Influence of Reduced Folate Carrier and Aminoimidazole Carboxamide Ribonucleotide Transformylase gene polymorphisms on the efficacy of methotrexate in juvenile idiopathic arthritis

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Treatment in juvenile rheumatoid arthritis and new treatment options

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of the childhood with the highest risk of disability. Active disease persists in the adulthood in a significant portion of children with juvenile rheumatoid arthritis despite many developments in the diagnosis and treatment. Therefore, initiation of efficient treatment in the early period of the disease may provide faster control of the inflammation and prevention of long-term harms. In recent years, treatment options have also increased in children with juvenile idiopathic arthritis owing to biological medications. All biological medications used in children have been produced to target the etiopathogenesis leading to disease including anti-tumor necrosis factor, anti-interleukin 1 and anti-interleukin 6 drugs. In this review, scientific data about biological medications used in the treatment of rheumatoid arthritis and new treatment options will be discussed

Leap Motion Controller–based training for upper extremity rehabilitation in children and adolescents with physical disabilities: A randomized controlled trial

Study Design: Randomized controlled trial. Introduction: Juvenile idiopathic arthritis (JIA), cerebral palsy (CP), and brachial plexus birth injury (BPBI) are the most common disorders that cause upper extremity impairments in children and adolescents. Leap Motion Controller–based training (LMCBT) is a novel therapeutic method for upper extremity rehabilitation. Purpose of the Study: The aim of the present study was to investigate the potential efficacy of an 8-week LMCBT program set as an upper extremity rehabilitation program by comparing conventional rehabilitation program in children and adolescents with physical disabilities such as JIA, CP, and BPBI. Methods: A randomized control trial which included children and adolescents of different disabilities (JIA, CP, BPBI) were grouped according to their diagnosis. All patients were randomized into 2 groups namely LMCBT (group I) and conventional treatment (group II) for the treatment (3 days/8 weeks). Duruoz Hand Index and Jebson Taylor Hand Function Test were used as primary outcomes. Secondary outcomes included the nine-hole peg test, Childhood Health Assessment Questionnaire, and assessments of grip and pinch strength using a dynamometer. Results: One hundred three patients were included in the study, and 92 of them completed the treatment. After treatment, significant differences were found in Childhood Health Assessment Questionnaire, Duruoz Hand Index, Jebson Taylor Hand Function Test, nine-hole peg test, and grip and pinch strength scores in almost all groups (effect size [ES] = 0.10 to -0.77 for group I and 0.09 to -0.70 for group II in CP; ES = 0.31 to 2.65 for the group I and 0.12 to 1.66 for group II in JIA; and ES = 0 to -0.44 for group I and 0.08 to -0.62 for group II in BPBI) (P .05). Conclusions: This study has quantitatively shown that LMCBT should be used as an effective alternative treatment option in children and adolescents with physical disabilities.Research and Development: 215S191 215S19

Reply to comment by Kao et al on "An overview of the relationship between juvenile idiopathic arthritis and potential environmental risk factors: Do early childhood habits or habitat play a role in the affair?"

In our study, in which the relationship between juvenile idiopathic arthritis (JIA) and particular environmental factors was evaluated, a correlation could not be established between the rate or duration of breastfeeding and the development or severity of the disease. Int J Rheum Dis, 25, 2022, 1376. It was determined that the time of introduction to cow's milk differed in JIA and juvenile-onset systemic lupus erythematosus patient groups compared to healthy controls. On the other hand, the fact that income level and maternal literacy were associated with high disability and damage scores and frequent recurrence rates stood as one of the remarkable results of our study. Kao et al drew attention to the relationship between socioeconomic status and chronic arthritis and quoted an adult study. The role of the parent factor has been stressed and the effect of maternal stress on disease development has been discussed. Although JIA is a heterogeneous disease and the tribulation of measuring the direct impact of environmental elements are limiting factors, it is essential to determine the parts that can be controlled to some extent and the precautions to be taken