Sacroiliitis in early ERA

早期 ERA 中的骶髂关节炎

基本信息

批准号：
8442283
负责人：
Pamela Fitch Weiss
金额：
$ 6.82万
依托单位：
CHILDREN'S HOSP OF PHILADELPHIA
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-04-01 至 2015-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8442283
关键词：
Accounting Address Adolescent Adult Affect Age Ankylosis Anti-Inflammatory Agents Anti-inflammatory Antirheumatic Agents Arthritis Back Pain Buttocks Categories Child Childhood Chronic Chronic Childhood Arthritis Clinical Clinical Trials Cross-Sectional Studies Data Detection Diagnosis Diagnostic Disease Early Diagnosis Early identification Early treatment Enrollment Exercise Extramural Activities Foundations Functional disorder Funding Future Gold Hip region structure Image Inflammation Inflammatory Intervention Studies Joints Knee Lateral Left Lesion Low Back Pain Lower Extremity Magnetic Resonance Imaging Morbidity - disease rate Newly Diagnosed Onset of illness Outcome Pain Palpation Pelvis Peripheral Pharmaceutical Preparations Pharmacoepidemiology Physical Examination Population Predictive Value Prevalence Psoriatic Arthritis Quality of life Recording of previous events Recovery Research Research Project Grants Rheumatism Risk Role Sacroiliac joint structure Sensitivity and Specificity Skeleton Spinal Spondylitis Testing Time Tumor Necrosis Factor-alpha X-Ray Computed Tomography clinical practice cohort comparative effectiveness design improved patient oriented research pre-clinical pressure prevent prospective sex

项目摘要

DESCRIPTION (provided by applicant): Juvenile idiopathic arthritis (JIA) is the most commonly diagnosed rheumatic disease in childhood, affecting 1 to 4 per 1,000 children. Enthesitis-related arthritis (ERA) and psoriatic arthritis (PsA) account for approximately 20% and 10% of JIA, respectively. ERA and PsA are characterized by enthesitis of the lower extremities and arthritis of the axial and peripheral skeleton. Children with these 2 conditions are also at rik of developing sacroiliitis, or inflammation of the sacroiliac joints. Left untreated, sacroiliitis ay progress to spondylitis, a condition characterized by radiographic findings of squaring, erosions, syndesmophytes, diskitis, and fusion of the axial joints. In cross-sectional studies as many as 44% and 30% of children with ERA and PsA, respectively, have clinical or radiographic evidence of sacroiliitis. The prevalence of sacroiliitis in children with ERA and PsA at the time o diagnosis is unknown. Early identification and aggressive treatment of sacroiliitis may be an opportunity to alter the disease course. If pre-clinical sacroilitis is detectable at ERA/PsA onset then immediate treatment with anti-TNF agents may alter the course of sacroiliitis and greatly impact the function and quality of life of affected children and adolescents. The proposed research plan is designed to determine the prevalence of sacroiliitis, as defined by MRI, in children and adolescents with newly diagnosed ERA or PsA, and to assess the accuracy of physical examination and a history of inflammatory back pain for the detection of sacroiliitis in children and adolescents. The research proposed in this application will provide the candidate with preliminary data regarding the recruitment and enrollment of children in prospective patient- oriented research, and the implementation, conduct, and analysis of two inter-related ERA/PsA studies. The candidate anticipates this project will build the foundation to develop and support applications for additional R01 extramural funding to: 1) further investigate the diagnostic and predictive value of sacroiliitis at disease onset in clinical practice and trials of pediatric ERA nd PsA; 2) investigate the role of whole body MRI at diagnosis for the detection of additional axial skeleton lesions in children with ERA or PsA at the time of diagnosis; and 3) perform prospective pharmacoepidemiology and comparative effectiveness studies for the treatment of sacroiliitis in pediatric ERA and PsA.

描述（由申请人提供）：幼年特发性关节炎 (JIA) 是儿童期最常诊断的风湿性疾病，每 1,000 名儿童中就有 1 至 4 人受影响。附着点炎相关关节炎 (ERA) 和银屑病关节炎 (PsA) 分别约占 JIA 的 20% 和 10%。 ERA和PsA的特征是下肢附着点炎以及中轴和外周骨骼的关节炎。患有这两种疾病的儿童也有患骶髂关节炎或骶髂关节炎症的风险。如果不及时治疗，骶髂关节炎可能会发展为脊柱炎，这种疾病的特征是放射学检查结果显示方形、糜烂、韧带骨赘、椎间盘炎和轴关节融合。在横断面研究中，分别有多达 44% 和 30% 的 ERA 和 PsA 儿童有骶髂关节炎的临床或放射学证据。 ERA 和 PsA 儿童诊断时骶髂关节炎的患病率尚不清楚。骶髂关节炎的早期识别和积极治疗可能是改变病程的机会。如果在 ERA/PsA 发病时可检测到临床前骶髂关节炎那么立即使用抗 TNF 药物治疗可能会改变骶髂关节炎的病程，并极大地影响受影响儿童和青少年的功能和生活质量。拟议的研究计划旨在确定新诊断 ERA 或 PsA 的儿童和青少年中 MRI 定义的骶髂关节炎的患病率，并评估体检和炎性背痛病史在儿童和青少年中检测骶髂关节炎的准确性。儿童和青少年。本申请中提出的研究将为候选人提供有关在前瞻性患者导向研究中招募和登记儿童的初步数据，以及两项相互关联的 ERA/PsA 研究的实施、实施和分析。候选人预计该项目将为开发和支持额外 R01 外部资金的申请奠定基础，以：1）在儿科 ERA 和 PsA 的临床实践和试验中进一步研究疾病发作时骶髂关节炎的诊断和预测价值； 2) 研究全身 MRI 在诊断时对 ERA 或 PsA 儿童额外中轴骨骼病变检测的作用； 3) 对儿科 ERA 和 PsA 中骶髂关节炎的治疗进行前瞻性药物流行病学和比较有效性研究。