Arthritis in Children Linked to Infections

TUESDAY, May 1 (HealthDay News) — Children with juvenile
arthritis have higher rates of bacterial infection when hospitalized than
children without arthritis, a new study says.

While taking high-dose steroids was associated with a higher infection
risk among kids with arthritis, other arthritis drugs — methotrexate and
tumor necrosis factor alpha (TNF) inhibitors — were not.

Researchers analyzed Medicaid data on nearly 8,500 children with
juvenile idiopathic arthritis and more than 360,000 arthritis-free
children. Idiopathic means that a disease occurs without a known
cause.

Pharmacy claims were examined to determine arthritis patients‘ use of
drugs that suppress the immune system, including high-dose glucocorticoids
(steroids), methotrexate and TNF inhibitors, according to the study
published May 1 in the journal Arthritis Rheumatism.

Kids with arthritis who were not currently treated with methotrexate or
TNF inhibitors had a 2-fold increase in bacterial infection rates while
hospitalized compared to children without arthritis, study leader Dr.
Timothy Beukelman, of the University of Alabama at Birmingham, said in a
journal news release. “This finding suggests the inflammatory or
autoimmune process may predispose children to infection regardless of
therapy,” Beukelman said.

Among children with juvenile arthritis, the rate of infection
associated with methotrexate or TNF inhibitor treatment was similar.

After they adjusted for methotrexate and TNF inhibitor use among the
arthritis patients, the researchers found that the rate of bacterial
infection among those who took high-dose steroids (10 milligrams or more
of prednisone a day) was more than twice that of those who did not take
steroids.

Limiting steroids may reduce the risk of serious infection in children
with arthritis, Beukelman concluded.

Nearly 300,000 children in the United States have juvenile idiopathic
arthritis, according to the American College of Rheumatology.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin
Diseases has more about juvenile arthritis.

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