Juvenile spondyloarthritis.

TitleJuvenile spondyloarthritis.
Publication TypeJournal Article
Year of Publication2015
AuthorsGmuca S, Weiss PF
JournalCurr Opin Rheumatol
Volume27
Issue4
Pagination364-72
Date Published07/2015
ISSN1531-6963
Abstract

PURPOSE OF REVIEW: This article provides a comprehensive update of the pathogenesis, diagnostic imaging, treatments, and disease activity measurements of juvenile spondyloarthritis (JSpA).

RECENT FINDINGS: Genetic and microbiome studies have provided new information regarding possible pathogenesis of JSpA. Recent work suggests that children with JSpA have decreased thresholds for pain in comparison to healthy children. In addition, pain on physical examination and abnormalities on ultrasound of the entheses are not well correlated. Treatment guidelines for juvenile arthritis, including JSpA, were published by the American College of Rheumatology and are based on active joint count and presence of sacroiliitis. Recent studies have established the efficacy of tumor necrosis factor inhibitors in the symptomatic treatment of axial disease, although their efficacy for halting progression of structural damage is less clear. Newly developed disease activity measures for JSpA include the Juvenile Arthritis Disease Activity Score and the JSpA disease activity index. In comparison to other categories of juvenile arthritis, children with JSpA are less likely to attain and sustain inactive disease.

SUMMARY: Further microbiome and genetic research may help elucidate JSpA pathogenesis. More randomized therapeutic trials are needed and the advent of new composite disease activity measurement tools will hopefully allow the design of these greatly needed trials.

DOI10.1097/BOR.0000000000000185
Alternate JournalCurr Opin Rheumatol
PubMed ID26002028
PubMed Central IDPMC4486266
Grant List1-K23-AR059749-01A1 / AR / NIAMS NIH HHS / United States
K23 AR059749 / AR / NIAMS NIH HHS / United States
R03 AR062665 / AR / NIAMS NIH HHS / United States