Arthritis und Rheuma 2017; 37(02): 126-135
DOI: 10.1055/s-0037-1618417
Kinderrheumatologie/Übersichtsarbeit
Schattauer GmbH

Die polyartikuläre Verlaufsform der juvenilen idiopathischen Arthritis

Polyarticular course of JIA
F. Weller-Heinemann
1   Prof.-Hess-Kinderklinik, Zentrum für Kinderheilkunde und Jugendmedizin am Klinikum Bremen – Mitte, Gesundheit Nord Klinikverbund Bremen, Bremen
› Author Affiliations
Further Information

Publication History

Publication Date:
27 December 2017 (online)

Zusammenfassung

Die juvenile Polyarthritis ist mit ca. 20 % die zweithäufigste Verlaufsform der juvenilen idiopathischen Arthritis (JIA). Die Polyarthritis ist aber Ursache eines bedeutenden Teils der Krankheitslast und der Langzeitprobleme der JIA. Etablierte Therapieformen mit Steroiden und konventionellen „disease-modifying antirheumatic drugs” (DMARDs) sind in den vergangenen Jahren insbesondere durch die Zulassung neuer Biologika erheblich erweitert worden. Die Erkrankung, ihre Diagnostik und aktuellen Therapiemöglichkeiten werden dargestellt.

Summary

Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory rheumatic disease in infancy and childhood. Approximately 20 % of patients suffer from the polyarticular form of the disease, which causes a substantial disease burden and long-term sequelae. Therapeutic approaches have used steroids and conventional disease-modifying antirheumatic drugs (DMARD), but over the last decade new drugs have become available for the treatment of JIA, in particular biologic DMARD. This article summarizes the clinical characteristics and outcomes, diagnosis and current treatment options of polyarticular JIA.

