Juvenile idiopathic arthritis: from aetiopathogenesis to therapeutic approaches.
Lina N ZaripovaAngela MidgleyStephen E ChristmasMichael W BeresfordEileen M BaildamRachel A OldershawPublished in: Pediatric rheumatology online journal (2021)
Juvenile idiopathic arthritis (JIA) is the most common paediatric rheumatological disorder and is classified by subtype according to International League of Associations for Rheumatology criteria. Depending on the number of joints affected, presence of extra-articular manifestations, systemic symptoms, serology and genetic factors, JIA is divided into oligoarticular, polyarticular, systemic, psoriatic, enthesitis-related and undifferentiated arthritis. This review provides an overview of advances in understanding of JIA pathogenesis focusing on aetiology, histopathology, immunological changes associated with disease activity, and best treatment options. Greater understanding of JIA as a collective of complex inflammatory diseases is discussed within the context of therapeutic interventions, including traditional non-biologic and up-to-date biologic disease-modifying anti-rheumatic drugs. Whilst the advent of advanced therapeutics has improved clinical outcomes, a considerable number of patients remain unresponsive to treatment, emphasising the need for further understanding of disease progression and remission to support stratification of patients to treatment pathways.
Keyphrases
- juvenile idiopathic arthritis
- disease activity
- rheumatoid arthritis
- systemic lupus erythematosus
- rheumatoid arthritis patients
- ankylosing spondylitis
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- prognostic factors
- peritoneal dialysis
- intensive care unit
- emergency department
- oxidative stress
- genome wide
- physical activity
- small molecule
- gene expression
- drug induced
- sleep quality
- replacement therapy