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Pediatric Rheumatology Comes of Age: Part I
The twenty-first century has been a time of enormous growth for pediatric rheumatology worldwide, spurred by the growing availability of multiple effective treatments and recognition that collaborative research is necessary to study successfully even the most common of pediatric rheumatic diseases. In North America, the incorporation and maturation of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) coincides with critical progress in approaches to treatment, disease pathogenesis, and ever-expanding medication options. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - September 7, 2021 Category: Rheumatology Authors: Yukiko Kimura, Laura E. Schanberg Tags: Preface Source Type: research

Pediatric Rheumatology Comes of Age
The twenty-first century has been a time of enormous growth for pediatric rheumatology worldwide, spurred by the growing availability of multiple effective treatments and recognition that collaborative research is necessary to study successfully even the most common of pediatric rheumatic diseases. In North America, the incorporation and maturation of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) coincides with critical progress in approaches to treatment, disease pathogenesis, and ever-expanding medication options. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - September 7, 2021 Category: Rheumatology Authors: Yukiko Kimura, Laura E. Schanberg Tags: Preface Source Type: research

Juvenile Idiopathic Arthritis Treatment Updates
This article discusses the key clinical features of juvenile idiopathic arthritis and treatment updates for oligoarthritis, polyarthritis, enthesitis-related arthritis, psoriatic arthritis, and systemic arthritis. Paradigm changes in management include the earlier use of biologic agents and the introduction of biosimilars and targeted synthetic disease modifying agents like tofacitinib. This review summarizes recent developments while considering potential areas for improvement and study. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - September 2, 2021 Category: Rheumatology Authors: Karen Onel, Dax G. Rumsey, Susan Shenoi Source Type: research

Updates on Juvenile Dermatomyositis from the Last Decade: Classification to Outcomes
Juvenile dermatomyositis (JDM) is a heterogeneous disease with new classification criteria and updates in myositis-specific autoantibody and myositis-associated antibody groups. There are many validated assessment tools for assessing disease activity in JDM. Future studies will optimize these tools and improve feasibility in clinical and research contexts. Genetic and environmental risk factors, mechanisms of muscle pathology, role of interferon, vascular markers, and changes in immune cells provide insights to JDM pathogenesis. Outcomes have improved, but chronic disease, damage, and mortality highlight the need for bette...
Source: Rheumatic Disease Clinics of North America - September 1, 2021 Category: Rheumatology Authors: Hanna Kim, Adam M. Huber, Susan Kim Source Type: research

Updates on Juvenile Dermatomyositis from the Last Decade: from Classification to Outcomes
Juvenile dermatomyositis (JDM) is a heterogeneous disease with new classification criteria and updates in myositis-specific autoantibody and myositis-associated antibody groups. There are many validated assessment tools for assessing disease activity in JDM. Future studies will optimize these tools and improve feasibility in clinical and research contexts. Genetic and environmental risk factors, mechanisms of muscle pathology, role of interferon, vascular markers, and changes in immune cells provide insights to JDM pathogenesis. Outcomes have improved, but chronic disease, damage, and mortality highlight the need for bette...
Source: Rheumatic Disease Clinics of North America - September 1, 2021 Category: Rheumatology Authors: Hanna Kim, Adam M. Huber, Susan Kim Source Type: research

Updates in Systemic Sclerosis Treatment and Applicability to Pediatric Scleroderma
Juvenile-onset systemic sclerosis (jSSc) is a complex multisystem inflammatory-driven disease of fibrosis, requiring multifaceted treatment including pharmacologic therapy, supportive care, and lifestyle modification. Most regimens are adapted from adult SSc treatment given the rarity of the disease. Landmark trials over the past decade in adult SSc have led to 2 Food and Drug Administration –approved therapies for SSc-associated interstitial lung disease, and several ongoing trials of other biological agents are underway. Resetting the immune system with autologous stem cell transplant to halt this disease earlier in it...
Source: Rheumatic Disease Clinics of North America - September 1, 2021 Category: Rheumatology Authors: Kathryn S. Torok Source Type: research

Carra
The Childhood Arthritis& Rheumatology Research Alliance (CARRA) launched in 2000 as a small network of pediatric rheumatologists and investigators dedicated to promoting collaborative research to improve the care and outcomes of childhood-onset rheumatic diseases. Over the past 2 decades, CARRA has grown to become a major driver of advances in evidence-based medicine and career development in pediatric rheumatology. Its research approach has transformed pediatric rheumatology. CARRA is a vibrant organization that will continue to facilitate impactful research in the care of children, adolescents, and young adults with rheu...
Source: Rheumatic Disease Clinics of North America - September 1, 2021 Category: Rheumatology Authors: Robert C. Fuhlbrigge, Laura E. Schanberg, Yukiko Kimura Source Type: research

