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BRIEF RESEARCH REPORT article

Front. Pediatr.
Sec. Pediatric Rheumatology
Volume 12 - 2024 | doi: 10.3389/fped.2024.1423362
This article is part of the Research Topic Building a Learning Health System in Pediatric Rheumatology View all 3 articles

Intra-articular Corticosteroid Utilization and Characterizations of Use in Juvenile Idiopathic Arthritis within the PR-COIN Registry

Provisionally accepted
Erin Balay-Dustrude Erin Balay-Dustrude 1,2Jennifer E. weiss Jennifer E. weiss 3Y. Ingrid Goh Y. Ingrid Goh 4,5Nathan Rubin Nathan Rubin 6Danielle Bullock Danielle Bullock 7*
  • 1 Department of Pediatric Rheumatology, Seattle Children's Hospital, Seattle, Washington, United States
  • 2 Seattle Children's Research Institute, Seattle, Washington, United States
  • 3 Hackensack University Medical Center, Hackensack, New Jersey, United States
  • 4 Division of Rheumatology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
  • 5 Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
  • 6 Masonic Cancer Center, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
  • 7 Division of Pediatric Rheumatology, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, United States

The final, formatted version of the article will be published soon.

    Objective: Intra-articular corticosteroid injections (IACI) have been shown to be effective at improving arthritis across juvenile idiopathic arthritis (JIA) categories. The American College of Rheumatology (ACR) recommends IACI use as primary and adjunctive therapy for JIA patients. However, there remains minimal data describing actual IACI use in North America. The objective of this study was to describe and to evaluate IACI use in JIA, utilizing the Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) registry.Methods: Study participants from 13 sites were enrolled in the PR-COIN registry from 2011-2015. Demographic and clinical variables were summarized and Chi-squared and t-tests were used to evaluate differences between participants who did or did not receive IACI. Multiple logistic regression models were used to evaluate characteristics associated with IACI treatment.Results: Our study included 3,241 participants, the majority of whom were white (85%), female (71%) and had oligoarticular JIA (39%). IACI was administered at least once in 23% of participants, the majority of whom had oligoarticular disease (52.5%), but overall use in oligoarticular participants was low at 30.8%. IACI use varied significantly between treatment centers and use was associated with oligoarticular disease, ANA positivity, and use of other systemic medications.This study demonstrates that participants with JIA enrolled in the PR-COIN registry between 2011 -2015 with persistent oligoarticular disease, ANA positivity, and use of other systemic medications were more likely to receive IACI. However, IACI use was lower than expected for oligoarticular participants.

    Keywords: juvenile idiopathic arthritis, Corticosteroid injection, Treatment, Outcome, Registry

    Received: 25 Apr 2024; Accepted: 12 Jul 2024.

    Copyright: © 2024 Balay-Dustrude, weiss, Goh, Rubin and Bullock. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Danielle Bullock, Division of Pediatric Rheumatology, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN 55454, Minnesota, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.