Effects of Biologics on Temporomandibular Joint Inflammation in Juvenile Idiopathic Arthritis: Inflammation, Temporomandibular Joint, Magnetic resonance imaging

TY - JOUR

T1 - Effects of Biologics on Temporomandibular Joint Inflammation in Juvenile Idiopathic Arthritis

T2 - Inflammation, Temporomandibular Joint, Magnetic resonance imaging

AU - Stoustrup, Peter

AU - Kellenberger, Christian J

AU - Høst, Christian

AU - Küseler, Annelise

AU - Pedersen, Thomas K

AU - Herlin, Troels

AU - Glerup, Mia

PY - 2024/12/1

Y1 - 2024/12/1

N2 - OBJECTIVE: This prospective study investigates the efficacy of biologics in combination with methotrexate or leflunomide 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 were performed between September 2018- 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 and 24 months after treatment initiation, 4) clinical follow-up contemporary with the MRI by a pediatric rheumatologist and an orthodontist.RESULTS: We included 18 patients (89% females). At time of first MRI median age was 13.2 years (IQR 11.3-16.9), median disease duration was 7.8 years (IQR 3.4-11.1) and 4 received MTX/leflunomide. 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 median 2 (IQR 1-3) at baseline to median 1(IQR 0-2) at 24 months, p=0.009. In 17 out of 36 TMJs (48%), 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.

AB - OBJECTIVE: This prospective study investigates the efficacy of biologics in combination with methotrexate or leflunomide 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 were performed between September 2018- 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 and 24 months after treatment initiation, 4) clinical follow-up contemporary with the MRI by a pediatric rheumatologist and an orthodontist.RESULTS: We included 18 patients (89% females). At time of first MRI median age was 13.2 years (IQR 11.3-16.9), median disease duration was 7.8 years (IQR 3.4-11.1) and 4 received MTX/leflunomide. 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 median 2 (IQR 1-3) at baseline to median 1(IQR 0-2) at 24 months, p=0.009. In 17 out of 36 TMJs (48%), 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.

U2 - 10.3899/jrheum.2024-0538

DO - 10.3899/jrheum.2024-0538

M3 - Journal article

C2 - 39617412

SN - 0315-162X

VL - Vol. 51

SP - 1

EP - 26

JO - The Journal of Rheumatology

JF - The Journal of Rheumatology

IS - Issue 12

M1 - 2024-0538

ER -