Oct 12: Clinical epidemiological studies for improving patient care in juvenile idiopathic arthritis
In his PhD thesis, Joeri van Straalen (UMC Utrecht) applied traditional and advanced epidemiological research methods to patient data from the Wilhelmina Children’s Hospital, the global Pharmachild registry and collaborating registries, in order to answer clinically relevant questions aimed at improving patient care in juvenile idiopathic arthritis (JIA).
Similar to adults, children can also develop arthritis. The most common type of chronic arthritis in children is called juvenile idiopathic arthritis (JIA) and affects roughly 1 in every 1,000 children in
the Netherlands. Since the introduction of a specific group of drugs called biologicals, reaching inactive disease has become a realistic target for most JIA patients. Still, there is much room for improvement in patient care for JIA. In his PhD thesis, Joeri van Straalen (Department of Pediatric Immunology and Rheumatology, Wilhelmina Children’s Hospital, part of UMC Utrecht) applied traditional and advanced epidemiological research methods to patient data from the Wilhelmina Children’s Hospital, the global Pharmachild registry and collaborating registries, in order to answer clinically relevant questions aimed at improving patient care in JIA.
Key results
- Joeri van Straalen and co-workers described the occurrence and predicting factors of coexisting diseases (also called comorbidities), which are common and complicate the approach to treating JIA.
- They also developed and validated for the first time a model for predicting uveitis (a chronic inflammation of the eye), that can assist clinicians in determining screening frequencies and drug therapy.
- Furthermore, van Straalen reported a preventive effect of the drug methotrexate on developing JIA-associated uveitis, identified factors that can be used to distinguish JIA from non-inflammatory chronic pain syndrome at the early diagnosis stage, and compared the effects of two common biological drug therapies (etanercept and adalimumab) on patient-reported well-being. Both drugs improved wellbeing in non-systemic JIA, with a trend towards a slightly stronger effect for etanercept.
- Vaccination of JIA patients against meningococcal disease is safe but elicits a weaker immune response in those using biological therapy.
- The investigators concluded from preliminary data from the THUIS study that in patients with inactive JIA home-monitoring using web-based questionnaires is a feasible and much appreciated method of remotely tracking disease activity. When implemented broadly, this would save time and costs for both patients, parents and healthcare providers.
PhD defense
Joeri van Straalen (1995, Hoorn) defended his PhD thesis on October 12, 2023 at Utrecht University. The title of his thesis was “Clinical epidemiological studies for improving patient care in juvenile idiopathic arthritis.” Supervisor was prof. dr. Nico Wulffraat (Department of Pediatric Immunology and Rheumatology, UMC Utrecht) and co-supervisors were dr. Sytze de Roock and dr. Joost Swart (both Department of Pediatric Immunology and Rheumatology, UMC Utrecht). As of may 2023, Joeri van Straalen works in the field of infectious disease control at the Public Health Service (GGD) Flevoland in Almere.