Are infections in children with juvenile idiopathic arthritis more frequent than in healthy children? A prospective multicenter observational study
BackgroundChildren with juvenile idiopathic arthritis (JIA) might be at a higher risk of infection. Our objectives are to describe and compare infection rates in patients with JIA vs. healthy patients.MethodsA prospective, multicenter observational study was performed in Spain from January 2017 to J...
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| Format: | Article |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.917731/full |
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| author | Clara Udaondo Clara Udaondo Clara Udaondo Esmeralda Núñez Cuadros Sara Murias Agustin Remesal Rosa Alcobendas Concepción Guerrero Sara Guillen-Martin Sara Guillen-Martin Marta Escuredo Esther Aleo Daniel Alonso Alfredo Tagarro Alfredo Tagarro Alfredo Tagarro Alfredo Tagarro Eloisa De Santiago Marisol Camacho-Lovillo Fatima Diaz Dolores Arenas Pilar Camacho Maria Jose Lirola Mariana Díaz Almirón Mariana Díaz Almirón Cristina Calvo Cristina Calvo Cristina Calvo |
| author_facet | Clara Udaondo Clara Udaondo Clara Udaondo Esmeralda Núñez Cuadros Sara Murias Agustin Remesal Rosa Alcobendas Concepción Guerrero Sara Guillen-Martin Sara Guillen-Martin Marta Escuredo Esther Aleo Daniel Alonso Alfredo Tagarro Alfredo Tagarro Alfredo Tagarro Alfredo Tagarro Eloisa De Santiago Marisol Camacho-Lovillo Fatima Diaz Dolores Arenas Pilar Camacho Maria Jose Lirola Mariana Díaz Almirón Mariana Díaz Almirón Cristina Calvo Cristina Calvo Cristina Calvo |
| author_sort | Clara Udaondo |
| collection | DOAJ |
| description | BackgroundChildren with juvenile idiopathic arthritis (JIA) might be at a higher risk of infection. Our objectives are to describe and compare infection rates in patients with JIA vs. healthy patients.MethodsA prospective, multicenter observational study was performed in Spain from January 2017 to June 2019. Patients with JIA from 7 participating hospitals and children without JIA (siblings of patients with JIA, and non-JIA children from primary health centers) were followed up with quarterly questionnaires to record infection episodes. Tuberculosis, herpes zoster, and infections requiring hospital admission were considered severe infections. Rates of infection (episodes/patient/year) were compared using a generalized estimating equations model.ResultsA total of 371 children (181 with and 190 without JIA) were included. The median age was 8.8 years (IQR 5.5–11.3); 75% of the patients with JIA received immunosuppressive treatment (24% methotrexate, 22% biologic, 26% both). A total of 667 infections were recorded; 15 (2.2%) were considered severe. The infection rate was 1.31 (95%CI 1.1–1.5) in JIA and 1.12 (95%CI 0.9–1.3) in non-JIA participants (p = 0.19). Age <4 years increased the infection rate by 2.5 times (2.72 vs. 1.12, p < 0.001) in both groups. The most frequent infection sites were upper respiratory (62.6% vs. 74.5%) and gastrointestinal (18.8% vs. 11.4%). There were no differences in severe infections (2.5% vs. 2%, p = 0.65) between the groups. In children with JIA, younger age and higher disease activity (JADAS71) were associated with a higher infection rate.ConclusionWe found no differences in the infection rate or infection severity between patients with and without JIA. Most infections were mild. An age younger than 4 years increased the infection risk in both groups. Higher disease activity was associated with a higher infection rate. |
| first_indexed | 2024-12-10T16:00:32Z |
| format | Article |
| id | doaj.art-2a5353c78fbe4e96abb40dedb55aea0b |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-10T16:00:32Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-2a5353c78fbe4e96abb40dedb55aea0b2022-12-22T01:42:26ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-08-011010.3389/fped.2022.917731917731Are infections in children with juvenile idiopathic arthritis more frequent than in healthy children? A prospective multicenter observational studyClara Udaondo0Clara Udaondo1Clara Udaondo2Esmeralda Núñez Cuadros3Sara Murias4Agustin Remesal5Rosa Alcobendas6Concepción Guerrero7Sara Guillen-Martin8Sara Guillen-Martin9Marta Escuredo10Esther Aleo11Daniel Alonso12Alfredo Tagarro13Alfredo Tagarro14Alfredo Tagarro15Alfredo Tagarro16Eloisa De Santiago17Marisol Camacho-Lovillo18Fatima Diaz19Dolores Arenas20Pilar Camacho21Maria Jose Lirola22Mariana Díaz Almirón23Mariana Díaz Almirón24Cristina Calvo25Cristina Calvo26Cristina Calvo27Pediatric Rheumatology Unit, University Hospital La Paz, Madrid, SpainLa Paz Research Institute (IDIPaz), Madrid, SpainCIBERINFEC ISCIII, Madrid, SpainPediatric Rheumatology Unit, UCG Pediatría, Hospital Regional Universitario de Málaga, Málaga, SpainPediatric Rheumatology Unit, University Hospital La Paz, Madrid, SpainPediatric Rheumatology Unit, University Hospital La Paz, Madrid, SpainPediatric Rheumatology Unit, University Hospital La Paz, Madrid, SpainPediatrics, CS Tres Cantos, Madrid, SpainPediatric Rheumatology Unit, UCG Pediatría, Hospital Regional Universitario de Málaga, Málaga, SpainPediatrics, Hospital de Getafe, Madrid, SpainPediatrics, CS Parque Europa, Madrid, SpainPediatrics, Fundación para la Investigación del Hospital Clínico San Carlos, Hospital Clinico San Carlos, Madrid, SpainPediatrics, CS Lucero, Madrid, Spain0Fundación de Investigación Biomédica Hospital 12 de Octubre. Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain1Department of Pediatrics, Infanta Sofía University Hospital, Madrid, Spain2Infanta Sofia University Hospital and Henares University Hospital Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid, Spain3Facultad de Medicina, Universidad Europea de Madrid, Madrid, Spain4Pediatrics, CS Tiro de Pichon, Málaga, Spain5Pediatric Immunology, Rheumatology and Infectious Diseases Department, Hospital Universitario Virgen del Rocío, Seville, Spain6Pediatrics, CS San Hilario, Seville, Spain7Pediatrics, CS Cisneo Alto, Seville, Spain8Pediatrics, Centro Alcala de Guadaira, Seville, Spain9Pediatric Rheumatology, Grupo IHP - Instituto Hispalense de Pediatría, Seville, SpainCIBERINFEC ISCIII, Madrid, Spain0Biostatistics, Investigation department, IDIPaz, University Hospital La Paz, Madrid, SpainCIBERINFEC ISCIII, Madrid, SpainPediatric Rheumatology Unit, UCG Pediatría, Hospital Regional Universitario de Málaga, Málaga, Spain1Pediatric Infectious Diseases Department, University Hospital La Paz, Madrid, SpainBackgroundChildren with juvenile idiopathic arthritis (JIA) might be at a higher risk of infection. Our objectives are to describe and compare infection rates in patients with JIA vs. healthy patients.MethodsA prospective, multicenter observational study was performed in Spain from January 2017 to June 2019. Patients with JIA from 7 participating hospitals and children without JIA (siblings of patients with JIA, and non-JIA children from primary health centers) were followed up with quarterly questionnaires to record infection episodes. Tuberculosis, herpes zoster, and infections requiring hospital admission were considered severe infections. Rates of infection (episodes/patient/year) were compared using a generalized estimating equations model.ResultsA total of 371 children (181 with and 190 without JIA) were included. The median age was 8.8 years (IQR 5.5–11.3); 75% of the patients with JIA received immunosuppressive treatment (24% methotrexate, 22% biologic, 26% both). A total of 667 infections were recorded; 15 (2.2%) were considered severe. The infection rate was 1.31 (95%CI 1.1–1.5) in JIA and 1.12 (95%CI 0.9–1.3) in non-JIA participants (p = 0.19). Age <4 years increased the infection rate by 2.5 times (2.72 vs. 1.12, p < 0.001) in both groups. The most frequent infection sites were upper respiratory (62.6% vs. 74.5%) and gastrointestinal (18.8% vs. 11.4%). There were no differences in severe infections (2.5% vs. 2%, p = 0.65) between the groups. In children with JIA, younger age and higher disease activity (JADAS71) were associated with a higher infection rate.ConclusionWe found no differences in the infection rate or infection severity between patients with and without JIA. Most infections were mild. An age younger than 4 years increased the infection risk in both groups. Higher disease activity was associated with a higher infection rate.https://www.frontiersin.org/articles/10.3389/fped.2022.917731/fulljuvenile idiopathic arthritis (JIA)safetyinfectionsmethotrexatetumor necrosis alpha antagonistinfection rate |
| spellingShingle | Clara Udaondo Clara Udaondo Clara Udaondo Esmeralda Núñez Cuadros Sara Murias Agustin Remesal Rosa Alcobendas Concepción Guerrero Sara Guillen-Martin Sara Guillen-Martin Marta Escuredo Esther Aleo Daniel Alonso Alfredo Tagarro Alfredo Tagarro Alfredo Tagarro Alfredo Tagarro Eloisa De Santiago Marisol Camacho-Lovillo Fatima Diaz Dolores Arenas Pilar Camacho Maria Jose Lirola Mariana Díaz Almirón Mariana Díaz Almirón Cristina Calvo Cristina Calvo Cristina Calvo Are infections in children with juvenile idiopathic arthritis more frequent than in healthy children? A prospective multicenter observational study Frontiers in Pediatrics juvenile idiopathic arthritis (JIA) safety infections methotrexate tumor necrosis alpha antagonist infection rate |
| title | Are infections in children with juvenile idiopathic arthritis more frequent than in healthy children? A prospective multicenter observational study |
| title_full | Are infections in children with juvenile idiopathic arthritis more frequent than in healthy children? A prospective multicenter observational study |
| title_fullStr | Are infections in children with juvenile idiopathic arthritis more frequent than in healthy children? A prospective multicenter observational study |
| title_full_unstemmed | Are infections in children with juvenile idiopathic arthritis more frequent than in healthy children? A prospective multicenter observational study |
| title_short | Are infections in children with juvenile idiopathic arthritis more frequent than in healthy children? A prospective multicenter observational study |
| title_sort | are infections in children with juvenile idiopathic arthritis more frequent than in healthy children a prospective multicenter observational study |
| topic | juvenile idiopathic arthritis (JIA) safety infections methotrexate tumor necrosis alpha antagonist infection rate |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.917731/full |
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