Children with juvenile arthritis have higher rates of bacterial infection

May 1, 2012, Wiley

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 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 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 use—10 mg or more of prednisone daily—more 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."

Explore further: Cancer rate 4 times higher in children with juvenile arthritis

More information: Arthritis & Rheumatism; Published Online: May 1, 2012 DOI: 10.1002/art.34458

Related Stories

Cancer rate 4 times higher in children with juvenile arthritis

February 13, 2012
New research reports that incident malignancy among children with juvenile idiopathic arthritis (JIA) is four times higher than in those without the disease. Findings now available in Arthritis & Rheumatism, a journal published ...

Recommended for you

Osteoarthritis could be treated as two diseases, scientists reveal

January 10, 2018
Scientists at The University of Manchester have discovered that most people with osteoarthritis can be subdivided into two distinct disease groups, with implications for diagnosis and drug development.

US arthritis prevalence is much higher than current estimates

November 27, 2017
New research indicates that the prevalence of arthritis in the United States has been substantially underestimated, especially among adults

Maintaining sufficient vitamin D levels may help to prevent rheumatoid arthritis

November 20, 2017
Maintaining sufficient vitamin D levels may help to prevent the onset of inflammatory diseases like rheumatoid arthritis, research led by the University of Birmingham has discovered.

Old World monkeys could be key to a new, powerful rheumatoid arthritis therapy

November 16, 2017
In the quest for a new and more effective treatment for rheumatoid arthritis, researchers from the Keck School of Medicine of USC looked to a primate that mostly roams the land in Asia, the Middle East and Africa. It was ...

Study lists foods for fighting rheumatoid arthritis symptoms and progression

November 8, 2017
A list of food items with proven beneficial effects on the progression and symptoms of rheumatoid arthritis is provided in a new study published today in Frontiers in Nutrition. The authors suggest incorporating these foods ...

Prototype equipment can detect rheumatoid arthritis

September 28, 2017
According to a first clinical study published in the scientific journal Photoacoustics, the University of Twente and various European partners have designed a device that shows the difference between healthy fingers and arthritic ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.