Steroid treatments for children with a particular form of arthritis may increase the risk of them being hospitalised with a bacterial infection. Juvenile idiopathic arthritis (JIA) is a form of the chronic joint inflammation condition that affects young people.
Around 12,000 youngsters under the age of 16 are affected in the UK. Juvenile idiopathic arthritis causes inflammation of the joints, leading to swelling and stiffness, with the possibility of restricted movement.
US research suggests that those with JIA who are treated with high-dose steroids known as glucocorticoids have an increased risk of infection compared to children without the condition. Using disease-modifying drugs such as Methotrexate (MTX) and inhibitors such as tumour necrosis factor alpha (TNF) in treating the condition was not found to have the same risk of increased infection.
The research, by the University of Alabama, compared the rates of bacterial infection that required hospitalisation in children with JIA with those who had attention-deficit hyperactivity disorder (ADHD), using data from US Medicaid for the years 2000-2005.
The findings, reported in the American College of Rheumatology’s journal, Arthritis & Rheumatism, revealed that those children with JIA who were treated with steroids but without any MTX or TNF inhibitors were twice as likely to be hospitalised with a bacterial infection compared to patients without arthritis. There was a similar result among children with JIA who were treated with steroids and MTX or TNF inhibitors with the rate of infection more than doubled compared to those whose treatment program did not involve steroids.
The observational study concluded that the effects of JIA on the immune system could mean patients with the condition are more at risk of infection, no matter what kind of drug treatment they are given. However, it also suggested that reducing the steroid treatment could also reduce the risk of bacterial infection.
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