Juvenile spondyloarthropathies and related arthritis.
This article reviews recent publications related to the classification and treatment of juvenile spondyloarthropathies. We have included studies on adult onset spondyloarthropathies that are particularly relevant to childhood onset disease. Significant questions concerning classification of juvenile spondyloarthropathies remain unresolved. Diagnostic criteria that are both sensitive and specific for identifying undifferentiated spondyloarthropathies in adults have been developed, and while separate criteria have been proposed for juvenile onset disease, they remain to be validated. The most significant recent advances have occurred in the area of treatment. A small number of studies suggest that bisphosphonates such as pamidronate may be efficacious. Several studies using the TNF inhibitors infliximab and etanercept suggest that these agents hold great promise for ameliorating symptoms and improving function, while long-term effects on disease progression remain to be evaluated.
William S. Rowe Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Ohio 45229-3039, USA.
Hulya
H
Bukulmez
Robert A
RA
Colbert
D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D002648:Child; D004164:Diphosphonates / Q000627:therapeutic use; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D000069285:Infliximab; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D025242:Spondylarthropathies / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D004164:Diphosphonates; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept