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Infectious complications in juvenile idiopathic arthritis
Andrew Hurd1, Timothy Beukelman
1Department of Pediatrics, Division of Rheumatology, The University of Alabama at Birmingham, Children's Park Place 210, 1600 7th Ave South, Birmingham, AL 35233, USA. ahurd@peds.uab.edu
Current Rheumatology Reports
|March 27, 2013
Summary
Juvenile idiopathic arthritis (JIA) may increase infection risk, even without immunosuppressants. Treatments like methotrexate and TNF inhibitors show a modest or no increase in serious infections for children with JIA.
Area of Science:
- Pediatric Rheumatology
- Infectious Disease Epidemiology
- Clinical Immunology
Background:
- Juvenile idiopathic arthritis (JIA) is the most prevalent rheumatic condition in childhood.
- Uncertainty exists regarding infection risks associated with JIA and its immunosuppressive therapies.
- JIA itself may elevate the baseline risk for serious bacterial infections.
Purpose of the Study:
- To evaluate the infection risk in children diagnosed with JIA.
- To assess the impact of immunosuppressive treatments on infection rates in JIA patients.
- To determine the safety of intra-articular glucocorticoid injections for JIA.
Main Methods:
- Review of existing evidence on infection risks in JIA.
- Analysis of data concerning methotrexate and TNF inhibitor use in JIA.
- Assessment of opportunistic infection rates in JIA cohorts.
- Evaluation of infectious complications from intra-articular glucocorticoid injections.
Main Results:
- JIA appears to increase the risk of serious bacterial infections independently of immunosuppressant use.
- Methotrexate and TNF inhibitors demonstrate a modest or negligible increase in serious infection risk.
- Opportunistic infections are rare but potentially more frequent in JIA patients compared to controls.
- Intra-articular glucocorticoid injections are generally safe, with rare infectious complications when administered carefully.
Conclusions:
- JIA patients face an elevated risk of serious bacterial infections.
- Current immunosuppressive treatments for JIA have a limited impact on infection risk.
- Further controlled studies, especially comparative trials of new therapies, are essential for a comprehensive understanding of JIA-associated infection risks.
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