No radiographic wrist damage after treatment to target in recent-onset juvenile idiopathic arthritis

P. C. E. Hissink Muller, W. G. van Braak, D. Schreurs, C. M. Nusman, S. A. Bergstra, R. Hemke, D. Schonenberg-Meinema, J. M. van den Berg, T. W. Kuijpers, Y. Koopman-Keemink, M. A. J. van Rossum, L. W. A. van Suijlekom-Smit, D. M. C. Brinkman, C. F. Allaart, R. ten Cate, M. Maas

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: To evaluate radiographic progression of patients with new-onset juvenile idiopathic arthritis (JIA) in response to an early, tightly-controlled, treatment-To-Target. Methods: Patients with JIA participating in the BeSt-for-Kids-study, randomized to 3 treatment strategy arms, were eligible if at least 1 conventional wrist-radiograph was available. Bone damage as reflected by carpal length was assessed using the Poznanski-score. The BoneXpert-method was used to determine the Bone Age (BA, > 5 years) and bone mineral density (BMD) of the wrist. These scores were evaluated over time and compared between the treatment arms and mean JADAS10-score using linear mixed models corrected for age and symptom duration. Results: In 60 patients, 252 radiographs were analysed. Baseline age and symptom duration were different between the arms. No difference in comparison to the healthy reference population was found at baseline for the Poznanski-score (IQR varying from-0,82; 0.68), nor for BA (varying from-0.88 to 0.74). Baseline BMD was statistically significantly lower in arm 3 (initial treatment with etanercept and methotrexate) (-1.48;-0.68) compared to arm 1 (-0.84;-0.04) and arm 2 (-0.93; 0.15). After treatment to target inactive disease, the Poznanski-scores and the BA remained clinically unchanged, while the BMD in arm 3 improved (p < 0.05 vs arm 1). Conclusions: Recent-onset JIA patients, treated-To-Target aimed at inactive disease, showed no signs of radiographic wrist damage (Poznanski-score, BA or BMD) either at baseline or at follow-up, irrespective of treatment arm. A lower BMD at baseline in arm 3, initially treated with methotrexate and etanercept, improved significantly after treatment. Trial registration: NTR, NL1504 (NTR1574). Registered 01-06-2009.
Original languageEnglish
Article number62
JournalPediatric Rheumatology
Volume17
Issue number1
DOIs
Publication statusPublished - 4 Sep 2019
Externally publishedYes

Cite this

Hissink Muller, P. C. E. ; van Braak, W. G. ; Schreurs, D. ; Nusman, C. M. ; Bergstra, S. A. ; Hemke, R. ; Schonenberg-Meinema, D. ; van den Berg, J. M. ; Kuijpers, T. W. ; Koopman-Keemink, Y. ; van Rossum, M. A. J. ; van Suijlekom-Smit, L. W. A. ; Brinkman, D. M. C. ; Allaart, C. F. ; ten Cate, R. ; Maas, M. / No radiographic wrist damage after treatment to target in recent-onset juvenile idiopathic arthritis. In: Pediatric Rheumatology. 2019 ; Vol. 17, No. 1.
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title = "No radiographic wrist damage after treatment to target in recent-onset juvenile idiopathic arthritis",
abstract = "Background: To evaluate radiographic progression of patients with new-onset juvenile idiopathic arthritis (JIA) in response to an early, tightly-controlled, treatment-To-Target. Methods: Patients with JIA participating in the BeSt-for-Kids-study, randomized to 3 treatment strategy arms, were eligible if at least 1 conventional wrist-radiograph was available. Bone damage as reflected by carpal length was assessed using the Poznanski-score. The BoneXpert-method was used to determine the Bone Age (BA, > 5 years) and bone mineral density (BMD) of the wrist. These scores were evaluated over time and compared between the treatment arms and mean JADAS10-score using linear mixed models corrected for age and symptom duration. Results: In 60 patients, 252 radiographs were analysed. Baseline age and symptom duration were different between the arms. No difference in comparison to the healthy reference population was found at baseline for the Poznanski-score (IQR varying from-0,82; 0.68), nor for BA (varying from-0.88 to 0.74). Baseline BMD was statistically significantly lower in arm 3 (initial treatment with etanercept and methotrexate) (-1.48;-0.68) compared to arm 1 (-0.84;-0.04) and arm 2 (-0.93; 0.15). After treatment to target inactive disease, the Poznanski-scores and the BA remained clinically unchanged, while the BMD in arm 3 improved (p < 0.05 vs arm 1). Conclusions: Recent-onset JIA patients, treated-To-Target aimed at inactive disease, showed no signs of radiographic wrist damage (Poznanski-score, BA or BMD) either at baseline or at follow-up, irrespective of treatment arm. A lower BMD at baseline in arm 3, initially treated with methotrexate and etanercept, improved significantly after treatment. Trial registration: NTR, NL1504 (NTR1574). Registered 01-06-2009.",
author = "{Hissink Muller}, {P. C. E.} and {van Braak}, {W. G.} and D. Schreurs and Nusman, {C. M.} and Bergstra, {S. A.} and R. Hemke and D. Schonenberg-Meinema and {van den Berg}, {J. M.} and Kuijpers, {T. W.} and Y. Koopman-Keemink and {van Rossum}, {M. A. J.} and {van Suijlekom-Smit}, {L. W. A.} and Brinkman, {D. M. C.} and Allaart, {C. F.} and {ten Cate}, R. and M. Maas",
year = "2019",
month = "9",
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doi = "10.1186/s12969-019-0362-1",
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Hissink Muller, PCE, van Braak, WG, Schreurs, D, Nusman, CM, Bergstra, SA, Hemke, R, Schonenberg-Meinema, D, van den Berg, JM, Kuijpers, TW, Koopman-Keemink, Y, van Rossum, MAJ, van Suijlekom-Smit, LWA, Brinkman, DMC, Allaart, CF, ten Cate, R & Maas, M 2019, 'No radiographic wrist damage after treatment to target in recent-onset juvenile idiopathic arthritis' Pediatric Rheumatology, vol. 17, no. 1, 62. https://doi.org/10.1186/s12969-019-0362-1

