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Diagnosis and treatment of enthesitis-related arthritis

Pamela F Weiss1

  • 1Division of Rheumatology and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Departments of Pediatrics and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.

Adolescent Health, Medicine and Therapeutics
|December 14, 2012
PubMed

Insights

Juvenile idiopathic arthritis (JIA) includes enthesitis-related arthritis (ERA), a condition affecting 10-20% of children. ERA management involves NSAIDs, DMARDs, and biologics, often adapted from adult RA and AS treatments.

Area of Science:

  • Pediatric Rheumatology
  • Immunology
  • Inflammatory Diseases

Background:

  • Juvenile idiopathic arthritis (JIA) is a chronic inflammatory condition of unknown cause.
  • Enthesitis-related arthritis (ERA) is a JIA subtype encompassing diverse presentations like enthesitis, arthritis, juvenile ankylosing spondylitis, and IBD-associated arthropathy.
  • ERA represents 10-20% of all JIA cases.

Purpose of the Study:

  • To describe the clinical characteristics and common manifestations of ERA in children.
  • To outline current treatment strategies for ERA.
  • To highlight the heterogeneity within the ERA JIA category.

Main Methods:

  • Literature review of JIA and ERA.
  • Analysis of clinical manifestations in ERA patients.
  • Summary of established treatment protocols for ERA.

Main Results:

  • ERA commonly presents with arthritis, enthesitis, and acute anterior uveitis.
  • Axial disease is frequently observed in children with established ERA.
  • Treatment approaches include NSAIDs, DMARDs, and biologics, often drawing from adult RA and AS protocols.

Conclusions:

  • ERA is a significant subtype of JIA with varied clinical features and a notable prevalence of axial disease.
  • Current treatment strategies for ERA are adapted from adult rheumatologic conditions.
  • Further research may refine ERA-specific treatment guidelines.

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