Sacroiliitis in early ERA

早期 ERA 中的骶髂关节炎

• 批准号: 8639964
• 负责人: Pamela Fitch Weiss
• 金额: $ 8.21万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8639964
• 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; 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

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）：少年特发性关节炎（JIA）是童年时期最常见的风湿病，影响每1000名儿童1至4个。与肠炎有关的关节炎（ERA）和银屑病关节炎（PSA）分别占JIA的20％和10％。 ERA和PSA的特征是轴向和外围骨骼的下肢和关节炎的肠炎。患有这两种疾病的儿童也处于发育中的s骨炎或s骨关节炎症的RIK。剩下的未经治疗的s骨炎会进展到脊柱炎，这种疾病的特征是射线照相发现，侵蚀，联合性莫面，椎间管炎和轴关节的融合。在横断面研究中，分别有44％和30％的ERA和PSA儿童具有sacroiliisis的临床或放射学证据。 o诊断时，ERA和PSA儿童的s骨炎患病率尚不清楚。早期鉴定和对s骨炎的积极治疗可能是改变疾病病程的机会。如果在ERA/PSA发作时可检测到临床前的s骨炎 然后，用抗TNF药物立即治疗可能会改变s骨炎的病程，并严重影响受影响儿童和青少年的生活和生活质量。拟议的研究计划旨在确定MRI，新诊断的ERA或PSA的儿童和青少年所定义的Sacroiliisis的患病率，并评估身体和青少年在儿童和青少年中发现Sacroiliisis炎的炎症性背痛的准确性和炎症性背痛病史。本申请中提出的研究将为候选人提供有关儿童招募和入学的初步数据，以预期的患者为导向的研究，以及对两个相互关联的ERA/PSA研究的实施，进行和分析。候选人预计，该项目将建立基础，以开发和支持额外R01校外资金的应用程序：1）进一步研究临床实践中疾病发病时s骨炎的诊断和预测价值，以及小儿ERA ND PSA的试验； 2）研究全身MRI在诊断时在患有ERA或PSA的儿童中发现其他轴向骨骼病变的诊断中的作用； 3）对小儿时代和PSA的s骨炎进行前瞻性药物ePidemiology和比较有效性研究。