi Xuan e Weiming Zhang. "The effect of joint position sense therapy on chronic shoulder pain with central sensitization". Medicine 103, n.º 15 (12 de abril de 2024): e37786. http://dx.doi.org/10.1097/md.0000000000037786.
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Background: Chronic shoulder pain is a common musculoskeletal problem associated with unreleased pain and functional dysfunction that can evolve into central sensitization. Some forms of manual therapy may exacerbate pain and central sensitization. This study investigated the impact of joint position sense therapy (JPST), a moderate joint proprioception training technique, on central sensitization, shoulder functional dysfunction, and pain in patients with chronic shoulder pain compared with more intense exercises or aggressive manual therapies. Methods: We assessed the pressure pain threshold (PPT) in 30 patients with and 30 patients without chronic shoulder pain. The assessment focused on 4 muscle sites: deltoid, upper trapezius, brachioradialis, and tibialis anterior. Thirty patients with chronic shoulder pain were randomly divided into the JPST and control groups. The JPST group underwent additional shoulder joint position–sense training. The efficiency outcomes were the disabilities of the arm, shoulder, and hand questionnaire, visual analog scale (VAS), and PPT, evaluated at baseline and after the intervention. Results: Significant differences were observed in the PPT values at the brachioradialis (P < .05), deltoid (P < .01), and trapezius (P < .001) among the non-chronic and chronic groups, but not in the tibialis anterior muscle (P > .05). Although both control and JPST interventions effectively improved the disabilities of the arm, shoulder, and hand questionnaire score, pain intensity, and PPT values in the upper limb, the outcomes in the JPST group were significantly different from those in the control group. Conclusions: Generalized hyperalgesia changes limited to the upper limbs were observed in patients with chronic shoulder pain. JPST has beneficial effects on pain control and functional dysfunction in patients with chronic shoulder pain.
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Ferejohn, John, e Frances Rosenbluth. "The 2003 APSA-JPSA Exchange". PS: Political Science & Politics 37, n.º 1 (janeiro de 2004): 162–64. http://dx.doi.org/10.1017/s1049096504004044.
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Stoll, Matthew L., e Peter A. Nigrovic. "Subpopulations Within Juvenile Psoriatic Arthritis: A Review of the Literature". Clinical and Developmental Immunology 13, n.º 2-4 (2006): 377–80. http://dx.doi.org/10.1080/17402520600877802.
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The presentation of juvenile psoriatic arthritis (JPsA) has long been recognized to be clinically heterogeneous. As the definition of JPsA expanded to accommodate atypical manifestations of psoriasis in young children, studies began to reflect an increasingly clear biphasic distribution of age of onset, with peaks in the first few years of life and again in early adolescence. These two subpopulations differ in gender ratio, pattern of joint involvement, laboratory findings and potentially response to therapy. Intriguingly, a similar distribution of age of onset has been observed in juvenile rheumatoid arthritis (JRA), and correlates with patterns of HLA association. While a secure classification of subpopulations within JPsA awaits improved pathophysiologic understanding, future research must consider the possibility that different disease mechanisms may be operative in distinct subsets of patients with this disorder.
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Aleksanyan, K., S. Chebysheva, A. Meleshkina, E. Popova e E. Zholobova. "AB0999 HALLMARK CLINICAL FEATURES of JUVENILE PSORIATIC ARTHRITIS (JPSA)". Annals of the Rheumatic Diseases 79, Suppl 1 (junho de 2020): 1792.1–1793. http://dx.doi.org/10.1136/annrheumdis-2020-eular.1275.
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Background:JPsA is presented in 4 to 9% children with juvenile arthritis [1,2]. According to ILAR criteria, patients with uveitis, HLA-B27-positivity, and other exclusion criteria cannot be included in the JPsA category. Therefore, in pediatric rheumatological practice, the Vancouver criteria are more often used [3].Objectives:to identify clinical features of psoriatic arthritis in children.Methods:a single center, prospective and retrospective, continuous clinical trial for the period from 1989 to 2019 was conducted.Results:We observed 83 patients with JPsA aged from 4 months to 17 years. Fifty-nine (71%) patients had definite JPsA and 24 (29%) had probable JPsA, according to the Vancouver criteria. The clinical and demographic characteristics are presented in Table 1.Table 1.The clinical and demographic characteristics of patients with JPsA (n=83)Demographic indicatorsJPsAМ ± σ (Ме)DefiniteProbableNumber of patients (n)5924Girl/Boy Ratio1,7:12:1Average age, years6,6±4 (5)6,3±2,7 (5)Duration of the disease, years3 ±2 (3)Family history of psoriasis n, (%)First-degree relative with psoriasis22 (26%)Second-degree relative with psoriasis34 (41%)Potential trigger n, (%)Infection22 (27%)Trauma12 (14%)Vaccination7 (8%)Insolation5 (6%)Stress3 (4%)Not identified34 (41%)In 17 (29%) children with definite JPsA, skin lesions presented as the first sign of the disease, joint damage in these patients developed after 3.5 ± 2 (2) years. In 28 (48%) patients articular syndrome was observed on the onset with subsequent skin manifestations after 5.3 ± 3 (5) years. Fourteen (23%) children with definite JPsA had simultaneous debut of skin and articular syndromes (Fig.1).Fig.1.Skin and / or articular syndromes in the onset of the disease in children with definite JPsAAmong 59 patients with definite JPsA, vulgar psoriasis was observed in 45 (76%) patients, guttate psoriasis in 9 (15%), isolated nail psoriasis in 3 (5%), and palmoplantar psoriasis in 2 (4%). Fifteen (28%) patients had a combination of cutaneous psoriasis with damage to the nail plates.Articular syndrome in the onset of the disease was represented by oligoarticular arthritis in 57 (69%) patients, in 15 (18%) children - symmetric rheumatoid-like arthritis, and in 11 (13%) - spondylitis. The most commonly involved joints at both presentation and during the course of the disease were the knee (41%), ankle (31%), and small joints of the hands (29%). During course of the disease, the articular syndrome transformed with symmetric rheumatoid-like arthritis prevalence (Fig. 2).Fig. 2.Articular syndrome JPsA in the onset and during the disease course (n, %)In 39 (47%) children, the disease at onset was characterized by high level of ESR – 34±12 (32) mm/h.Conclusion:In most patients with JPsA, the onset of the disease occurred at the age of 6.6±4 years. Articular syndrome in the onset of the disease was presented as oligoarticular arthritis in 69% children. Overall, transformation to symmetric rheumatoid-like arthritis was the most common. Skin lesions were represented by vulgar psoriasis in 76%, guttate psoriasis in 15%, isolated nail psoriasis in 5%, palmoplantar psoriasis in 4%, and 28% of patients had a combination of cutaneous psoriasis with damage to the nail plates.References:[1]Beukelman, T., et al. The new Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry: design, rationale, and characteristics of patients enrolled in the first 12 months. Pediatr Rheumatol Online J. 2017;15(1):30[2]Horneff G., et al. Update on malignancies in children with juvenile idiopathic arthritis in the German BIKER Registry. Clin. Exp. Rheumatol. 2016; 34(6):1113–1120.[3]Southwood T.R., et al. Psoriatic arthritis in children. Arthritis Rheum.1989; 32(8):1007-1013.Disclosure of Interests:Karina Aleksanyan: None declared, Svetlana Chebysheva: None declared, Angelina Meleshkina: None declared, Ekaterina Popova: None declared, Elena Zholobova Grant/research support from: Novartis and Pfizer Inc, Speakers bureau: AbbVie, Novartis, Pfizer Inc and Roche
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Chebysheva, Svetlana Nikolaevna, Elena Spartakovna Zholobova, Natalya Anatolevna Geppe, Karina Vladimirovna Aleksanyan, Angelina Valerevna Meleshkina, Khitrov Alexandr Nikolaevich, Saltykov Alexandr Borisovich et al. "The Diverse and Heterogeneous Clinical Features of Juvenile Psoriatic Arthritis". Serbian Journal of Experimental and Clinical Research 22, n.º 4 (1 de dezembro de 2021): 351–56. http://dx.doi.org/10.2478/sjecr-2021-0066.
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Abstract Juvenile Psoriatic Arthritis (JPsA) is a chronic inflammatory disorder that accounts for 3-10% of all juvenile arthritis. The main objective is to identify the clinical features of psoriatic arthritis in children. This study was open-label, single-center, prospective, observational (1989-2020) cohort clinical study included 85 patients (3-17.0 y/o) who met Vancouver and I/E criteria. The features of skin and articular syndromes in children with JPsA were revealed. In most patients with PSA, the disease began at the age of 6.6 years. In childhood, arthritis is usually preceded by psoriasis. The most common clinical form of psoriasis is plaque psoriasis. At the onset of the disease, symmetric polyarthritis predominates. During the disease, transformation of the joint syndrome with a predominance of rheumatoid arthritis is noted. All observed patients showed pronounced osteoporosis, which is not characteristic of JPsA.