No radiographic wrist damage after treatment to target in recent-onset juvenile idiopathic arthritis. / Hissink Muller, P. C. E.; van Braak, W. G.; Schreurs, D.; Nusman, C. M.; Bergstra, S. A.; Hemke, R.; Schonenberg-Meinema, D.; van den Berg, J. M.; Kuijpers, T. W.; Koopman-Keemink, Y.; van Rossum, M. A. J.; van Suijlekom-Smit, L. W. A.; Brinkman, D. M. C.; Allaart, C. F.; ten Cate, R.; Maas, M.

In: Pediatric Rheumatology, Vol. 17, No. 1, 62, 04.09.2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - No radiographic wrist damage after treatment to target in recent-onset juvenile idiopathic arthritis

AU - Hissink Muller, P. C. E.

AU - van Braak, W. G.

AU - Schreurs, D.

AU - Nusman, C. M.

AU - Bergstra, S. A.

AU - Hemke, R.

AU - Schonenberg-Meinema, D.

AU - van den Berg, J. M.

AU - Kuijpers, T. W.

AU - Koopman-Keemink, Y.

AU - van Rossum, M. A. J.

AU - van Suijlekom-Smit, L. W. A.

AU - Brinkman, D. M. C.

AU - Allaart, C. F.

AU - ten Cate, R.

AU - Maas, M.

PY - 2019/9/4

Y1 - 2019/9/4

N2 - Background: To evaluate radiographic progression of patients with new-onset juvenile idiopathic arthritis (JIA) in response to an early, tightly-controlled, treatment-To-Target. Methods: Patients with JIA participating in the BeSt-for-Kids-study, randomized to 3 treatment strategy arms, were eligible if at least 1 conventional wrist-radiograph was available. Bone damage as reflected by carpal length was assessed using the Poznanski-score. The BoneXpert-method was used to determine the Bone Age (BA, > 5 years) and bone mineral density (BMD) of the wrist. These scores were evaluated over time and compared between the treatment arms and mean JADAS10-score using linear mixed models corrected for age and symptom duration. Results: In 60 patients, 252 radiographs were analysed. Baseline age and symptom duration were different between the arms. No difference in comparison to the healthy reference population was found at baseline for the Poznanski-score (IQR varying from-0,82; 0.68), nor for BA (varying from-0.88 to 0.74). Baseline BMD was statistically significantly lower in arm 3 (initial treatment with etanercept and methotrexate) (-1.48;-0.68) compared to arm 1 (-0.84;-0.04) and arm 2 (-0.93; 0.15). After treatment to target inactive disease, the Poznanski-scores and the BA remained clinically unchanged, while the BMD in arm 3 improved (p < 0.05 vs arm 1). Conclusions: Recent-onset JIA patients, treated-To-Target aimed at inactive disease, showed no signs of radiographic wrist damage (Poznanski-score, BA or BMD) either at baseline or at follow-up, irrespective of treatment arm. A lower BMD at baseline in arm 3, initially treated with methotrexate and etanercept, improved significantly after treatment. Trial registration: NTR, NL1504 (NTR1574). Registered 01-06-2009.

AB - Background: To evaluate radiographic progression of patients with new-onset juvenile idiopathic arthritis (JIA) in response to an early, tightly-controlled, treatment-To-Target. Methods: Patients with JIA participating in the BeSt-for-Kids-study, randomized to 3 treatment strategy arms, were eligible if at least 1 conventional wrist-radiograph was available. Bone damage as reflected by carpal length was assessed using the Poznanski-score. The BoneXpert-method was used to determine the Bone Age (BA, > 5 years) and bone mineral density (BMD) of the wrist. These scores were evaluated over time and compared between the treatment arms and mean JADAS10-score using linear mixed models corrected for age and symptom duration. Results: In 60 patients, 252 radiographs were analysed. Baseline age and symptom duration were different between the arms. No difference in comparison to the healthy reference population was found at baseline for the Poznanski-score (IQR varying from-0,82; 0.68), nor for BA (varying from-0.88 to 0.74). Baseline BMD was statistically significantly lower in arm 3 (initial treatment with etanercept and methotrexate) (-1.48;-0.68) compared to arm 1 (-0.84;-0.04) and arm 2 (-0.93; 0.15). After treatment to target inactive disease, the Poznanski-scores and the BA remained clinically unchanged, while the BMD in arm 3 improved (p < 0.05 vs arm 1). Conclusions: Recent-onset JIA patients, treated-To-Target aimed at inactive disease, showed no signs of radiographic wrist damage (Poznanski-score, BA or BMD) either at baseline or at follow-up, irrespective of treatment arm. A lower BMD at baseline in arm 3, initially treated with methotrexate and etanercept, improved significantly after treatment. Trial registration: NTR, NL1504 (NTR1574). Registered 01-06-2009.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/31484539

U2 - 10.1186/s12969-019-0362-1

DO - 10.1186/s12969-019-0362-1

M3 - Article

VL - 17

JO - Pediatric Rheumatology

JF - Pediatric Rheumatology

SN - 1546-0096

IS - 1

M1 - 62

ER -