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Differences of hip involvement in systemic and non-systemic juvenile idiopathic arthritis

https://doi.org/10.47360/1995-4484-2022-102-111

Abstract

Systemic corticosteroids are continued to be administered in juvenile idiopathic arthritis (JIA) patients, especially in systemic JIA (sJIA), despite the ability of biologic therapy. One of the complications of long-term CS treatment is delayed hip arthritis development with risk of secondary hip osteoarthritis formation and total hip arthroplasty (THA).
We compared different types of hip joint lesions in JIA, especially, secondary hip osteoarthritis development and THA rates in systemic and non-systemic JIA, and evaluate systemic corticosteroids contribution to those complications.
The study included 753 JIA patients. They were divided into 2 groups: patients with sJIA and non-systemic JIA (nsJIA). Clinical and demographic characteristics, CS treatment regimens were compared.
Results. Hip arthritis was found equally often in both groups, but both secondary hip osteoarthritis (19% vs 5,3%) and THA (8.6% vs 1.6%) prevailed in the sJIA. Patients with sJIA had delayed hip involvement (57.9% vs 30.6%; p=0.019), earlier secondary hip osteoarthritis development (4.5 vs 5.1 years after the JIA onset) with younger age of secondary hip osteoarthritis achievement (13.7 vs 15.2 years; р=0.045), they also had higher inflammatory activity, greater systemic corticosteroids administration (94.8% vs 56.1%; р=0.0000001) and higher cumulative systemic corticosteroids dose (3085 mg vs 2000 mg; p=0,005). More than half patients (56.1%) with nsJIA had systemic corticosteroids treatment and impaired calcium-phosphorus metabolism.
Conclusion. Systemic corticosteroid treatment and delayed hip involvement are independent predictors of secondary hip osteoarthritis in all JIA categories. Calcium and phosphate metabolism disturbances are additional predictor for secondary hip osteoarthritis in non-systemic JIA categories

About the Authors

L. S. Sorokina
Saint-Petersburg State Pediatric Medical University
Russian Federation

Lyubov S. Sorokina

194100, Saint Petersburg, Litovskaya str., 2


Competing Interests:

нет



I. S. Avrusin
Saint-Petersburg State Pediatric Medical University
Russian Federation

Ilia S. Avrusin

194100, Saint Petersburg, Litovskaya str., 2


Competing Interests:

нет



R. K. Raupov
Saint-Petersburg State Pediatric Medical University
Russian Federation

Rinat K. Raupov

194100, Saint Petersburg, Litovskaya str., 2


Competing Interests:

нет



N. T. Garipova
Almazov National Medical Research Centre
Russian Federation

Nina T. Garipova

197341, Saint Petersburg, Akkuratova str., 2


Competing Interests:

нет



M. M. Gharabaghtsyan
Institute of Child and Adolescent Health (ICAH) with the Arabkir Medical Center
Armenia

Mariam M. Gharabaghtsyan

0014, Yerevan, Mamikonyants str., 30


Competing Interests:

нет



S. V. Khrypov
Saint-Petersburg Clinical Research and Practical Center for Specialized Healthcare (Oncology)
Russian Federation

Sergey V. Khrypov

197758, Saint Petersburg, Pesochny settlement, Leningradrkaya str., 68А


Competing Interests:

нет



M. A. Kaneva
Saint-Petersburg State Pediatric Medical University
Russian Federation

Maria A. Kaneva

194100, Saint Petersburg, Litovskaya str., 2


Competing Interests:

нет



E. A. Isupova
Saint-Petersburg State Pediatric Medical University
Russian Federation

Eugenia A. Isupova

194100, Saint Petersburg, Litovskaya str., 2


Competing Interests:

нет



E. V. Gaidar
Saint-Petersburg State Pediatric Medical University
Russian Federation

Ekaterina V. Gaidar

194100, Saint Petersburg, Litovskaya str., 2


Competing Interests:

нет



I. A. Chikova
Saint-Petersburg State Pediatric Medical University
Russian Federation

Irina A. Chikova

194100, Saint Petersburg, Litovskaya str., 2


Competing Interests:

нет



M. F. Dubko
Saint-Petersburg State Pediatric Medical University
Russian Federation

Margarita F. Dubko

194100, Saint Petersburg, Litovskaya str., 2


Competing Interests:

нет



V. V. Masalova
Saint-Petersburg State Pediatric Medical University
Russian Federation

Vera V. Masalova

194100, Saint Petersburg, Litovskaya str., 2


Competing Interests:

нет



T. S. Likhacheva
Saint-Petersburg State Pediatric Medical University
Russian Federation

Tatiana S. Likhacheva

194100, Saint Petersburg, Litovskaya str., 2


Competing Interests:

нет



L. S. Snegireva
Saint-Petersburg State Pediatric Medical University
Russian Federation

Lyudmila S. Snegireva

194100, Saint Petersburg, Litovskaya str., 2


Competing Interests:

нет



O. V. Kalashnikova
Saint-Petersburg State Pediatric Medical University
Russian Federation

Olga V. Kalashnikova

194100, Saint Petersburg, Litovskaya str., 2


Competing Interests:

нет



M. M. Kostik
Saint-Petersburg State Pediatric Medical University; Almazov National Medical Research Centre
Russian Federation

Mikhail M. Kostik

194100, Saint Petersburg, Litovskaya str., 2

197341, Saint Petersburg, Akkuratova str., 2


Competing Interests:

нет



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For citations:


Sorokina L.S., Avrusin I.S., Raupov R.K., Garipova N.T., Gharabaghtsyan M.M., Khrypov S.V., Kaneva M.A., Isupova E.A., Gaidar E.V., Chikova I.A., Dubko M.F., Masalova V.V., Likhacheva T.S., Snegireva L.S., Kalashnikova O.V., Kostik M.M. Differences of hip involvement in systemic and non-systemic juvenile idiopathic arthritis. Rheumatology Science and Practice. 2022;60(1):102-111. (In Russ.) https://doi.org/10.47360/1995-4484-2022-102-111

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ISSN 1995-4484 (Print)
ISSN 1995-4492 (Online)