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Aoki, Takuya, Yasuki Fujinuma e Masato Matsushima. "Associations of primary care structures with polypharmacy and patient-reported indicators in patients with complex multimorbidity: a multicentre cross-sectional study in Japan". BMJ Open 12, n.º 1 (janeiro de 2022): e054348. http://dx.doi.org/10.1136/bmjopen-2021-054348.
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ObjectivesEvidence supporting the effects of primary care structures on the quality of care for patients with complex multimorbidity, which is one of the most important challenges facing primary care, is scarce internationally. This study aimed to examine the associations of the types of primary care facilities with polypharmacy and patient-reported indicators in patients with complex multimorbidity, with a focus on differences between community clinics and hospitals.DesignMulticentre cross-sectional study.SettingA total of 25 primary care facilities (19 community clinics and 6 small- and medium-sized hospitals).ParticipantsAdult outpatients with complex multimorbidity, which was defined as the co-occurrence of three or more chronic conditions affecting three or more different body systems within one person.Primary outcome measurePolypharmacy, the Patient-Reported Experience Measure using the Japanese version of Primary Care Assessment Tool Short Form (JPCAT-SF) and the Patient-Reported Outcome Measure using self-rated health status (SRH).ResultsData were analysed for 492 patients with complex multimorbidity. After adjustment for possible confounders and clustering within facilities, clinic-based primary care practices were significantly associated with a lower prevalence of polypharmacy, higher JPCAT-SF scores in coordination and community orientation, and a lower prevalence of poor or fair SRH compared with hospital-based primary care practices. In contrast, the JPCAT-SF score in first contact was significantly lower in clinic-based practices. The associations between the types of primary care facilities and JPCAT-SF scores in longitudinality and comprehensiveness were not statistically significant.ConclusionsClinic-based primary care practices were associated with a lower prevalence of polypharmacy, better patient experience of coordination and community orientation, and better SRH in patients with complex multimorbidity compared with hospital-based primary care practices. In the primary care setting, small and tight teams may improve the quality of care for patients with complex multimorbidity.
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Weisberg, Herb, e Clyde Wilcox. "APSA/JPSA Exchange: A Continuing Tradition". PS: Political Science & Politics 30, n.º 02 (junho de 1997): 245–46. http://dx.doi.org/10.1017/s1049096500043559.
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Haas, J. P., e R. Häfner. "Juvenile Psoriasis-Arthritis". Arthritis und Rheuma 30, n.º 03 (2010): 164–70. http://dx.doi.org/10.1055/s-0037-1618015.
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ZusammenfassungDie juvenile Psoriasis-Arthritis (jPsA) wird als eine Kategorie der juvenilen idiopathischen Arthritis (JIA) definiert und weist unterschiedliche klinische Manifestationsformen auf. Die größte Gruppe bilden Patienten mit einer asymmetrischen Arthritis im Schulalter, gefolgt von Kindern mit Oligoarthritis und Beginn im Kleinkindalter. Bei zehn bis 20 Prozent besteht eine symmetrische Polyarthritis. In der Klassifikation nach ILAR von 2002 gelten Ausschlusskriterien, die insbesondere Jungen mit einer Spondylarthropathie betreffen. Dadurch ergeben sich Schwierigkeiten im Vergleich mit früheren Studien sowie bei Lanzeitstudien. Die Spondylitis psoriatica stellt eine typische Manifestation der adulten Psoriasis-Arthritis dar. Die Erkrankung dieser Patienten muss im Kindesalter jedoch oft als undifferenzierte Arthritis klassifiziert werden. Die Therapie der jPsA erfolgt multidisziplinär entsprechend den Richtlinien der JIA. Die medikamentöse Behandlung schließt neben der dermatologisch topischen Versorgung die Gabe von NSAR, intraartikuläre Steroidinjektionen und je nach Verlauf auch Basismedikamente und/oder Biologika mit ein. Wichtige Bestandteile der Therapie sind Physio- und Ergotherapie sowie Hilfsmittelversorgung. Im Hinblick auf den chronischen Verlauf ist auch eine psychosoziale Betreuung von Kind und Familie erforderlich. Primär muss von einem lebenslänglichen Verlauf ausgegangen werden, weshalb beim Übergang ins Erwachsenenalter auch eine betreute Transition der Patienten in die Erwachsenenrheumatologie erfolgen sollte. Die Prognose hängt entscheidend von einer frühzeitigen konsequenten Therapie ab. Anhaltenden Remissionen stehen progredient destruktive Verläufe gegenüber. Neben einer Übersicht zum Thema werden Daten aus den Langzeitverläufen von 79 Patienten mit einer jPsA vorgestellt und diskutiert. Die ILAR-Klassifikation der jPsA bietet eine gute Klassifikationsgrundlage, definiert jedoch einige Ausschlusskriterien, die angesichts unserer Analysen zuviele Patienten aus dieser Gruppe ausgrenzen.
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Turoňová, Lenka, Kristína Kubejová, Karolína Vorčáková, Peter Ďurdík, Tatiana Péčová e Klára Martinásková. "Endothelial Dysfunction in Children with Juvenile Psoriatic Arthritis". Acta Medica (Hradec Kralove, Czech Republic) 61, n.º 3 (2018): 79–85. http://dx.doi.org/10.14712/18059694.2018.122.
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Background: To evaluate the presence of endothelial dysfunction in Slovak children with juvenile psoriatic arthritis in the absence of classic cardiovascular risk factors in order to assess its relationship to the disease activity and disability. Methods: 25 juvenile psoriatic arthritis patients (JPSA) and 25 healthy controls aged 6–19 years were enrolled into this study. In all subjects vascular measurements over a period of three years (January 2013 – January 2016) were performed, in accordance with the guidelines for ultrasonographic evaluation of FMD% (flow-mediated endothelial dependent vasodilatation) of the brachial artery. The measured items were compared to the variables reflecting the disease activity and disability. Results: Significantly lower FMD% values in patients with JPSA when compared to healthy controls {mean(SD), median, range: 5.49% (3.77), 3.55, 0.3–13.0 vs. 9.28% (1.72), 9.3, 6.4–13.1} (p < 0.001) have been documented. Strong correlations between FMD% values and disease duration (p < 0.01), non-specific inflammatory markers levels (p < 0.001) or functional disability (p < 0.01) have been observed. Significantly lower FMD% values in patients with an early disease onset (JPSA onset < 5 years of age) when compared to the rest of JPSA group {mean (SD), median, range: 4.39% (2.47), 4.45, 0.9–13.2 vs. 6.38% (1.42), 6.3, 3.2–12.1} (p < 0.01) have also been detected. Conclusion: Study is the only one addressing endothelial dysfunction development in Slovak children with psoriatic arthritides. We state that endothelial dysfunction is present in these patients even during childhood and in the absence of classic cardiovascular risk factors. Its development seems to be related to an early disease onset as well as to the increased disease activity and disability. Potential genetic predictors have also been identified.
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Facharztmagazine, Redaktion. "EU-Zulassung für Secukinumab bei EAA und jPSA". Orthopädie & Rheuma 25, n.º 4 (agosto de 2022): 51. http://dx.doi.org/10.1007/s15002-022-3607-1.
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Butbul Aviel, Yonatan, Pascal Tyrrell, Rayfel Schneider, Sandeep Dhillon, Brian M. Feldman, Ronald Laxer, Rotraud K. Saurenmann et al. "Juvenile Psoriatic Arthritis (JPsA): juvenile arthritis with psoriasis?" Pediatric Rheumatology 11, n.º 1 (2013): 11. http://dx.doi.org/10.1186/1546-0096-11-11.
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Chow, J., e L. Bennett. "Pre-training assessment tool (JPAT) - A pilot study". EDTNA-ERCA Journal 27, n.º 1 (3 de janeiro de 2001): 37–41. http://dx.doi.org/10.1111/j.1755-6686.2001.tb00134.x.
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Facharztmagazine, Redaktion. "Positive CHMP-Empfehlung für Tofacitinib bei JIA und JPsA". Orthopädie & Rheuma 24, n.º 4 (agosto de 2021): 63. http://dx.doi.org/10.1007/s15002-021-3329-9.
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Chow, J. "A PRE-TRAINING ASSESSMENT TOOL FOR HOME DIALYSIS (JPAT)". EDTNA-ERCA Journal 31, n.º 1 (3 de janeiro de 2005): 19–23. http://dx.doi.org/10.1111/j.1755-6686.2005.tb00384.x.
