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Juvenile idiopathic arthritis: biomarkers predict long-term outcomes


Data presented at the European League Against Rheumatism Annual Congress ( EULAR 2014 ) have demonstrated the possibility of using biomarkers ( developed from whole blood gene expression profiles ) in children with juvenile idiopathic arthritis ( JIA ) to predict the status of their disease at 12 months.
The long-term disease status at 12 months was accurately predicted only after treatment had been initiated, in newly diagnosed patients.

Juvenile idiopathic arthritis is the most common childhood chronic rheumatic disease, affecting 16-150 children in every 100,000. The cause of JIA is largely unknown.

Blood gene expression profiling has led to major advances in the field of rheumatology over the last decade but to date it has only been possible to predict therapeutic outcome at 6 months.

In the study, researchers have discovered the appearance of different mechanisms of response in rheumatoid factor ( RF ) positive and RF negative patients after four months of therapy, a finding that could explain the relative refractoriness of RF positive patients to otherwise effective therapies.

Whole blood expression profiles were studied from children enrolled in the TREAT study, a clinical trial comparing Methotrexate ( MTX ) with Methotrexate plus Etanercept in children with newly-diagnosed juvenile idiopathic arthritis.
Gene expression profiles were examined to determine those genes whose expression levels best predicted outcome ( active vs inactive disease ) at 12 months.

Researchers have described seven types of juvenile idiopathic arthritis, which are distinguished by their signs and symptoms, the number of joints affected, the results of laboratory tests, and the family history.

In general, symptoms include joint pain, swelling, tenderness and stiffness that last for more than six continuous weeks; the condition can also affect the eyes and lymph nodes. ( Xagena )

Source: European League Against Rheumatism ( EULAR ) Meeting, 2014

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