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Minerva Pediatrics 2021 Sep 13

DOI: 10.23736/S2724-5276.21.06343-6


lingua: Inglese

Early intra-articular corticosteroid injection is predictors of remission of juvenile idiopathic arthritis

Federica FILOSCO 1 , Alessandro GIALLONGO 1, Salvatore LEONARDI 2 , Venera TOMASELLI 3, Patrizia BARONE 2

1 Postgraduate Training Program in Pediatrics, Department of clinical and Experimental Medicine, University of Catania, Catania, Italy; 2 Department of clinical and Experimental Medicine, University of Catania, Catania Italy; 3 Department of Political and Social Sciences, University of Catania, Catania, Italy


BACKGROUND: to assess predictors of remission in children with Juvenile Idiopathic Arthritis (JIA), treated with intraarticular corticosteroid injection (IACI) as monotherapy or in combination with Methotrexate (MTX).
METHODS: a retrospective study of 43 patients diagnosed with different JIA subtypes and followed-up at a tertiary centre between 2000 and 2014. We included patients treated with IACI as monotherapy or in combination with MTX at onset or thereafter. We excluded patients treated with MTX as monotherapy or in combination with biologics. Patients were divided into two groups on the basis of assigned treatment. Primary outcomes were disease remission and duration. We performed descriptive analysis, bivariate analysis and cross-correlation analysis between variables. Statistically significant results (pvalue <0.05) were chosen as variables for multivariate analysis.
RESULTS: Median age of onset was 4.56 years (SD ± 3.85). Median time between disease onset and first IACI was 16.9 months (SD ± 34.7). We evaluated between time to remission in relation to age, time interval between onset and first IACI, time between onset and start of treatment with MTX, and time between first and second IACI. All of these were statistically significant (p-value <0.05) in bivariate analysis, but time between onset and first IACI was the only statistically significant result, using multiple linear regression analysis. Therefore, in our study, 37 patients (86%) of patients went into remission on medication after a median disease duration of 48.8 months.
CONCLUSIONS: We found that remission was related to time between onset and first IACI. Our predictive model showed that early IACI can be considered as a strong predictor of remission.

KEY WORDS: Intra-articular corticosteroid injection; Arthritis; Methotrexate; Remission; Treatments

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