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Downs, William M. "APSA-JPSA Exchange: Building Bridges from Boston to Matsuyama". Political Science and Politics 36, n.º 01 (janeiro de 2003): 112. http://dx.doi.org/10.1017/s1049096503001847.
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Palmou-Fontana, N., I. Calvo, G. Diaz Cordoves Rego, A. Garcia-Rogero, J. C. Lopez Robledillo, B. P. Magallares López, P. Mesa del Castillo et al. "AB1417 HOW TO DIAGNOSE: JUVENILE PSORIATIC ARTHRITIS. MULTICENTER PROSPECTIVE OBSERVATIONAL STUDY IN CHILDREN WITH SUSPECTED DIAGNOSIS". Annals of the Rheumatic Diseases 82, Suppl 1 (30 de maio de 2023): 1937.1–1937. http://dx.doi.org/10.1136/annrheumdis-2023-eular.1883.
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BackgroundJuvenile psoriatic artritis (JPSA), a subtype of juvenile idiopathic arthritis (JIA), constitutes 5% of JIA. The literature is inconsistent regarding features of JPSA, and physicians debate whether it is a distinct entity within JA. Moreover, the criteria diagnosis for JPsA is currently in debate.There are two pediatric diagnostic classifications based on clinical criteria: ILAR classification criteria and Vancouver classification criteria. Classification of JIA has been a great debate since this entity disappeared. [1] The CASPAR criteria are standard in adults. These criteria have a specificity of 91.4% and a sensitivity of 98.7%, makingdiagnostic classification easier. However, the peculiarities of childhood cause some differences to consider.ObjectivesTo compare 3 diagnostic criteria for JPSA ILAR, Vancouver and CASPAR.MethodsMulticenter, cross-sectional study of data from children with JPsA (diagnosis by prescritor physician) who consecutivelly attended in ped-rheumatology outpatient clinic and enrolled from 9 centers within the last 1.5 years. Sociodemographic, clinical characteristics and family history of Psoriasis were collected to assess compliance with diagnostic classification criteria using using the Cohen’s Kappa statistic index.ResultsForty eight children were included with the following sociodemographics characteristics;(table1) Thirty eight children who met the VANCOUVER criteria (80,9%) while thirty two children met the ILAR criteria (68.1%). As for the CASPAR criteria, thirty eight children were diagnosed (80.9%). The diagnostic agreement between the ILAR and CASPAR criteria and ILAR and Vancouver criteria (diagnosed defined) was weak (K=0.67 and K=0.67). In contrast, the agreement was total (K=1 between the CASPAR and Vancouver criteria.ConclusionDespite minimal changes between the Vancouver and ILAR criteria, the ILAR exclusion criteria limit the diagnosis of PsA in childhood. Given that the CASPAR and Vancouver were able to detect a significant number of patients with PsA in our series (predominantly adolescents), the application of the CASPAR criteria in the subgroup of children with late onset could be considered.References[1] Alberto martini, Angelo Ravelli, Tad Avcin, et al. Toward new Classification Criteria for Juvenile Idiopathic Arthritis: First Steps, Pediatric Rheumatology International Trials Organization International Consensus; J Rheumatol. 2019: 46(2):190-197.Table 1.Clinical and demographic data of the study populationTotal (n=48)Sex, female (%)34(70.8)Age at inclusion (years), mean (SD)11.5(4)Age at articular onset (years), mean (SD)7.1(5)Age at psoriasis onset (years), mean (SD)10(3.2)Type of onset Oligoarthritis n (%)33(68.7) Poliarthritis n (%)12(25) No arthritis n (%)3(6.2)Family with Psoriasis39(81.2)Extra-articular involvement Uveitis n (%)(12.5) Entesitis n (%)7(14.6) Onicopathy n(%)14(29.2)---.Skin-Psoriasis26(54.2)Lab AAN: positive n (%)19(39.5) RF: negative n (%)48(100) HLAB27: negative n (%):43(89.6)Acknowledgements:NIL.Disclosure of InterestsNatalia Palmou-Fontana: None declared, Inmaculada Calvo Speakers bureau: ABVIEE, NOVARTIS, JANSEN, GSK, GISELLA DIAZ CORDOVES REGO: None declared, ADRIAN GARCIA-ROGERO: None declared, Juan Carlos Lopez Robledillo: None declared, Berta Paula Magallares López: None declared, Pablo Mesa del Castillo: None declared, ESTEFANIA MORENO RUZAFA: None declared, CARLOS REDONDO-FIGUERO: None declared, MARTINA STEINER: None declared, PAZ COLLADO: None declared.
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Nieves-Ríos, Christian, Guillermo A. Requejo Figueroa, Sofía C. Ayala Rodríguez, Alejandra Santiago-Díaz, Eduardo J. Rodriguez-Garcia, Alejandro L. Perez, Erick Rivera-Grana, Adriana C. Figueroa-Díaz, Rafael Martín-García e Armando L. Oliver. "Bilateral Granulomatous Iridocyclitis Associated with Early-Onset Juvenile Psoriatic Arthritis". Case Reports in Ophthalmological Medicine 2022 (7 de outubro de 2022): 1–5. http://dx.doi.org/10.1155/2022/3990406.
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Purpose. The purpose of this study is to report on a case of bilateral granulomatous iridocyclitis in a patient with early-onset juvenile psoriatic arthritis (JPsA). Methods. The method used is an observational case report. Observations. A 3-year-old Hispanic girl was sent to our uveitis service for further evaluation of her granulomatous uveitis. The initial ophthalmologic examination revealed bilateral band keratopathy, large mutton-fat keratic precipitates, multiple posterior synechiae, and 4+ anterior chamber cells. The physical exam was notable for left knee edema and right axillary rash. Laboratory testing was remarkable for an erythrocyte sedimentation rate of 80 mm/h, positive antinuclear antibodies (1 : 1, 280), and negative human leukocyte antigen B27. A cutaneous biopsy was obtained, which confirmed the diagnosis of a psoriatic rash. Treatment with oral prednisolone and topical prednisolone acetate with atropine sulfate resulted in the complete resolution of the uveitis. Conclusion and Importance. Bilateral granulomatous iridocyclitis may be a rare presentation of ocular involvement in patients with early-onset JPsA.
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Minden, K., C. Sengler e N. Brüggemann. "Die juvenile Psoriasis-Arthritis". Arthritis und Rheuma 37, n.º 06 (2017): 411–17. http://dx.doi.org/10.1055/s-0038-1624231.
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ZusammenfassungDie juvenile Psoriasis-Arthritis (jPsA), eine Subgruppe der juvenilen idiopathischen Arthritis, stellt kein einheitliches Krankheitsbild dar. Dies führt bis heute zu Schwierigkeiten bei der Klassifikation. Es sind zumindest zwei Gruppen von Patienten zu unterscheiden: i)die im Kleinkind-/Vorschulalter erkrankten, meist weiblichen, häufig ANA-positiven Patienten, die oft eine Daktylitis und/oder einen Befall kleiner Gelenke zeigen, sowie ii)jene, die im Schulalter erkranken, häufiger eine Enthesitis und/oder einen axialen Gelenkbefall aufweisen und sich damit eher wie eine Spondyloarthritis bzw. PsA des Erwachsenen präsentieren. Pathophysiologisch fand man eine Dysbalance von regulatorischen und proinflammatorischen Immunzellen und deren jeweiligen Mediatoren, hier insbesondere von dendritischen Zellen und T-Zellen mit der Produktion von IL-23, IL-17 und TNF-alpha. Aus diesen Erkenntnissen konnten neue Therapien, die spezifisch diese Mechanismen blockieren, entwickelt werden, von denen bisher allerdings nur ein TNFalpha-Blocker für die jPsA zugelassen ist. Bei gleichzeitigem Befall von Haut und Gelenken können die Patienten gegebenenfalls von der Zulassung neuer Substanzen für die Hautmanifestation profitieren.
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Collado, P., N. Palmou-Fontana, P. Mesa del Castillo, B. P. Magallares López, I. Calvo, G. Diaz-Cordobes, E. Moreno Ruzafa, M. Steiner e J. C. Lopez Robledillo. "POS0752 MUSCULOSKELETAL INVOLVEMENT IMPAIRS QUALITY OF LIFE IN JUVENILE PSORIATIC ARTHRITIS". Annals of the Rheumatic Diseases 82, Suppl 1 (30 de maio de 2023): 667.1–667. http://dx.doi.org/10.1136/annrheumdis-2023-eular.3892.
