Juvenile idiopathic arthritis (JIA) refers to a group of chronic childhood arthropathies of unknown aetiology. Comprising seven clinically distinct subtypes, JIA is the most common form of childhood arthritis. JIA has long been thought of as a therapeutic orphan, for which no successful treatment was available, but over the past 15 years JIA treatment has been revolutionized with the development of biologic agents targeting TNF, IL-1 and IL-6. This Collection of articles covers recent developments in this field, with the aim of informing readers with regard to JIA pathogenesis, assessment and management.
PERSPECTIVES
Advances from clinical trials in juvenile idiopathic arthritis
Daniel J. Lovell, Nicola Ruperto, Edward H. Giannini & Alberto Martini
doi:10.1038/nrrheum.2013.105
Nature Reviews Rheumatology 9, 557-563 (2013)
Many advances in the treatment of juvenile idiopathic arthritis have been underpinned by the development of organizations such as PRINTO and PRCSG. This Perspectives provides a timeline for these advances, including clinical trial designs and diagnostic criteria essential to performing research in this small group of patients whose age necessitates a cautious approach to treatment.
REVIEWS
Vaccinations in juvenile chronic inflammatory diseases: an update
Clovis A. Silva, Nadia E. Aikawa & Eloisa Bonfa
doi:10.1038/nrrheum.2013.95
Nature Reviews Rheumatology 9, 532-543 (2013)
Vaccinating children with underlying rheumatic diseases is important to reduce their risk of acquiring infectious diseases. These vaccines are safe to use in this patient group, with the exceptions of profoundly immunosuppressed pateints or those with malevonate kinase deficiency. Some vaccines also induce lower than normal immune responses in these children.
Advances and challenges in imaging in juvenile idiopathic arthritis
Silvia Magni-Manzoni, Clara Malattia, Stefano Lanni & Angelo Ravelli
doi:10.1038/nrrheum.2012.30
Nature Reviews Rheumatology 8, 329-336 (2012)
Imaging modalities are vital for the accurate assessment of joint disease. In this Review, the authors focus on imaging in paediatric rheumatic disease, which presents unique challenges. They discuss the utility and limitations of various imaging techniques—including MRI, ultrasonography and conventional radiography—in the assessment and treatment of children with juvenile idiopathic arthritis.
New advances in juvenile spondyloarthritis
Shirley M. L. Tse & Ronald M. Laxer
doi:10.1038/nrrheum.2012.37
Nature Reviews Rheumatology 8, 269-279 (2012)
Spondyloarthritis in childhood (juvenile SpA) is distinct from the disease in adults, typically affecting the lower extremities (peripheral arthritis and enthesitis) with spinal or sacroiliac joint involvement rare at disease onset. This Review provides an update on the advances in diagnosis and management of juvenile SpA, summarizing classification and diagnostic criteria, clinical features, outcomes and guidelines for treatment.
Pathogenesis of systemic juvenile idiopathic arthritis: some answers, more questions
Elizabeth D. Mellins, Claudia Macaubas & Alexei A. Grom
doi:10.1038/nrrheum.2011.68
Nature Reviews Rheumatology 7, 416-426 (2011)
Several models for the pathogenesis of systemic juvenile idiopathic arthritis have been proposed, but the mechanisms underlying this disease are unclear. As outlined in this Review, intensive research in these areas has provided intriguing new insights, but numerous issues remain to be addressed.
Adult outcomes of childhood-onset rheumatic diseases
Aimee Hersh, Emily von Scheven & Ed Yelin
doi:10.1038/nrrheum.2011.38
Nature Reviews Rheumatology 7, 290-295 (2011)
As the number of patients with childhood-onset rheumatic diseases who survive into adulthood has improved markedly over the past few decades, the long-term effects of these diseases have become an important focus of research. In this Review, the authors describe the most recent outcome data for several pediatric rheumatic diseases in terms of disease activity, functional and quality of life outcomes.
NEWS & VIEWS
Paediatric rheumatology: Juvenile idiopathic arthritis—are biologic agents effective for pain?
Alessandro Consolaro & Angelo Ravelli
doi:10.1038/nrrheum.2013.108
Nature Reviews Rheumatology 9, 447-448 (2013)
Paediatric rheumatic disease: Biologic therapy and risk of infection in children with JIA
Gerd Horneff
doi:10.1038/nrrheum.2012.114
Nature Reviews Rheumatology 8, 504-505 (2012)
Pediatric rheumatic disease: Vaccination in pediatric rheumatic disease—risks and benefits
Ginger Janow & Norman T. Ilowite
doi:10.1038/nrrheum.2012.13
Nature Reviews Rheumatology 8, 188-190 (2012)
JIA in 2011: New takes on categorization and treatment
Alberto Martini
doi:10.1038/nrrheum.2011.198
Nature Reviews Rheumatology 8, 67-68 (2012)
Pediatric Rheumatology: Improving the assessment of children with JIA
Nadia Luca & Brian M. Feldman
doi:10.1038/nrrheum.2011.99
Nature Reviews Rheumatology 7, 442-444 (2011)
RESEARCH HIGHLIGHTS
Paediatric rheumatology: Biologic therapy for systemic juvenile idiopathic arthritis—times they are a'changing!
Jenny Buckland
doi:10.1038/nrrheum.2013.2
Nature Reviews Rheumatology 9, 63 (2013)
Paediatric rheumatology: New risk loci for JIA identified
David Killock
doi:10.1038/nrrheum.2013.69
Nature Reviews Rheumatology 9, 320 (2013)
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