Effects of Biologics on Temporomandibular Joint Inflammation in Juvenile Idiopathic Arthritis.

IF 3.6 2区医学 Q2 RHEUMATOLOGY

Journal of Rheumatology Pub Date : 2025-01-15 DOI:10.3899/jrheum.2024-0538

Peter Stoustrup, Christian J Kellenberger, Christian Høst, Annelise Küseler, Thomas K Pedersen, Troels Herlin, Mia Glerup

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引用次数: 0

Abstract

Objective: This prospective study investigates the efficacy of biologics in combination with methotrexate (MTX) or leflunomide (LEF) on juvenile idiopathic arthritis (JIA)-related temporomandibular joint (TMJ) arthritis measured by magnetic resonance imaging (MRI)-based inflammation score and deformity score.

Methods: A prospective, single-center observational cohort study of 18 consecutive patients was performed between September 2018 and April 2023. Inclusion criteria were (1) diagnosis of JIA, (2) MRI-verified TMJ arthritis leading to treatment with tumor necrosis factor inhibitor (TNFi), (3) MRI at 6 months and 24 months after treatment initiation, and (4) clinical follow-up together with an MRI by a pediatric rheumatologist and an orthodontist.

Results: We included 18 patients (89% female). At the time of the first MRI, median age was 13.2 years (IQR 9.9-17.4), median disease duration was 7.8 years (IQR 3.4-11.1), and 4 received MTX or LEF. During the observation period, significant improvements were observed in TMJ movement pain (P = 0.01), morning stiffness (P = 0.004), opening capacity (P = 0.03), and maximal incisal opening P = 0.006). The inflammation score decreased significantly from a median of 2 (IQR 1-3) at baseline to a median of 1 (IQR 0-2) at 24 months (P = 0.009). In 17 of 36 TMJs (47%), the deformity score improved or remained stable and no significant increase in the median score was observed.

Conclusion: This is the first prospective, observational study with evidence to support that the orofacial signs, symptoms, and MRI-derived inflammation score in TMJ arthritis can be reduced by treatment with TNFi.

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生物制剂对幼年特发性关节炎颞下颌关节炎症的影响。

目的：本前瞻性研究探讨生物制剂联合甲氨蝶呤或来氟米特治疗青少年特发性关节炎（JIA）相关颞下颌关节（TMJ）关节炎的疗效，方法为基于磁共振成像（MRI）的炎症评分和畸形评分。方法：2018年9月至2023年4月，对18例连续患者进行前瞻性单中心观察队列研究。纳入标准为：1)诊断为JIA； 2) MRI证实的TMJ关节炎导致肿瘤坏死因子抑制剂（TNFi）治疗；3)开始治疗后6个月和24个月的MRI检查；4)由儿科风湿病医生和正畸医生进行临床随访，同时进行MRI检查。结果：纳入18例患者（89%为女性）。首次MRI时的中位年龄为13.2岁（IQR 11.3-16.9），中位病程为7.8年（IQR 3.4-11.1）， 4例接受MTX/来氟米特治疗。观察期间，颞下颌关节运动疼痛（p=0.01）、晨僵（p=0.004）、开口量（p=0.03）和最大切牙开口（p=0.006）均有显著改善。炎症评分从基线时的中位数2 （IQR 1-3）降至24个月时的中位数1(IQR 0-2), p=0.009。在36例tmj中，17例（48%）畸形评分改善或保持稳定，中位评分未见显著增加。结论：这是第一个前瞻性观察性研究，有证据支持TNFi治疗可以降低TMJ关节炎的口面部体征、症状和mri衍生炎症评分。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Rheumatology 医学-风湿病学

CiteScore

6.50

自引率

5.10%

发文量

285

审稿时长

1 months

期刊介绍： The Journal of Rheumatology is a monthly international serial edited by Earl D. Silverman. The Journal features research articles on clinical subjects from scientists working in rheumatology and related fields, as well as proceedings of meetings as supplements to regular issues. Highlights of our 41 years serving Rheumatology include: groundbreaking and provocative editorials such as "Inverting the Pyramid," renowned Pediatric Rheumatology, proceedings of OMERACT and the Canadian Rheumatology Association, Cochrane Musculoskeletal Reviews, and supplements on emerging therapies.