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BackgroundJuvenile psoriatic arthritis (JPsA) is one of the least common subtypes of JIA. Information on JPsA is mainly clinical, but scarce regarding the impact of musculoskeletal involvement on children’s quality of life.ObjectivesTo describe the clinical and ultrasound (US) characteristics of children with JPsA, and to assess their impact using a composite quality of life index, the PsAID (Psoriasis Arthritis Impact of Disease).MethodsA multicentre cross-sectional observational study recruited consecutive JPsA patients, from January-2020 to May-2022. Inclusion criteria: 1/ age at onset ≤ 16 years, 2/ diagnosis by the prescribing physician based on one of the 2 JPsA diagnostic classification systems (ILAR or Vancouver). All were assessed clinically and US (independently) and completed two questionnaires: PsAID (1) and Child Health Assessment Questionnaire (CHAQ, to measure physical disability). Statistics included correlation Spearman (rho) and PsAID was identified as the dependent variable.ResultsThe 48 children included (mean age at inclusion 11±4 years), 71% girls, 67% had oligoarthritis and 80% psoriasis in a first or second-degree relative. Mostly arthritis started before the psoriasis. The median time lag between the diagnosis and the onset of specific musculoskeletal manifestations was 1 year; interquartile range 0.5-2. ANA and HLAB27 were present in 19 (40%) and 5 (10%) of the children, respectively. A history of axial inflammatory symptoms was present in 3 (5%) patients, and unilateral sacroiliitis was confirmed by MRI in only one patient. Psoriasis and dactylitis were the most frequent manifestations identified (≥50%), while uveitis was less common (12%). Twenty-eight (58%) patients used methotrexate, 21 used anti-TNF agents and 14 needed corticosteroid infiltration. The population showed low clinical activity in the DAPSA composite activity index (md 3.5; range 0-25). Similarly, US showed a low number of affected joints but US was slightly superior to clinical examination, while US was clearly superior to detect enthesitis and tenosynovitis, particularly tendons of the fingers.The PsAID index (median 0.4; range 0-9.2) showed low correlation with CHAQ (r 0.3) and high with DAPSA (r 0.7); however, the correlation between PsAID and total joint count was low for both clinical and US assessment (r 0.4). The correlation between PsAID and total joint count was moderate for clinical (r 0.5) and low for US (r 0.4). Children with the presence of enthesitis and clinical dactylitis had a higher mean PsAID score than those without (dactylitis; p=0.002, and enthesitis; p<0.001).ConclusionThe study supports the existence of an atypical pattern of late-onset JPA characterised by a predominance of girls with peripheral involvement and little uveal involvement. Based on our results, dactylitis and enthesitis have a greater impact on the child’s quality of life than joint involvement per se. Studies with a larger sample size and/or disease activity are needed to confirm these findings.Reference[1]Gossec L, et al.A patient-derived and a patient-reported outcome measure for assessing psoriatic arthritis: elaboration and preliminary validation of the Psoriasis Arthritis Impact of Disease, PsAID questionnaire, a 13-country EULAR initiative. Ann Rheum Dis 2014;73:1012AcknowledgementsSociedad Española de Reumatología Pediátrica (SERPE)Disclosure of InterestsNone Declared.
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Nikishina, I., S. Arsenyeva, M. Kaleda, A. Shapovalenko, O. Kostareva, A. Latypova e T. Pachkoria. "THU0514 BIOLOGICAL THERAPY IN JUVENILE PSORIATIC ARTHRITIS – 15 YEARS OF SINGLE CENTER EXPERIENCE". Annals of the Rheumatic Diseases 79, Suppl 1 (junho de 2020): 495.2–496. http://dx.doi.org/10.1136/annrheumdis-2020-eular.6366.
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Background:Juvenile psoriatic arthritis (JPsA) is one of the clinical variants of juvenile idiopathic arthritis (JIA), which is often characterized by an unfavorable course, refractory to therapy, requiring the prescription of Biological agents (BA).Objectives:analysis of BA use in patients with JPsA and therapy survival, switching to another line of BA.Methods:the retrospective cohort study included 1095 JIA patients who received BA and were observed in our clinic from 2004 to 2019. All cases of new onset psoriasis were collected; clinical features of disease onset and course, exposure to Methotrexate (MTX) and BA, presence of ANA, HLA B27 were studied.Results:among 1095 JIA patients who received BA over the past 15 years, a separate cohort of patients with JPsA for analysis was allocated. We identified 50 pts (57% female) aged 2-18 years (Me 13.3) at the time of initiation of therapy. All patients met the JPsA classification criteria, the average age of arthritis onset was 7.4±5.3 years (ME 6.75). However, cutaneous psoriasis occurred only in 68 %(34 pts), with manifestation at the age of 10±5 years. In 25 of 34 pts (73.5%) the development of psoriasis was preceded by joint manifestations in an average of 5±3.9 (ME 3) years. 6 pts from 1095 (0.65%) developed psoriasis under BA therapy: infliximab - 2 cases (0.62/100PY), adalimumab - 3 (0.15/100PY), abatacept -1 (0.31/100PY). 2/6 pts was ANA+, 3/6 – HLA B27+. Average age of disease onset was 9.8±7.8 years; BA exposure before psoriasis was 2.7±1.1 years and in 3.6±1.3 (ME 4) after the onset of arthritis. Therapy was continued in 4/6 pts; switched from infliximab to adalimumab in 2. Serious comorbid pathology was associated with JPsA in 7 pts (type 1 diabetes mellitus – 2 pts; Down syndrome; endogenous mental illness (schizophrenia); oligophrenia; ovaries polycystic; acute lymphoblastic leukemia in a state of incomplete remission). The clinical picture of the disease was represented by polyarthritis in 84%, oligoarthritis in 8%, the same number of patients 8% had an axial lesion. Sacroiliitis was detected in 20 patients (40%), dactylitis in 21 (42%), and uveitis in 10 (20%). HLA B27 was detected in 16/35 pts (45%), 32% pts were ANA-positive. The duration of the disease at the time of application of the first BA was 5±4 (Me 3.75) years. In 49 patients, BA was used in combination with methotrexate. The total number of BA courses switching included was 80 (infliximab-19, adalimumab-22, etanercept-27, golimumab-4, abatacept-5, tocilizumab-2, rituximab-1). 49% of patients have experience of using >2 BA (16 pts-2 BA, 4 pts-3 BA, 1 pt - 5 BA). Primary/secondary inefficiency (18/35; 51%), adverse events (8/35; 23%), organizational difficulties in market access mostly after the age of 18 (7/35; 20%), and remission (2/35; 6%) were the reasons for the withdrawn of BA. Among the serious adverse events, multiple sclerosis was registered after 6 years of abatacept using (the relationship with the drug used has not been proven), pregnancy in the 3rd year of adalimumab use (interruption at 16 weeks); serious local reaction after etanercept using– 1; infusion reactions (1-rituximab, 2-infliximab); uveitis de novo (2- etanercept).Conclusion:JPsA is one of the most severe variants of JIA, characterized by a high proportion of serious comorbid conditions, the development of refractoriness and adverse events of BA therapy (including uveitis, multiple sclerosis), requiring switching to line 2 and 3 with a limited choice of BA with pediatric indications. Special study requires the manifestation of psoriasis de novo mainly developed during TNF-monoclonal antibodies therapy.Disclosure of Interests:None declared
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Joelianto, Endra, e Alex Dananjaya. "Pemrograman Ladder PLC Pada Otomasi Proses Produksi Bioetanol Berbasis Jala Petri Sinyal Terinterpretasi (JPST)". TEKNIK 41, n.º 2 (25 de agosto de 2020): 152–62. http://dx.doi.org/10.14710/teknik.v0i0.24638.
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LURATI, ALFREDOMARIA, ALESSANDRA SALMASO, VALERIA GERLONI, MAURIZIO GATTINARA e FLAVIO FANTINI. "Accuracy of Wallace Criteria for Clinical Remission in Juvenile Idiopathic Arthritis: a Cohort Study of 761 Consecutive Cases". Journal of Rheumatology 36, n.º 7 (1 de junho de 2009): 1532–35. http://dx.doi.org/10.3899/jrheum.080434.