 
  • Literatur

  • 1 Petty RE. et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol 2004; 31 (02) 390-392.
  • 2 Modesto C, Antón J, Rodriguez B. et al. Incidence and prevalence of juvenile idiopathic arthritis in Catalonia (Spain). Scand J Rheumatol 2010; 39: 472-479.
  • 3 Adib N. et al. Association between duration of symptoms and severity of disease at first presentation to paediatric rheumatology: results from the Childhood Arthritis Prospective Study. Rheumatology (Oxford) 2008; 47 (07) 991-995.
  • 4 Abdwani R, Abdalla E, Al AS. et al. Epidemiology of juvenile idiopathic arthritis in Oman. Pediatr Rheumatol Online J 2015; 13: 33
  • 5 Prakken B. et al. Juvenile idiopathic arthritis. Lancet 2011; 377: 2138-2149.
  • 6 Greenwald AG. et al. Later-onset rheumatoid factor negative polyarticular juvenile idiopathic arthritis (JIA): a unique patient group?. Clin Exp Rheumatol 2013; 31 (04) 645-652.
  • 7 Saurenmann RK. et al. Epidemiology of juvenile idiopathic arthritis in a multiethnic cohort: ethnicity as a risk factor. Arthritis Rheum 2007; 56 (06) 1974-1984.
  • 8 Twilt M. et al. Long-term followup of temporomandibular joint involvement in juvenile idiopathic arthritis. Arthritis Rheum 2008; 59 (04) 546-552.
  • 9 Hospach T. et al. Cervical spine involvement in patients with juvenile idiopathic arthritis - MRI follow-up study. Pediatr Rheumatol Online J 2014; 12: 9
  • 10 Elhai M. et al. Radiological cervical spine involvement in young adults with polyarticular juvenile idiopathic arthritis. Rheumatology (Oxford) 2013; 52 (02) 267-275.
  • 11 Ringold S. et al. Inactive disease in polyarticular juvenile idiopathic arthritis: current patterns and associations. Rheumatology (Oxford) 2009; 48 (08) 972-977.
  • 12 Ansell BM. Juvenile chronic arthritis with persistently positive tests for rheumatoid factor (sero-positive juvenile rheumatoid arthritis). Ann Pediatr (Paris) 1983; 30 (08) 545-550.
  • 13 Schanberg LE. et al. Pain, stiffness, and fatigue in juvenile polyarticular arthritis: contemporaneous stressful events and mood as predictors. Arthritis Rheum 2005; 52 (04) 1196-1204.
  • 14 Sabri K. et al. Course, complications, and outcome of juvenile arthritis-related uveitis. J AAPOS 2008; 12 (06) 539-545.
  • 15 Kotaniemi K. et al. Occurrence of uveitis in recently diagnosed juvenile chronic arthritis: a prospective study. Ophthalmology 2001; 108 (11) 2071-2075.
  • 16 Heiligenhaus A. et al. Review for disease of the year: epidemiology of juvenile idiopathic arthritis and its associated uveitis: the probable risk factors. Ocul Immunol Inflamm 2013; 21 (03) 180-191.
  • 17 Schmeling H. et al. Efficacy and safety of adalimumab as the first and second biologic agent in juvenile idiopathic arthritis: the German Biologics JIA Registry. Arthritis Rheumatol 2014; 66 (09) 2580-2589.
  • 18 Hollenbach JA, Thompson SD, Bugawan TL. et al. Juvenile idiopathic arthritis and HLA class I and class II interactions and age-at-onset effects. Arthritis Rheum 2010; 62: 1781-1791.
  • 19 Hersh AO, Prahalad S. Immunogenetics of juvenile idiopathic arthritis: A comprehensive review. J Autoimmun 2015; 64: 113-124.
  • 20 Dueckers G. et al. Evidence and consensus based GKJR guidelines for the treatment of juvenile idiopathic arthritis. Clin Immunol 2012; 142 (02) 176-193.
  • 21 Beukelman T. et al. 2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: initiation and safety monitoring of therapeutic agents for the treatment of arthritis and systemic features. Arthritis Care Res (Hoboken) 2011; 63 (04) 465-482.
  • 22 Niehues T. 2011 Leitlinien AWMF Register Nr. 027/020
  • 23 Hashkes PJ, Laxer RM. Medical treatment of juvenile idiopathic arthritis. JAMA 2005; 294 (13) 1671-1684.
  • 24 Beukelman T. et al. Disease-modifying antirheumatic drug use in the treatment of juvenile idiopathic arthritis: a cross-sectional analysis of the CARRA Registry. J Rheumatol 2012; 39 (09) 1867-1874.
