title: Pain experience in children with juvenile idiopathic arthritis treated with anti-TNF agents compared to non-biologic standard treatment.
abstract: BACKGROUND
  Anti-TNF agents have proven efficacy in children with severe juvenile idiopathic arthritis (JIA) who are unresponsive to standard therapy. Therefore pain reduction or elimination could be expected. The aim of this study was to compare the pain experience in children with JIA treated with anti-TNF agents (n = 41) or non-biologic standard treatment (n = 50).
  
  
  METHODS
  All children completed a 2-week pain diary and, for children treated with anti-TNF agents, measures of pain-coping and pain-specific beliefs. Parents rated the child's level of functional disability. Clinical data were collected from the pediatric rheumatologists.
  
  
  RESULTS
  No significant differences were found between the anti-TNF group and non-biologic standard treatment group for average pain score, number of children with daily pain reported in the pain diary, or level of functional disability. Significantly more children in the anti-TNF group reported no pain at all. Children undergoing standard treatment had significantly higher disease activity. Significant differences were found between the high pain patients treated with anti-TNF agents and the rest of the anti-TNF group in regards to their pain-specific beliefs of disability and harm, and the pain-coping strategy of catastrophizing.
  
  
  CONCLUSIONS
  These results indicate that a great proportion of children treated with anti-TNF agents respond well to the treatment in regards to disease activity and pain, but pain was still a problem for a subgroup of children though they were in remission with biological agents. More focus on pain management is needed.
authors: Department of Psychology, Aarhus University, Bartholins Allé 9, Aarhus 8000, Denmark. johanhj@psy.au.dk.
authors: Johanne Jeppesen
authors: JJ
authors: Lomholt
authors: Mikael
authors: M
authors: Thastum
authors: Troels
authors: T
authors: Herlin
references: Arthritis Rheum. 2004 Apr 15;51(2):222-7
references: 15077263
references: Acta Paediatr. 1999 Feb;88(2):132-8
references: 10102143
references: Clin Exp Rheumatol. 2007 May-Jun;25(3):494-501
references: 17631752
references: Clin Exp Rheumatol. 2008 Sep-Oct;26(5):954-61
references: 19032837
references: Pediatrics. 2001 Sep;108(3):E47
references: 11533365
references: Arthritis Rheum. 2000 Aug;43(8):1849-57
references: 10943876
references: J Rheumatol. 2004 Feb;31(2):390-2
references: 14760812
references: Clin Exp Rheumatol. 2001 Jul-Aug;19(4 Suppl 23):S50-4
references: 11510331
references: Arthritis Rheum. 2004 Jul;50(7):2191-201
references: 15248217
references: Pain. 2001 Aug;93(2):173-183
references: 11427329
references: Pain. 1998 May;76(1-2):83-96
references: 9696461
references: Arthritis Rheum. 2005 Apr 15;53(2):178-84
references: 15818646
references: N Engl J Med. 1992 Apr 16;326(16):1043-9
references: 1549149
references: Pain. 2003 Jan;101(1-2):33-43
references: 12507698
references: Br J Rheumatol. 1995 Jan;34(1):61-7
references: 7881842
references: Rheum Dis Clin North Am. 2007 Aug;33(3):625-60
references: 17936179
references: N Engl J Med. 2008 Aug 21;359(8):810-20
references: 18716298
references: Nat Clin Pract Rheumatol. 2007 Apr;3(4):210-8
references: 17396106
references: Pain. 2000 Jul;87(1):51-58
references: 10863045
references: Psychol Bull. 2007 Jul;133(4):581-624
references: 17592957
references: Pain. 1996 Sep;67(1):141-150
references: 8895242
references: Pain. 1987 Jan;28(1):27-38
references: 3822493
references: Arthritis Rheum. 2003 May;48(5):1390-7
references: 12746912
references: Pain. 2008 Jun;136(3):281-292
references: 17723279
references: Clin Rheumatol. 2008 Jan;27(1):67-76
references: 17570009
references: Arthritis Rheum. 2006 Jun;54(6):1987-94
references: 16732547
references: Arthritis Rheum. 2003 Jan;48(1):218-26
references: 12528122
references: Arthritis Care Res. 1995 Mar;8(1):36-42
references: 7794979
references: J Pediatr Psychol. 1993 Oct;18(5):561-73
references: 8295080
references: Curr Rheumatol Rep. 2002 Aug;4(4):313-21
references: 12126583
references: J Int Med Res. 2010 Jul-Aug;38(4):1213-24
references: 20925993
references: Pain. 2007 Feb;127(3):276-286
references: 17071000
references: Arthritis Rheum. 2001 Apr;45(2):159-66
references: 11324780
references: Arthritis Rheum. 2006 Apr 15;55(2):199-207
references: 16583399
references: J Pediatr Psychol. 1996 Apr;21(2):237-50
references: 8920155
references: J Pediatr. 1990 Jun;116(6):921-3
references: 2348295
references: Pain. 1994 Jun;57(3):301-309
references: 7936708
references: Scand J Rheumatol. 1997;26(4):272-9
references: 9310107
references: Pediatrics. 2010 Nov;126(5):e1168-98
references: 20921070
references: Pain. 2011 Mar;152(3 Suppl):S2-S15
references: 20961685
references: Arthritis Rheum. 2007 Sep;56(9):3096-106
references: 17763439
references: N Engl J Med. 2000 Mar 16;342(11):763-9
references: 10717011
references: J Pediatr Psychol. 2002 Apr-May;27(3):215-26
references: 11909929
references: Pain. 1997 Nov;73(2):181-189
references: 9415504
references: J Rheumatol. 2013 Jul;40(7):1212-7
references: 23637324
references: J Rheumatol. 2011 Jan;38(1):155-60
references: 20952477
references: Scand J Rheumatol. 1996;25(5):293-9
references: 8921922
references: Ann Rheum Dis. 1992 Mar;51(3):343-6
references: 1575578
references: Arthritis Rheum. 2008 May;58(5):1496-504
references: 18438876
references: Clin Exp Rheumatol. 2004 Jan-Feb;22(1):125-30
references: 15005016
references: Arthritis Rheum. 2009 May 15;61(5):658-66
references: 19405003
references: Ann Rheum Dis. 2010 Jan;69(1):138-42
references: 19581280
references: J Rheumatol. 2001 May;28(5):1091-8
references: 11361195
references: J Pediatr Psychol. 1987 Jun;12(2):241-55
references: 3612426