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Objective.To evaluate disease course and clinical usefulness in some categories of juvenile idiopathic arthritis (JIA) by applying newly developed Wallace definitions of remission off drugs.Methods.In a retrospective study, charts of patients with chronic form of primary (idiopathic) arthritis followed from our center since 1970 were reviewed and clinical/laboratory variables were collected for further analysis.Results.The cohort included 761 eligible patients [516 (67.8%) female, 245 (32.2%) male] with JIA. Mean disease onset age (± standard deviation) was 6.25 ± 4.4 years (range 0.5–15.9). Disease mean duration to last visit was 10.02 ± 4.31 years. Followup mean period was 7.6 ± 6.4 years (range 1.5–35 yrs). A total of 247 (32.46%) patients achieved remission according to criteria [persistent oligoarthritis 153 (42.9%); extended oligoarthritis 15 (13.1%); seronegative polyarthritis 21 (22.4%); systemic arthritis 33 (33.7%); enthesitis related arthritis (ERA) plus juvenile psoriatic arthritis (JPsA) 25 (33.4%)]. No patients with seropositive polyarthritis achieved remission status (p < 0.001). In remitted patients the mean survival function (± standard error of the mean) before relapse calculated by Kaplan-Meier was of 20.9 (± 1.3) months overall: 21.7 (± 0.46) in persistent oligoarthritis, 25.0 (± 6.6) in extended oligoarthritis, 26.7 (± 13.2) in seronegative polyarthritis, and 17.6 (± 2.44) in ERA+JPsA (p > 0.1).Conclusion.In our cohort about one-third of cases obtained a remission episode in 4 decades of observation, with a significant difference between oligoarthritis and other categories (p < 0.001) using the Kaplan-Meier method; the remission status duration before a relapse has been about 20 months, without a significant difference between JIA categories.
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Wijayanti, Dyana, Imam Kusmaryono, Hevy Rizqi Maharani, Mohamad Aminudin, Nila Ubaidah e Mochamad Abdul Basir. "Penggunaan Open Journal System (OJS) bagi Guru SMA Negeri 1 Pegandon". Indonesian Journal of Community Services 5, n.º 1 (23 de maio de 2023): 20. http://dx.doi.org/10.30659/ijocs.5.1.20-28.
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Guru diwajibkan melaksanakan publikasi pada pangkat tertentu sebagai proses penjaminan kualitas pendidikan. Namun begitu, berbagai kendala dihadapi oleh guru dalam proses publikasi. Salah satu di antaranya adalah adaptasi penggunaan teknologi dalam mengajukan artikel pada laman �Open Journal System�. Tim pengabdian Pendidikan Matematika Unissula menyasar pada masalah tersebut dengan melaksanakan workshop Manajemen Penggunaan Open Journal System (OJS) bagi Guru SMA Negeri 1 Pegandon, Kabupaten Kendal. Kegiatan ini dilaksanakan secara hybrid, baik daring maupun luring. Secara kualitas, beberapa guru di SMAN 1 Pegandon telah mengajukan artikelnya pada laman jurnal http://jurnal.unissula.ac.id/index.php/jpsa. Secara kuantitas, kegiatan ini mendapat antusias dari banyak guru SMAN 1 Pegandon. Hal ini terbukti dengan kehadiran guru yang melebihi 80% pada kegiatan sosialisasi.
In the process of ensuring the quality of education, teachers are required to carry out publications at certain ranks. However, teachers face various obstacles in the publication process. One of them is the adaptation of the use of technology in submitting articles on the �Open Journal System� page. The Unissula Mathematics Education service team targeted this problem by conducting a Workshop on Management of the Use of the Open Journal System (OJS) for teachers at SMA Negeri 1 Pegandon, Kendal Regency. This activity is carried out in a hybrid way, both challenge and offline. In terms of quality, several teachers at SMAN 1 Pegandon have submitted their articles in the journal http://jurnal.unissula.ac.id/index.php/jpsa. Quantitatively, this activity got the enthusiasm of many teachers. This is evidenced by the presence of teachers who exceed 80% in socialization activities.
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Knitza, Johannes, Rachel Knevel, Karim Raza, Tor Bruce, Ekaterina Eimer, Isabel Gehring, Linda Mathsson-Alm et al. "Toward Earlier Diagnosis Using Combined eHealth Tools in Rheumatology: The Joint Pain Assessment Scoring Tool (JPAST) Project". JMIR mHealth and uHealth 8, n.º 5 (15 de maio de 2020): e17507. http://dx.doi.org/10.2196/17507.
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Outcomes of patients with inflammatory rheumatic diseases have significantly improved over the last three decades, mainly due to therapeutic innovations, more timely treatment, and a recognition of the need to monitor response to treatment and to titrate treatments accordingly. Diagnostic delay remains a major challenge for all stakeholders. The combination of electronic health (eHealth) and serologic and genetic markers holds great promise to improve the current management of patients with inflammatory rheumatic diseases by speeding up access to appropriate care. The Joint Pain Assessment Scoring Tool (JPAST) project, funded by the European Union (EU) European Institute of Innovation and Technology (EIT) Health program, is a unique European project aiming to enable and accelerate personalized precision medicine for early treatment in rheumatology, ultimately also enabling prevention. The aim of the project is to facilitate these goals while at the same time, reducing cost for society and patients.
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Ruperto, N., I. Foeldvari, E. Alexeeva, N. Aktay Ayaz, I. Calvo, O. Kasapcopur, V. Chasnyk et al. "LB0004 EFFICACY AND SAFETY OF SECUKINUMAB IN ENTHESITIS-RELATED ARTHRITIS AND JUVENILE PSORIATIC ARTHRITIS: PRIMARY RESULTS FROM A RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED, TREATMENT WITHDRAWAL, PHASE 3 STUDY (JUNIPERA)". Annals of the Rheumatic Diseases 80, Suppl 1 (19 de maio de 2021): 201–2. http://dx.doi.org/10.1136/annrheumdis-2021-eular.5038.
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Background:Enthesitis-related arthritis (ERA) and juvenile psoriatic arthritis (JPsA) are two ILAR categories of juvenile idiopathic arthritis (JIA) and represent paediatric correlates of axial spondyloarthritis (axSpA) and adult psoriatic arthritis (PsA), respectively.1,2 Secukinumab (SEC) has demonstrated efficacy and safety in adult patients (pts) with PsA, ankylosing spondylitis and non-radiographic axSpA.3-5Objectives:Evaluate efficacy and safety of SEC using a flare prevention design in pts with active ERA and JPsA.Methods:This 2-yr study consisted of an open-label (OL) s.c. SEC (75/150 mg in pts <50/ ≥50 kg) at baseline (BL), and at Weeks (Wk) 1, 2, 3, 4, 8 and 12 in treatment-period (TP) 1. Responder pts who achieved at least JIA ACR 30 response at Wk 12 were randomised into the double-blinded TP2 to continue SEC or placebo (PBO) q4w until a disease flare, or up to Wk 100. Pts (aged 2 to <18 yrs) classified as ERA or JPsA according to ILAR criteria of ≥6 months duration with active disease were included. Primary endpoint was time to flare in TP2 and key secondary endpoints were JIA ACR 30/50/70/90/100, inactive disease, JADAS, enthesitis count and safety. Analysis of time to flare in TP2 included proportion of disease flare, Kaplan-Meier (KM) estimate of median time to flare in days, hazard ratio (95% CI) from Cox model, and P-value for the Stratified log-rank test. KM estimates of the probability to disease flare by treatment groups in TP2 were plotted against days. Observed data were used in all analyses. Post-hoc analyses using non-responder imputation (NRI) were performed for JIA ACR 30/50/70/90/100 responses.Results:86/97 (89%) pts were enrolled in the OL period TP1 (mean age, 13.1 yrs; female, 33.7%; ERA, n=52; JPsA, n=34). At BL, mean JADAS-27 score was 15.1 and enthesitis count was 2.6. At the end of TP1, 90.4% (75/83) of pts achieved JIA ACR 30 and 69.9% (58/83) achieved JIA ACR 70. There were 21 and 10 flares in TP2, respectively in PBO and SEC treated pts with a significantly longer time to flare and 72% risk of flare reduction in SEC treatment vs PBO (HR: 0.28; 95% CI: 0.13–0.63; P<0.001) (Figure 1). JIA ACR responses, disease activity and enthesitis count are reported in Table 1. NRI analyses showed that 87.2%, 83.7%, 67.4%, 38.4% and 24.4% of pts achieved JIA ACR 30/50/70/90/100, respectively. Rates of adverse events (AEs; 91.7% vs 92.1%) and serious AEs (14.6% vs 10.5%) in SEC and PBO groups were comparable in the entire TP. No new safety signals were observed.Table 1.Efficacy of secukinumab in Treatment Periods 1 and 2 (Key secondary endpoints)Efficacy Outcomes, %TP1TP2¥SEC (N=83)^SEC (N=37)PBO (N=37)P-valueJIA ACR 3090.489.264.90.014JIA ACR 5086.778.462.20.152JIA ACR 7069.967.643.20.042JIA ACR 9039.851.440.50.431JIA ACR 10025.343.237.80.745Inactive disease#36.147.237.80.500JADAS-27, mean (SD)15.1 (7.2)14.6 (8.1)13.3 (5.8)NAEnthesitis count, mean change from BL (SD)−1.8 (2.3)−2.1 (2.0)−1.9 (1.2)NAP-values: Cochran-Mantel-Haenszel test, adjusted for analysis factors: JIA category (ERA/ JPsA) and MTX use at BL¥The N numbers are values at the end of TP2^Efficacy outcomes (%) in TP1 calculated in patients with evaluable data at Wk 12 (N=83)#Inactive disease: Definition adapted from JIA ACR criteria of Wallace et al., 2011. N=36 for SEC at the end of TP2JADAS, Juvenile Arthritis Disease Activity Score; N, total number of patients in the treatment group; NA, data not availableFigure 1.Time to flare in Treatment Period 2 (Primary Endpoint)Conclusion:In children and adolescents with ERA and JPsA, efficacy of SEC was demonstrated with a significantly longer time to flare vs PBO with sustained improvement of signs and symptoms up to Wk 104 and a favourable safety profile.References:[1]Colbert RA. Nat Rev Rheumatol. 2010;6:477–85.[2]Martini A, et al. J Rheumatol. 2019;46:190–7.[3]McInnes IB, et al. Lancet. 2015;386:1137–46.[4]Baeten D, et al. N Engl J Med. 2015;373:2534–48.[5]Deodhar A, et al. Arthritis Rheumatol. 2021;73:110–20.Disclosure of Interests:Nicolino Ruperto Consultant of: Ablynx, Astrazeneca-Medimmune, Bayer, Biogen, Boehringer, Bristol Myers and Squibb, Celgene, Eli-Lilly, EMD Serono, Glaxo Smith and Kline, Hoffmann-La Roche, Janssen, Merck, Novartis, Pfizer, R-Pharma, Sinergie, Sobi and UCB, Grant/research support from: BMS, Eli-Lilly, GlaxoSmithKline, F Hoffmann-La Roche, Janssen, Novartis, Pfizer, Sobi, Speakers bureau: Ablynx, Astrazeneca-Medimmune, Bayer, Biogen, Boehringer, Bristol Myers and Squibb, Celgene, Eli-Lilly, EMD Serono, Glaxo Smith and Kline, Hoffmann-La Roche, Janssen, Merck, Novartis, Pfizer, R-Pharma, Sinergie, Sobi and UCB, Ivan Foeldvari Consultant of: Novartis, Speakers bureau: Novartis, Ekaterina Alexeeva Grant/research support from: Novartis, Pfizer, Sanofi, MSD, AMGEN, Eli Lilly, Roche, Speakers bureau: Novartis, Pfizer, Sanofi, MSD, AMGEN, Eli Lilly, Roche, NURAY AKTAY AYAZ: None declared, Inmaculada Calvo Consultant of: Sobi, Novartis, Abbvie, GlaxoSmithKline, Pfizer, Amgen, Clementia, Speakers bureau: Sobi, Novartis, Abbvie, GlaxoSmithKline, Pfizer, Amgen, Clementia, Ozgur KASAPCOPUR: None declared, Vyacheslav Chasnyk: None declared, Markus Hufnagel Grant/research support from: Astellas, F. Hoffmann-La Roche, Novartis, Zbigniew Żuber: None declared, Grant Schulert Consultant of: Sobi, Novartis, Seza Ozen: None declared, Artem Popov: None declared, Athimalaipet Ramanan Speakers bureau: Roche, Sobi, Eli Lilly, UCB, Novartis, Christiaan Scott: None declared, Betül Sözeri: None declared, Elena Zholobova Grant/research support from: Pfizer, Novartis, Speakers bureau: Abbvie, Pfizer, Roche, Novartis, Xuan Zhu Employee of: Novartis, sarah whelan Employee of: Novartis, Shareholder of: Novartis, Luminita Pricop Employee of: Novartis, Shareholder of: Novartis, Angelo Ravelli Consultant of: Abbvie, Bristol-Myers Squibb, Pfizer, Hoffmann-LaRoche, Novartis, Centocor, Angelini Holding, Reckitt Benckiser, Speakers bureau: Abbvie, Bristol-Myers Squibb, Pfizer, Hoffmann-LaRoche, Novartis, Centocor, Angelini Holding, Reckitt Benckiser, Alberto Martini Consultant of: Eli Lilly, EMD Serono, Janssen, Novartis, Pfizer, Abbvie, Speakers bureau: Eli Lilly, EMD Serono, Janssen, Novartis, Pfizer, Abbvie, Daniel J Lovell Consultant of: AstraZeneca, Wyeth, Amgen, Abbott, Pfizer, Hoffmann-La Roche, Novartis, UBC, Takeda, Janssen, GlaxoSmithKline, Boehringer Ingelheim, Celgene, Bristol Myers Squibb, AbbVie, Forest Research, Speakers bureau: AstraZeneca, Wyeth, Amgen, Abbott, Pfizer, Hoffmann-La Roche, Novartis, UBC, Takeda, Janssen, GlaxoSmithKline, Boehringer Ingelheim, Celgene, Bristol Myers Squibb, AbbVie, Forest Research, Hermine Brunner Consultant of: Aurina, AbbVie, Astra Zeneca-Medimmune, Biogen, Boehringer, Bristol-Myers Squibb, Celgene, Eli Lilly, EMD Serono, GlaxoSmithKline, F. Hoffmann-La Roche, Merck, Novartis, R-Pharm, Sanofi, Pfizer, Grant/research support from: Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, F. Hoffmann-La Roche, Janssen, Novartis, and Pfizer, Speakers bureau: Pfizer, Roche and GlaxoSmithKline
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Baquet-Walscheid, Karoline, Kai Rothaus, Martina Niewerth, Jens Klotsche, Kirsten Minden e Arnd Heiligenhaus. "Occurrence and Risk Factors of Uveitis in Juvenile Psoriatic Arthritis: Data From a Population-based Nationwide Study in Germany". Journal of Rheumatology, 15 de janeiro de 2022, jrheum.210755. http://dx.doi.org/10.3899/jrheum.210755.
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Objective Data on uveitis in juvenile psoriatic arthritis ( JPsA), a category of juvenile idiopathic arthritis ( JIA), are scarce. We describe prevalence and risk factors for JPsA-associated uveitis ( JPsA-U). Methods Cross-sectional data from the German National Pediatric Rheumatological Database (2002–2014) were used to characterize JPsA-U and assess risk factors for the development of uveitis. Results Uveitis developed in 6.6% of 1862 patients with JPsA. Patients with JPsA-U were more frequently female (73.0 vs 62.9%, P = 0.03), antinuclear antibody (ANA) positive (60.3 vs 37.0%, P < 0.001), younger at JPsA onset (5.3 ± 4.1 vs 9.3 ± 4.4 yrs, P < 0.001), and treated with disease-modifying antirheumatic drugs (DMARDs) significantly more frequently compared with JPsA patients without uveitis. On a multivariable analysis of a subgroup of 655 patients enrolled in the study ≤ 1 year after arthritis onset, mean clinical Juvenile Arthritis Disease Activity Score for 10 joints during study documentation was significantly associated with uveitis development. Children with early onset of JPsA (aged < 5 yrs vs ≥ 5 yrs) were significantly more frequently ANA positive (48.4% vs 35.7%, P < 0.001), affected by uveitis (17.3% vs 3.8%, P < 0.001), and treated with DMARDs (52.9% vs 43.8%, P < 0.001), but less often affected by skin disease (55.3% vs 61.0%, P = 0.03). Conclusion The characteristics of patients with JPsA developing uveitis are similar to those of patients with uveitis in other JIA categories, such as oligoarticular JIA. Children with early-onset JPsA are at a higher risk for ocular involvement. Our data support the notion of a major clinical difference between those patients with early vs late onset of JPsA.
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Low, Jie Man, Kimme L. Hyrich, Coziana Ciurtin, Flora McErlane, Lucy R. Wedderburn, Nophar Geifman e Stephanie J. W. Shoop-Worrall. "The impact of psoriasis on wellbeing and clinical outcomes in juvenile psoriatic arthritis". Rheumatology, 19 de julho de 2023. http://dx.doi.org/10.1093/rheumatology/kead370.