  • 25 Giannini EH. et al. Methotrexate in resistant juvenile rheumatoid arthritis. Results of the U.S.A.-U.S.S.R. double-blind, placebo-controlled trial. The Pediatric Rheumatology Collaborative Study Group and The Cooperative Children‘s Study Group. N Engl J Med 1992; 326 (16) 1043-1049.
  • 26 Alsufyani K. et al. The role of subcutaneous administration of methotrexate in children with juvenile idiopathic arthritis who have failed oral methotrexate. J Rheumatol 2004; 31 (01) 179-182.
  • 27 Ruperto N. et al. A randomized trial of parenteral methotrexate comparing an intermediate dose with a higher dose in children with juvenile idiopathic arthritis who failed to respond to standard doses of methotrexate. Arthritis Rheum 2004; 50 (07) 2191-2201.
  • 28 Céspedes-Cruz A. et al. Methotrexate improves the health-related quality of life of children with juvenile idiopathic arthritis. Ann Rheum Dis 2008; 67 (03) 309-314.
  • 29 Albers HM. Time to treatment as an important factor for the response to methotrexate in juvenile idiopathic arthritis. Arthritis Rheum 2009; 61: 46-51.
  • 30 Savolainen HA. et al. Azathioprine in patients with juvenile chronic arthritis: a longterm followup study. J Rheumatol 1997; 24 (12) 2444-2450.
  • 31 Kvien TK, Hoyeraal HM, Sandstad B. Azathioprine versus placebo in patients with juvenile rheumatoid arthritis: a single center double blind comparative study. J Rheumatol 1986; 13: 118-123.
  • 32 Curtis JR. et al. Clinical Response within 12 Weeks as a Predictor of Future Low Disease Activity in Early RA Patients: Results from the TEAR Trial. J Rheumatol 2013; 40 (05) 572-578.
  • 33 Hissink Muller. et al. A comparison of three treatment strategies in recent onset non-systemic Juvenile Idiopathic Arthritis: initial 3-months results of the BeSt for Kids-study. Pediatric Rheumatology 2017; 15: 11
  • 34 Smolen JS. et al. Efficacy and safety of leflunomide compared with placebo and sulphasalazine in active rheumatoid arthritis: a double-blind, randomised, multicentre trial. European Leflunomide Study Group. Lancet 1999; 353 9149 259-266.
  • 35 Silverman E. et al. Leflunomide or methotrexate for juvenile rheumatoid arthritis. N Engl J Med 2005; 352 (16) 1655-1666.
  • 36 Ringold S. et al. Childhood arthritis and rheumatology research alliance consensus treatment plans for new onset polyarticular juvenile idiopathic arthritis. Arthritis Care Res (Hoboken) 2014; 66: 1063-1072.
  • 37 Breit W. et al. A subgroup-specific evaluation of the efficacy of intraarticular triamcinolone hexacetonide in juvenile chronic arthritis. J Rheumatol 2000; 27 (11) 2696-2702.
  • 38 Huppertz HI. et al. Progress in pediatric rheumatology: apprehend the opportunities of the future without forgetting the lessons from the past. Rheumatol Int 2011; 31 (10) 1259-1262.
  • 39 Huppertz HI. Recommendations for juvenile idiopathic arthritis by the American College of Rheumatology: comment on the article by Beukelman. et al. Arthritis Care Res (Hoboken) 2011; 63 (09) 1354-1355. author reply 1355-1356
  • 40 Huppertz HI, Lehmann HW. Evidence of treatment of chronic inflammation in childhood and adolescence with biologics. Z Rheumatol 2014; 73 (10) 907-916.
  • 41 Beukelman T, Brunner H. Chapter 6 in: Petty R, Laxer R, et al. Textbook of Pediatric Rheumatology. Toronta, Canada: Elsevier; 2016
  • 42 Horneff G. et al. Safety and efficacy of combination of etanercept and methotrexate compared to treatment with etanercept only in patients with juvenile idiopathic arthritis (JIA): preliminary data from the German JIA Registry. Ann Rheum Dis 2009; 68 (04) 519-525.
  • 43 Lovell DJ. et al. Safety and efficacy of up to eight years of continuous etanercept therapy in patients with juvenile rheumatoid arthritis. Arthritis Rheum 2008; 58 (05) 1496-1504.
  • 44 Lovell DJ. et al. Etanercept in children with polyarticular juvenile rheumatoid arthritis. Pediatric Rheumatology Collaborative Study Group. N Engl J Med 2000; 342 (11) 763-769.
