{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:00:10Z","timestamp":1792083610502,"version":"4.4.0"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,7,1]],"date-time":"2013-07-01T00:00:00Z","timestamp":1372636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the outcome and predicting factors of multiple intraarticular corticosteroid (IAC) injections in children with juvenile idiopathic arthritis (JIA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The clinical charts of patients who received their first IAC injection in \u22653 joints between January 2002 and December 2011 were reviewed. The corticosteroid used was triamcinolone hexacetonide for large joints and methylprednisolone acetate for small or difficult to access joints. In each patient, the followup period after IAC injection was censored in case of synovitis flare or at the last visit with continued remission. Predictors included sex, age at disease onset, JIA category, antinuclear antibody (ANA) status, age and disease duration, disease course, general anesthesia, number and type of injected joints, acute\u2010phase reactants, and concomitant systemic medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 220 patients who had 1,096 joints injected were included. Following IAC therapy, 66.4% of patients had synovitis flare after a median of 0.5 years, whereas 33.6% of patients had sustained remission after a median of 0.9 years. The cumulative probability of survival without synovitis flare was 50.0%, 31.5%, and 19.5% at 1, 2, and 3 years, respectively. On Cox regression analysis, positive C\u2010reactive protein value, negative ANA, lack of concomitant methotrexate administration, and a polyarticular (versus an oligoarticular) disease course were the strongest predictors for synovitis flare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multiple IAC injection therapy induced sustained remission of joint synovitis in a substantial proportion of patients. A controlled trial comparing multiple IAC injection therapy and methotrexate versus methotrexate and a tumor necrosis factor antagonist is worthy of consideration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.21947","type":"journal-article","created":{"date-parts":[[2013,1,17]],"date-time":"2013-01-17T11:24:14Z","timestamp":1358421854000},"page":"1112-1120","source":"Crossref","is-referenced-by-count":44,"title":["Delineating the Role of Multiple Intraarticular Corticosteroid Injections in the Management of Juvenile Idiopathic Arthritis in the Biologic Era"],"prefix":"10.1002","volume":"65","author":[{"given":"Charalampia","family":"Papadopoulou","sequence":"first","affiliation":[{"name":"Istituto Giannina Gaslini Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikhail","family":"Kostik","sequence":"additional","affiliation":[{"name":"Istituto Giannina Gaslini Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Isabel","family":"Gonzalez\u2010Fernandez","sequence":"additional","affiliation":[{"name":"Istituto Giannina Gaslini Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Bohm","sequence":"additional","affiliation":[{"name":"Istituto Giannina Gaslini Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Nieto\u2010Gonzalez","sequence":"additional","affiliation":[{"name":"Istituto Giannina Gaslini Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Pistorio","sequence":"additional","affiliation":[{"name":"Istituto Giannina Gaslini Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Lanni","sequence":"additional","affiliation":[{"name":"Istituto Giannina Gaslini Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Consolaro","sequence":"additional","affiliation":[{"name":"Istituto Giannina Gaslini and Universit\u00e0 degli Studi di Genova Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Martini","sequence":"additional","affiliation":[{"name":"Istituto Giannina Gaslini and Universit\u00e0 degli Studi di Genova Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Ravelli","sequence":"additional","affiliation":[{"name":"Istituto Giannina Gaslini and Universit\u00e0 degli Studi di Genova Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60363-8"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.13.1671"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2005.11.008"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002281-199809000-00013"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.88.3.192"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-010-1365-x"},{"key":"e_1_2_6_8_1","first-page":"2036","article-title":"Current treatment by United States and Canadian pediatric rheumatologists","volume":"26","author":"Cron RQ","year":"1999","journal-title":"J Rheumatol"},{"key":"e_1_2_6_9_1","first-page":"1918","article-title":"Variation in the initial treatment of knee monoarthritis in juvenile idiopathic arthritis: a survey of pediatric rheumatologists in the United States and Canada","volume":"34","author":"Beukelman T","year":"2007","journal-title":"J Rheumatol"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24190"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199911)42:11<2330::AID-ANR11>3.0.CO;2-B"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199807)41:7<1210::AID-ART10>3.0.CO;2-5"},{"key":"e_1_2_6_13_1","first-page":"91","article-title":"Report from a symposium on corticosteroid therapy in juvenile chronic arthritis","volume":"11","author":"Southwood TR","year":"1993","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_6_14_1","first-page":"774","article-title":"A reappraisal of intra\u2010articular corticosteroid therapy in juvenile idiopathic arthritis","volume":"28","author":"Scott C","year":"2010","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_6_15_1","first-page":"700","article-title":"Usage of intra\u2010articular corticosteroid injections for the treatment of juvenile idiopathic arthritis: a survey of pediatric rheumatologists in the United States and Canada","volume":"26","author":"Beukelman T","year":"2008","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20460"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker165"},{"key":"e_1_2_6_18_1","first-page":"390","article-title":"International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001","volume":"31","author":"Petty RE","year":"2004","journal-title":"J Rheumatol"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30076"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq292"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1671"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.120842"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27431"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.111441"},{"key":"e_1_2_6_25_1","first-page":"2330","article-title":"Benefit of intraarticular corticosteroid injection under fluoroscopic guidance for subtalar arthritis in juvenile idiopathic arthritis","volume":"33","author":"Beukelman T","year":"2006","journal-title":"J Rheumatol"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facr.21947","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.21947","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T14:24:47Z","timestamp":1759415087000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.21947"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,7]]},"references-count":24,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2013,7]]}},"alternative-id":["10.1002\/acr.21947"],"URL":"https:\/\/doi.org\/10.1002\/acr.21947","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,7]]}}}