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Abstract Objectives Juvenile psoriatic arthritis (JPsA) has varied clinical features that are distinctive to other juvenile idiopathic arthritis (JIA) categories. This study investigates whether such features impact patient-reported and clinical outcomes. Methods Children and young people (CYP) were selected if recruited to the Childhood Arthritis Prospective Study, a UK multicentre JIA inception cohort, between January 2001 and March 2018. At diagnosis, patient/parent-reported outcomes (as age-appropriate) included the parental global assessment (10 cm VAS), functional ability (CHAQ), pain (10 cm VAS), health-related quality of life (CHQ psychosocial score), mood/depressive symptoms (MFQ) and parent psychosocial health (GHQ). Three-year outcome trajectories have previously been defined using active joint counts, physician and parent global assessments (PGA, PaGA respectively). Patient-reported outcomes and outcome trajectories were compared in i) CYP with JPsA versus other JIA categories, ii) CYP within JPsA, with and without psoriasis via multivariable linear regression. Results There were no significant differences in patient-reported outcomes at diagnosis between CYP with JPsA and non-JPsA. Within JPsA, those with psoriasis had more depressive symptoms (coefficient = 9.8, 95% CI = 0.5–19.0) than those without psoriasis at diagnosis. CYP with JPsA had 2.3 times the odds of persistent high PaGA than other ILAR categories, despite improving joint counts and PGA (95% CI 1.2, 4.6). Conclusion CYP with psoriasis at JPsA diagnosis report worse mood, supporting a greater disease impact in those with both skin and joint involvement. Multidisciplinary care with added focus to support wellbeing in children with JPsA plus psoriasis may help improve these outcomes.
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Brunello, Francesco, Francesca Tirelli, Luca Pegoraro, Filippo Dell'Apa, Alessandra Alfisi, Giulia Calzamatta, Camilla Folisi e Francesco Zulian. "New Insights on Juvenile Psoriatic Arthritis". Frontiers in Pediatrics 10 (26 de maio de 2022). http://dx.doi.org/10.3389/fped.2022.884727.
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Juvenile psoriatic arthritis (JPsA) is a relatively rare condition in childhood as it represents approximately 5% of the whole Juvenile Idiopathic Arthritis (JIA) population. According to International League of Associations of Rheumatology (ILAR) classification, JPsA is defined by the association of arthritis and psoriasis or, in the absence of typical psoriatic lesions, with at least two of the following: dactylitis, nail pitting, onycholysis or family history of psoriasis in a first-degree relative. However, recent studies have shown that this classification system could conceal more homogeneous subgroups of patients differing by age of onset, clinical characteristics and prognosis. Little is known about genetic factors and pathogenetic mechanisms which distinguish JPsA from other JIA subtypes or from isolated psoriasis without joint involvement, especially in the pediatric population. Specific clinical trials testing the efficacy of biological agents are lacking for JPsA, while in recent years novel therapeutic agents are emerging in adults. In this review, we summarize the clinical features and the current evidence on pathogenesis and therapeutic options for JPsA in order to provide a comprehensive overview on the clinical management of this complex and overlapping entity in childhood.
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"10.2141/jpsa.2015/02/05". CrossRef Listing of Deleted DOIs 1 (2000). http://dx.doi.org/10.2141/jpsa.2015/02/05.
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Iwakuma, Miho, Takuya Aoki e Mariko Morishita. "Patient experience (PX) among individuals with disabilities in Japan: a mixed-methods study". BMC Primary Care 23, n.º 1 (26 de julho de 2022). http://dx.doi.org/10.1186/s12875-022-01800-0.
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Abstract Background People with disabilities (PWDs) tend to be disadvantaged in terms of receiving preventive medicine and medical checkups. About 7.6% of the Japanese population is estimated to have a disability. Although patient experience (PX) is an effective measure of patient-centeredness, little is known about the PX of PWDs. The present study aimed to compare the PX of PWDs with those of the non-disabled both quantitatively and qualitatively. Methods The present study involved a questionnaire survey and a free-response question on the survey form. The quantitative part of the study involved a comparison of JPCAT scores between PWDs and non-disabled participants. JPCAT is composed of five primary care principles: First contact, Longitudinality, Coordination, Comprehensiveness (service provided and service available), and Community orientation. Descriptive statistics were used to assess age, sex, years of education, self-rated health status, and type of disability (for PWDs). Multivariable analysis was performed using a linear regression model to detect differences between PWDs and non-disabled participants in total and domain-specific JPCAT scores. The model included the following confounding variables: age, sex, years of education, and self-rated health status. The qualitative part of the study involved a thematic analysis of answers to the free-response question. Results Data from 338 participants (169 PWDs and 169 non-disabled participants) were analyzed (response rate of 36% for PWDs). After adjusting for age, sex, years of education, and self-rated health status, PWD scores were significantly lower than those of non-disabled participants for the Longitudinality, Community Orientation, and Comprehensiveness (services available) domains of the JPCAT. Qualitative analysis yielded six themes, each of which was further divided to have Disability-Specific and General themes. Conclusions JPCAT scores in PWDs were significantly lower than those of non-disabled participants for the Longitudinality, Community Orientation, and Comprehensiveness (services available) domains. Qualitative analysis revealed that PWDs shared several themes with non-disabled participants, but also to face unique challenges due to disabilities, such as the lack of a health care provider familiar with disabilities and the insurance transition at age 65, a unique feature of the Japanese health care system. Trial registration The study was a non-interventional, observational research trial, and thus registration was not required.
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Brunner, Hermine I., Ivan Foeldvari, Ekaterina Alexeeva, Nuray Aktay Ayaz, Inmaculada Calvo Penades, Ozgur Kasapcopur, Vyacheslav G. Chasnyk et al. "Secukinumab in enthesitis-related arthritis and juvenile psoriatic arthritis: a randomised, double-blind, placebo-controlled, treatment withdrawal, phase 3 trial". Annals of the Rheumatic Diseases, 12 de agosto de 2022, annrheumdis—2022–222849. http://dx.doi.org/10.1136/ard-2022-222849.
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BackgroundTreatment options in patients with enthesitis-related arthritis (ERA) and juvenile psoriatic arthritis (JPsA) are currently limited. This trial aimed to demonstrate the efficacy and safety of secukinumab in patients with active ERA and JPsA with inadequate response to conventional therapy.MethodsIn this randomised, double-blind, placebo-controlled, treatment-withdrawal, phase 3 trial, biologic-naïve patients (aged 2 to <18 years) with active disease were treated with open-label subcutaneous secukinumab (75/150 mg in patients <50/≥50 kg) in treatment period (TP) 1 up to week 12, and juvenile idiopathic arthritis (JIA) American College of Rheumatology 30 responders at week 12 were randomised 1:1 to secukinumab or placebo up to 100 weeks. Patients who flared in TP2 immediately entered open-label secukinumab TP3 that lasted up to week 104. Primary endpoint was time to disease flare in TP2.ResultsA total of 86 patients (median age, 14 years) entered open-label secukinumab in TP1. In TP2, responders (ERA, 44/52; JPsA, 31/34) received secukinumab or placebo. The study met its primary end point and demonstrated a statistically significant longer time to disease flare in TP2 for ERA and JPsA with secukinumab versus placebo (27% vs 55%, HR, 0.28; 95% CI 0.13 to 0.63; p<0.001). Exposure-adjusted incidence rates (per 100 patient-years (PY), 95% CI) for total patients were 290.7/100 PY (230.2 to 362.3) for adverse events and 8.2/100 PY (4.1 to 14.6) for serious adverse events in the overall JIA population.ConclusionsSecukinumab demonstrated significantly longer time to disease flare than placebo in children with ERA and JPsA with a consistent safety profile with the adult indications of psoriatic arthritis and axial spondyloarthritis.Trial registration numberNCT03031782.
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"APSA/JPSA Exchange Reaches 7th Year". PS: Political Science & Politics 29, n.º 04 (dezembro de 1996): 749. http://dx.doi.org/10.1017/s1049096500045935.
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Srinivasalu, Hemalatha, Jessica Simpson e Matthew L. Stoll. "Drug therapy in juvenile spondyloarthritis". Current Opinion in Rheumatology, 22 de abril de 2024. http://dx.doi.org/10.1097/bor.0000000000001016.
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Purpose of review This review summarizes latest developments in treatment of juvenile spondyloarthritis (JSpA), specifically enthesitis-related arthritis (ERA) and juvenile psoriatic arthritis (JPsA). Recent findings There has been addition of biologic disease modifying antirheumatic drugs (bDMARDs) beyond tumor necrosis factor inhibitors (TNFi) for JSpA such as IL-17 blockers, IL-23 blockers, and janus activating kinase inhibitors with favorable safety profile. Conducting robust clinical trials for this subpopulation of JIA remains a challenge; extrapolation studies are being used to obtain approval from regulatory agencies. Summary Newer drug therapies have expanded the scope of treatment for patients with JSpA. bDMARDs such as adalimumab, etanercept, infliximab, and secukinumab have demonstrated clinically significant treatment efficacy in ERA and JPsA. Based on extrapolation studies, intravenous golimumab, etanercept, abatacept, and ustekinumab have gained Food and Drug Administration (FDA) approval for JPsA. Long-term follow-up studies continue to demonstrate acceptable safety profiles. There is need for more real-world data on drug efficacy from Registry studies and research on effective de-escalation strategies.