  • 45 Papsdorf V, Horneff G. Complete control of disease activity and remission induced by treatment with etanercept in juvenile idiopathic arthritis. Rheumatology (Oxford) 2011; 50 (01) 214-221.
  • 46 Nielsen S. et al. Preliminary evidence that etanercept may reduce radiographic progression in juvenile idiopathic arthritis. Clin Exp Rheumatol 2008; 26 (04) 688-692.
  • 47 Beukelman T. et al. Rates of hospitalized bacterial infection associated with juvenile idiopathic arthritis and its treatment. Arthritis Rheum 2012; 64: 2773-2780.
  • 48 Toussi SS. et al. Infections in children and adolescents with juvenile idiopathic arthritis and inflammatory bowel disease treated with tumor necrosis factor-α inhibitors: systematic review of the literature. Clin Infect Dis 2013; 57 (09) 1318-1330.
  • 49 McCroskery P. et al. Summary of worldwide pediatric malignancies reported after exposure to etanercept. Pediatr Rheumatol Online J 2010; 8: 18-26.
  • 50 Beukelman T. et al. Rates of malignancy associated with juvenile idiopathic arthritis and its treatment. Arthritis Rheum 2012; 64 (04) 1263-1271.
  • 51 Simard JF. et al. Juvenile idiopathic arthritis and risk of cancer: a nationwide cohort study. Arthritis Rheum 2010; 62 (12) 3776-3782.
  • 52 Lovell DJ. et al. Adalimumab with or without methotrexate in juvenile rheumatoid arthritis. N Engl J Med 2008; 359 (08) 810-820.
  • 53 Brunner H, Ruperto N, Tzaribachev N. et al. A 148: a multi-center, doubleblind, randomized-withdrawal trial of subcutaneous golimumab in pediatric patients with active polyarticular course juvenile idiopathic arthritis despite methotrexate therapy: week 48 results. Arthritis Rheum 2014; 66: S191-S192.
  • 54 Ruperto N. et al. Abatacept in children with juvenile idiopathic arthritis: a randomised, double-blind, placebo-controlled withdrawal trial. Lancet 2008; 372 9636 383-391.
  • 55 Brunner HI. et al. Efficacy and safety of tocilizumab in patients with polyarticular-course juvenile idiopathic arthritis: results from a phase 3, randomised, double-blind withdrawal trial. Ann Rheum Dis 2015; 74 (06) 1110-1117.
  • 56 Holzinger D. et al. The Toll-like receptor 4 agonist MRP8/14 protein complex is a sensitive indicator for disease activity and predicts relapses in systemic-onset juvenile idiopathic arthritis. Ann Rheum Dis 2012; 71 (06) 974-980.
  • 57 Arkela-Kautiainen et al. Favourable social functioning and health related quality of life of patients with JIA in early adulthood. Ann Rheum Dis 2005; 64: 875
  • 58 Selvaag AM. et al. Disease progression into adulthood and predictors of long-term active disease in juvenile idiopathic arthritis. Ann Rheum Dis 2016; 75 (01) 190-195.
  • 59 Swart JF, de Roock S, Wulffraat NM. What are the immunological consequences of long-term use of biological therapies for juvenile idiopathic arthritis?. Arthritis Res Ther 2013; 15 (03) 213
  • 60 Oen K, Malleson PN, Cabral DA. et al. Disease course and outcome of juvenile rheumatoid arthritis in a multicenter cohort. J Rheumatol 2002; 29 (09) 1989-1999.
  • 61 Minden K, Niewerth M, Listing J. et al. Long-term outcome in patients with juvenile idiopathic arthritis. Arthritis Rheum 2002; 46 (09) 2392-2401.
  • 62 Foster HE, Marshall N. et al. Outcome in adults with juvenile idiopathic arthritis: a quality of life study. Arthritis Rheum 2003; 48 (03) 767-775.
  • 63 Flato B. et al. Prognostic factors in juvenile rheumatoid arthritis: a case-control study revealing early predictors and outcome after 14.9 years. J Rheumatol 2003; 30 (02) 386-393.
  • 64 Lurati A. et al. Wallace criteria for clinical remission in juvenile idiopathic arthritis: a cohort study of 761 consecutive cases. J Rheumatol 2009; 36 (07) 1532-1535.
  • 65 Nordal E, Zak M, Aalto K. et al. Nordic Study Group of Pediatric Rheumatology. Ongoing disease activity and changing categories in a long-term Nordic cohort study of juvenile idiopathic arthritis. Arthritis Rheum 2011; 63: 2809-2818.