Pharmacosurveillance in Juvenile Idiopathic Arthritis
This article provides an overview of methodologies for pharmacosurveillance in juvenile idiopathic arthritis, including spontaneous reporting systems and the use of diverse data sources, such as electronic health records, administrative claims, and clinical registries. The risks of infections and malignancies are then briefly reviewed. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - September 1, 2021 Category: Rheumatology Authors: Natalie J. Shiff, Timothy Beukelman Source Type: research

Juvenile Localized Scleroderma
Children and adolescents with localized scleroderma (LS) are at high risk for extracutaneous-related functional impairment including hemiatrophy, arthropathy, seizures, and vision impairment. Compared with adult-onset LS, pediatric disease has a higher likelihood for poor outcome, with extracutaneous involvement twice as prevalent in linear scleroderma, disease relapses more common, and disease duration more than double. Consensus among pediatric rheumatologists on treating patients at risk for significant morbidity with systemic immunosuppressants has led to major improvements in outcome. This review discusses recent prog...
Source: Rheumatic Disease Clinics of North America - September 1, 2021 Category: Rheumatology Authors: Natalia Vasquez-Canizares, Suzanne C. Li Source Type: research

Uveitis in Children and Adolescents
Childhood noninfectious uveitis leads to sight-threatening complications. Idiopathic chronic anterior uveitis and juvenile idiopathic arthritis –associated uveitis are most common. Inflammation arises from an immune response against antigens within the eye. Ophthalmic work-up evaluates anatomic involvement, disease activity, ocular complications, and disease course. Local and/or systemic glucocorticoids are initial treatment, but not as l ong-term sole therapy to avoid glucocorticoids-induced toxicity or persistent ocular inflammation. Children with recurrent, refractory, or severe disease require systemic immunosuppress...
Source: Rheumatic Disease Clinics of North America - August 27, 2021 Category: Rheumatology Authors: Margaret H. Chang, Jessica G. Shantha, Jacob J. Fondriest, Mindy S. Lo, Sheila T. Angeles-Han Source Type: research

Recent Advances in Pediatric Vasculitis
This article provides an overview of the clinical presentation and diagnosis of select pediatric primary systemic vasculitides. Important advances in understanding the pathogenesis of these rare diseases also are discussed and efforts to harmonize treatment through consensus-based guidelines and multicenter and international collaborations highlighted. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - August 27, 2021 Category: Rheumatology Authors: Laura Cannon, Eveline Y. Wu Source Type: research

Unique Aspects of Pediatric Sj ögren Disease
Sj ögren disease increasingly is recognized in pediatric patients. Clinical features, primarily parotitis and sicca symptoms, and results of diagnostic tests may be different from those in adult disease. Adult criteria fail to capture most pediatric patients. Pediatric-specific criteria are urgently n eeded to define the natural history of the disease, identify risk and prognostic factors, and evaluate the impact of therapeutics and other interventions on disease course in young patients. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - August 27, 2021 Category: Rheumatology Authors: Rachel L. Randell, Scott M. Lieberman Source Type: research

Pathogenesis and Treatment of Refractory Disease Courses in Systemic Juvenile Idiopathic Arthritis
Systemic juvenile idiopathic arthritis is a distinct and heterogeneous disease presently classified under the umbrella of juvenile idiopathic arthritis, with some patients following a monophasic remitting course, whereas others have persistent disease with chronic organ- and life-threatening complications. Although biologic therapies have revolutionized treatment, recent follow-up studies report significant numbers of children with persistently active disease on long term follow-up. This review focuses on refractory disease courses, specifically refractory arthritis, systemic juvenile idiopathic arthritis with recurrent, o...
Source: Rheumatic Disease Clinics of North America - August 21, 2021 Category: Rheumatology Authors: Remco Erkens, Ysabella Esteban, Christopher Towe, Grant Schulert, Sebastiaan Vastert Source Type: research

The Temporomandibular Joint in Juvenile Idiopathic Arthritis
This article discusses the latest evidence on diagnosis and treatment of JIA-associated TMJ arthritis. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - August 21, 2021 Category: Rheumatology Authors: Peter Stoustrup, Melissa A. Lerman, Marinka Twilt Source Type: research

Chronic Nonbacterial Osteomyelitis
This article focuses on recent insights into the pathogenesis of chronic nonbacterial osteomyelitis and outlines recent advances and ongoing research. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - August 21, 2021 Category: Rheumatology Authors: Farzana Nuruzzaman, Yongdong Zhao, Polly J. Ferguson Source Type: research