Children with juvenile arthritis have higher rates of bacterial infection
Children with juvenile idiopathic arthritis (JIA) have higher rates of hospitalized bacterial infection than children without JIA according to an observational study appearing in Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR). The findings show that the risk of infection among JIA patients was significantly increased with use of high-dose glucocorticoids (steroids). Methotrexate (MTX) and tumor necrosis factor alpha (TNF) inhibitors were not found to increase infection risk in this pediatric population.
Arthritis is an inflammation of the joints that causes pain, swelling, stiffness and can lead to disability. JIA refers to chronic arthritis diseases that attack young patients and the ACR estimates close to 300,000 children in the U.S are affected. While immunosuppressant therapies such as steroids, MTX, and TNF inhibitors are used to treat JIA, it is unclear how they impact infection risk.
To compare bacterial infection incidence in children with and without JIA, a research team led by Dr. Timothy Beukelman from the University of Alabama at Birmingham used U.S. Medicaid data from 2000 to 2005. The team identified 8,479 JIA patients with 13,003 person-years of follow-up and a group of 360,489 children with attention-deficit hyperactivity disorder (ADHD) for comparison. Pharmacy claims were used to determine exposure to MTX, TNF inhibitors, and oral steroid medications. Infections were identified using hospital discharge diagnoses.
Researchers determined that 42% of JIA patients used MTX and 17% used TNF inhibitors to manage their disease. JIA patients without current exposure to MTX or TNF inhibitors had an increased rate of bacterial infection compared to patients with ADHD, even after adjusting for steroid use. "Patients with JIA who were not currently treated with MTX or TNF inhibitors had a 2-fold increase in hospitalized bacterial infection rates compared to children without arthritis," explains Dr. Beukelman, "This finding suggests the inflammatory or autoimmune process may predispose children to infection regardless of therapy."
Among children with JIA, the rate of infection associated with MTX or TNF inhibitor use was similar. After adjusting for MTX and TNF inhibitor use among children with JIA, high-dose steroid use10 mg or more of prednisone dailymore than doubled the rate of subsequent infection compared to patients not taking steroids. Dr. Beukelman concludes, "A steroid-sparing treatment strategy may reduce the risk of serious infection in children with JIA."
More information: Arthritis & Rheumatism; Published Online: May 1, 2012 DOI: 10.1002/art.34458
Journal reference: Arthritis & Rheumatism
Provided by Wiley
- Cancer rate 4 times higher in children with juvenile arthritis Feb 13, 2012 | not rated yet | 0
- Etanercept helps restore normal growth in children with juvenile arthritis Nov 03, 2010 | not rated yet | 0
- New clinical practice guidelines developed for juvenile idiopathic arthritis Mar 30, 2011 | not rated yet | 0
- Subclinical markers predict relapse in juvenile idiopathic arthritis post methotrexate withdrawal Jun 11, 2009 | not rated yet | 0
- Current smokers with early rheumatoid arthritis less responsive to TNF inhibitors, methotrexate Jan 04, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
siphon and bernouli theorum
1 hour ago 1. I found this diagram on book but there weren't any description.can someone tell me, what its trying to tell specially by those two red lines...
Hot gas expansion rate into outer space
1 hour ago Good Morning Sirs, it seems to be surprisingly hard to get the numbers of a mystery: How fast expand hot rocket exhaust gases into empty space? ...
Magnetic field lines through copper
6 hours ago Hello. Assume an electron gun, as in CRT, made of plumbing copper instead of glass. Using magnetic scanning coils to move electron beam. Will the...
Lagrangian of object with air resistance
8 hours ago So I was going through an ODEs textbook and in a section discussing physical problems, decided that it would be interesting to come up with the...
Does electromagnetic waves are generated by dc current?
9 hours ago I am beginner in physics.I have question that when dc current flow they flow with apparent drift velocity so it appears that it should not emit em...
Please check what's in the Ulaby book regarding reflection.
13 hours ago Attached is a scanned of the page in question. This is regarding to Perpendicularly polarized plane wave. in equation (9.47a) at the lower left...
- More from Physics Forums - Classical Physics
More news stories
(Medical Xpress)—UCD researchers led by Conway Fellow, Professor David Brayden in UCD School of Veterinary Medicine have successfully reduced inflammation in the swollen arthritic knees of a murine model using a novel nanoparticle.
Arthritis & Rheumatism May 24, 2013 | 5 / 5 (1) | 0
In a series of lab experiments designed to unravel the workings of a key enzyme widely considered a possible trigger of rheumatoid arthritis, researchers at Johns Hopkins have found that in the most severe ...
Arthritis & Rheumatism May 22, 2013 | 5 / 5 (3) | 0 |
(HealthDay)—Injections of a sugar solution appear to help relieve knee pain and stiffness related to osteoarthritis, a new study suggests.
Arthritis & Rheumatism May 21, 2013 | 4.5 / 5 (2) | 0 |
A novel study reports that white men and women of European descent inherit common foot disorders, such as bunions (hallux valgus) and lesser toe deformities, including hammer or claw toe. Findings from the Framingham Foot ...
Arthritis & Rheumatism May 20, 2013 | not rated yet | 0 |
Scientists at Johns Hopkins have turned their view of osteoarthritis (OA) inside out. Literally. Instead of seeing the painful degenerative disease as a problem primarily of the cartilage that cushions joints, ...
Arthritis & Rheumatism May 19, 2013 | 4.9 / 5 (8) | 0 |
Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality ...
4 hours ago | 5 / 5 (1) | 4
Women at a particular stage in their monthly menstrual cycle may be more vulnerable to some of the psychological side-effects associated with stressful experiences, according to a study from UCL.
23 hours ago | 3.7 / 5 (3) | 3 |
Heart failure accelerates the aging process and brings on early andropausal syndrome (AS), according to research presented today at the Heart Failure Congress 2013. AS, also referred to as male 'menopause', was four times ...
4 hours ago | not rated yet | 1
Two mutations central to the development of infantile myofibromatosis (IM)—a disorder characterized by multiple tumors involving the skin, bone, and soft tissue—may provide new therapeutic targets, according to researchers ...
20 hours ago | 3 / 5 (2) | 0 |
Biological processes are generally based on events at the molecular and cellular level. To understand what happens in the course of infections, diseases or normal bodily functions, scientists would need to ...
23 hours ago | 5 / 5 (5) | 0 |
(AP)—Department of Justice lawyers have again asked a federal appeals court in New York to delay lifting age restrictions and prescription requirements on an emergency contraceptive popularly known as the morning-after ...
4 hours ago | not rated yet | 0