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"JPSA offers 300mm silicon wafer singulation capability". III-Vs Review 19, n.º 6 (agosto de 2006): 9. http://dx.doi.org/10.1016/s0961-1290(06)71737-9.
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Hashad, Soad S., Hala M. Etayari, Iman A. Almsellati, Majda N. Etfil, Aya Altwati e Zuhaira Awhida. "E25 The pattern of juvenile psoriatic arthritis in a tertiary centre in Libya". Rheumatology 62, Supplement_3 (1 de agosto de 2023). http://dx.doi.org/10.1093/rheumatology/kead323.025.
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Abstract Background Juvenile psoriatic arthritis (JPsA) is a relatively rare condition in childhood as it represents ∼5% of the whole Juvenile Idiopathic Arthritis (JIA). There are fewer reports describing the characteristics and outcome of patients with JPsA. Aim To describe the characteristic features and the treatment modalities of JPsA among Libyan children in pediatric rheumatology clinic at the Tripoli Children Hospital which is the only referral clinic covering the western, northern and southern part of Libya and to compare our results with other populations worldwide. Methods All the medical records of the children who were diagnosed to have JPsA according to ILAR classification criteria or Vancouver criteria (definite or probable) from January 2001 to January 2020 were included and retrospectively reviewed. Data were collected about demographic, clinical, and laboratory features and treatment Results The study included a total of 30 cases of JPsA that represents a 12% of total JIA cases over the study period, the mean age at presentation was 5.8 ± 5.3 years with male to female ratio of 1:1, with the mean duration of symptoms prior to diagnosis of JIA of 9 ± 10 months. The foremost common type of arthritis was peripheral polyarthritis (83% & 58.3%), with the Small joints commonly affected, 30% of patients had hip joint involvement. 13% of the patient had psoriasis, half of them before presentation of arthritis. Nail changes secondary to psoriasis was seen in 1 of the cohort, and the percentage of patients with dactylitis among the group was 30%. Family history of psoriasis found in 83% of the cohort, 26% found to be ANA positive. Chronic uveitis occurred in 10%. Patients of the total cohort, ANA positive, Unilateral anterior uveitis being the most common presentation. The following table summarizes the Medications used during the course of the disease At the time of the first visit 100%of total patients fulfilled the Vancouver criteria for juvenile PsA, While 5 of the12 patients didn’t fulfilled the ILAR criteria for JPsA. Conclusions Juvenile psoriatic arthritis constituted 12% of our patients with juvenile idiopathic arthritis. Juvenile psoriatic arthritis constitutes 8% to20% of JIA patients worldwide with equal gender distribution and peak age at presentation of 6–13 years. More than four peripheral joints involvement were the most frequent presentation. Half of the patients had skin involvement before the development of arthritis. Prevalence of chronic anterior uveitis was higher in our cohort than worldwide (10% vs 5% respectively) as an extra articular manifestation. All patients were treated with NSAIDs at presentation and/or during follow-up. Methotrexate was the most commonly used second-line agent Ethics Our study was approved by local ethical committee of pediatric department at Tripoli children hospital.
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Aoki, Takuya, Sota Zukeran e Masato Matsushima. "The role of primary care attributes in preventing loss or change of usual source of care: a nationwide cohort study". Family Practice, 21 de fevereiro de 2024. http://dx.doi.org/10.1093/fampra/cmae006.
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Abstract Background The existence of a stable usual source of care (USC) is fundamental to the provision of quality health care. However, no longitudinal studies have examined whether core primary care attributes influence the stability of USC status. Objectives We aimed to examine the association between primary care attributes (first contact, longitudinality, coordination, comprehensiveness, and community orientation) and the loss or change of USC. Methods This nationwide cohort study was conducted during the coronavirus disease 2019 pandemic using a representative sample of the Japanese adult population aged 40–75 years. The primary outcome measures were loss of USC and voluntary change in USC during the 12-month follow-up period. Primary care attributes were evaluated in the baseline survey using the Japanese version of Primary Care Assessment Tool (JPCAT). Results Data were analyzed for 725 participants who had a USC at baseline. Among them, 93 (12.8 %) lost their USC and 46 (6.3%) changed their USC during the follow-up period. Multivariable multinominal logistic regression analyses showed that the JPCAT total score was associated with decreased loss of USC and change in USC. Among the JPCAT domains, longitudinality, comprehensiveness (services available), and community orientation were associated with reductions in both USC loss and change. Conclusions Our study indicates that primary care attributes play an important role in preventing the loss or change of USC and contribute to the stability of USC status. These findings provide additional rationale for policymakers, healthcare providers, and managers to seek to strengthen core attributes of primary care.
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Hayashi, Shinu, Yutaka Shirahige, Satoshi Fujioka, Yukio Tsugihashi, Hidezaku Iida, Misaki Hirose, Masakazu Yasunaka e Noriaki Kurita. "Relationship between patient-centred care and advance care planning among home medical care patients in Japan: the Zaitaku evaluative initiatives and outcome study". Family Practice, 28 de julho de 2022. http://dx.doi.org/10.1093/fampra/cmac062.
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Abstract Background There is a growing need to realize high-quality end-of-life care at home that respects the patient’s wishes. Objective To examine the association between the quality of primary care and advance care planning (ACP) participation among patients receiving home-based medical care. Methods In this multicentre, cross-sectional study, 29 home medical care clinics in Japan were included. Adult Japanese patients receiving home medical care were surveyed to assess their consideration of ACP. The quality of primary care, which reflects patient-centredness, was assessed with the Japanese version of the Primary Care Assessment Tool-Short Form (JPCAT-SF). Information on the clinical conditions that require home medical care was collected from physicians. Results Of the 194 patients surveyed from 29 home medical services, 62 patients (32%) showed signs of ACP participation. Lack of opportunities was the most common reason for not participating in the ACP. In a multivariable-adjusted generalized estimating equation, primary care quality was associated with ACP participation (per 10-point increase, adjusted odds ratio: 1.96, 95% confidence interval: 1.51–2.56). In addition, all domains of the JPCAT-SF were associated with ACP participation. Conclusions Patient-centredness in home medical care facilitates the initiation of ACP participation.
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Chebysheva, Svetlana N., Natalia A. Geppe, Angelina V. Polyanskaya, Lelia A. Galstian, Natalia V. Alexakova, Anna V. Zhelannikova, Khaybat H. Hajiyeva et al. "The role of ultrasound diagnostics in the management of patients with juvenile psoriatic arthritis". Pediatrics. Consilium Medicum, n.º 2 (2 de dezembro de 2023). http://dx.doi.org/10.26442/26586630.2023.2.202320.
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Psoriatic arthritis (PsA) is a chronic inflammatory disease of the peripheral joints, entheses, and spine joints, affecting 10–25% of patients with psoriasis. Early diagnosis of the disease is challenging due to the possible delayed skin and joint symptoms and signs. Before the advent of ultrasound examination, the diagnosis of joint diseases was limited only to the radiological method. The ultrasound diagnosis of joint diseases in children is not established and needs a more comprehensive study.
Materials and methods. The study included 50 PsA patients aged 3 to 17 years. We performed an ultrasound examination of 178 various joints. Knee joints were involved in 46 children, hip joints in 24, ankle joints in 34, and interphalangeal joints in 10. The mean age at onset was 7.8 years (range 1.5 to 14 years). The mean duration of the disease was 4.7 years.
Results. Homogeneous joint effusion was the most common finding in patients with juvenile PsA (JPsA) – 83%. The effusion heterogeneity (17%) was due to hyperechoic inclusions (fibrin) in anechoic content. Diffuse synovium thickening was found in 91% of the joints. In 12.3% of joints, cartilage thinning was observed (in patients with a disease duration of 5 years or more), with fuzzy contours in some cases and normal echostructure in others.
Conclusion. Periarticular structures, most often ligaments and tendons, are also involved in JPsA. The inflammation progresses steadily, with the rate depending on disease activity. Joint ultrasound is a reliable and highly informative method of JPsA diagnosing. It can identify a wide range of joint abnormalities; moreover, the severity of ultrasound abnormalities correlates with the disease severity, enabling using this method for monitoring disease-modifying therapy and as a screening tool for detecting the early signs of arthritis in patients with psoriasis. Joint ultrasound helps to detect early abnormalities.