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Cardiovascular Disease in Juvenile Idiopathic Arthritis
Elisavet Arsenaki1, Panagiotis Georgakopoulos2, Panagiota Mitropoulou3
1St. George's University of London, London, United Kingdom.
Insights
Juvenile idiopathic arthritis (JIA) patients, especially those with systemic forms, face increased long-term cardiovascular risks due to adverse lipid profiles and early arterial changes. Holistic management including CV screening is recommended.
Area of Science:
- Rheumatology
- Cardiology
- Pediatrics
Background:
- Juvenile idiopathic arthritis (JIA) comprises inflammatory disorders starting before age 16.
- While many children achieve remission, systemic or polyarticular JIA can persist into adulthood.
- Pathogenesis overlap with adult rheumatic diseases raises concerns about long-term cardiovascular (CV) risk in JIA patients.
Purpose of the Study:
- To review evidence of CV involvement in JIA.
- To present data on CV risk factors and arterial disease markers in JIA.
- To discuss medication effects and propose CV screening strategies for JIA management.
Main Methods:
- Literature review summarizing current evidence.
- Analysis of CV risk factors and surrogate markers in JIA.
- Evaluation of anti-inflammatory medication effects on CV health.
Main Results:
- Systemic JIA patients exhibit unfavorable lipid profiles and early arterial changes.
- These changes suggest accelerated arterial disease progression.
- Data on actual CV outcomes in JIA is limited.
Conclusions:
- JIA, particularly systemic forms, is associated with indicators of accelerated cardiovascular disease.
- A comprehensive management approach for JIA is crucial.
- This approach should integrate CV risk factor monitoring, lifestyle modifications, and judicious use of CV-safe anti-inflammatory therapies.
Abstract:
Juvenile idiopathic arthritis (JIA), is a term used to describe a group of inflammatory disorders beginning before the age of 16 years. Although for the majority of children remission is achieved early, those with systemic or polyarticular form of the disease may present persistent symptoms in adulthood. Considering that there is overlap in the pathogenesis of JIA with adult rheumatic diseases, concerns have been raised as to whether JIA patients could be at increased cardiovascular (CV) risk in the long-term. In this review, we summarize evidence for CV involvement in JIA and present data on CV risk factors and surrogate markers of arterial disease. We also provide information on beneficial and harmful CV effects of anti-inflammatory medications in the context of JIA and suggest strategies for CV screening. Overall, patients with systemic forms of JIA demonstrate an adverse lipid profile and early arterial changes relevant to accelerated arterial disease progression. Although there is paucity of data on CV outcomes, we recommend a holistic approach in the management of JIA patients, which includes CV risk factor monitoring and lifestyle modification as well as use, when necessary, of antiinflammatory therapies with documented CV safety.
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