biostudies-literatureUnknown17(1)Hissink Muller PCEBACKGROUND:To evaluate radiographic progression of patients with new-onset juvenile idiopathic arthritis (JIA) in response to an early, tightly-controlled, treatment-to-target. METHODS:Patients with JIA participating in the BeSt-for-Kids-study, randomized to 3 treatment strategy arms, were eligible if at least 1 conventional wrist-radiograph was available. Bone damage as reflected by carpal length was assessed using the Poznanski-score. The BoneXpert-method was used to determine the Bone Age (BA, >?5?years) and bone mineral density (BMD) of the wrist. These scores were evaluated over time and compared between the treatment arms and mean JADAS10-score using linear mixed models corrected for age and symptom duration. RESULTS:In 60 patients, 252 radiographs were analysed. Baseline age and symptom duration were different between the arms. No difference in comparison to the healthy reference population was found at baseline for the Poznanski-score (IQR varying from -?0,82; 0.68), nor for BA (varying from -?0.88 to 0.74). Baseline BMD was statistically significantly lower in arm 3 (initial treatment with etanercept and methotrexate) (-?1.48; -?0.68) compared to arm 1 (-?0.84; -?0.04) and arm 2 (-?0.93; 0.15). After treatment to target inactive disease, the Poznanski-scores and the BA remained clinically unchanged, while the BMD in arm 3 improved (p?<?0.05 vs arm 1). CONCLUSIONS:Recent-onset JIA patients, treated-to-target aimed at inactive disease, showed no signs of radiographic wrist damage (Poznanski-score, BA or BMD) either at baseline or at follow-up, irrespective of treatment arm. A lower BMD at baseline in arm 3, initially treated with methotrexate and etanercept, improved significantly after treatment. TRIAL REGISTRATION:NTR, NL1504 (NTR1574). Registered 01-06-2009.Pediatric rheumatology online journal62https://www.ebi.ac.uk/biostudies/studies/S-EPMC6727344biostudies-literatureNo radiographic wrist damage after treatment to target in recent-onset juvenile idiopathic arthritis.PMC6727344van Rossum MAJSchonenberg-Meinema DAllaart CFNusman CMTen Cate RSchreurs DBrinkman DMCKoopman-Keemink Yvan den Berg JMKuijpers TWHemke RHissink Muller PCEBergstra SAvan Suijlekom-Smit LWAvan Braak WGMaas MfalseNo radiographic wrist damage after treatment to target in recent-onset juvenile idiopathic arthritis.BACKGROUND:To evaluate radiographic progression of patients with new-onset juvenile idiopathic arthritis (JIA) in response to an early, tightly-controlled, treatment-to-target. METHODS:Patients with JIA participating in the BeSt-for-Kids-study, randomized to 3 treatment strategy arms, were eligible if at least 1 conventional wrist-radiograph was available. Bone damage as reflected by carpal length was assessed using the Poznanski-score. The BoneXpert-method was used to determine the Bone Age (BA, >?5?years) and bone mineral density (BMD) of the wrist. These scores were evaluated over time and compared between the treatment arms and mean JADAS10-score using linear mixed models corrected for age and symptom duration. RESULTS:In 60 patients, 252 radiographs were analysed. Baseline age and symptom duration were different between the arms. No difference in comparison to the healthy reference population was found at baseline for the Poznanski-score (IQR varying from -?0,82; 0.68), nor for BA (varying from -?0.88 to 0.74). Baseline BMD was statistically significantly lower in arm 3 (initial treatment with etanercept and methotrexate) (-?1.48; -?0.68) compared to arm 1 (-?0.84; -?0.04) and arm 2 (-?0.93; 0.15). After treatment to target inactive disease, the Poznanski-scores and the BA remained clinically unchanged, while the BMD in arm 3 improved (p?<?0.05 vs arm 1). CONCLUSIONS:Recent-onset JIA patients, treated-to-target aimed at inactive disease, showed no signs of radiographic wrist damage (Poznanski-score, BA or BMD) either at baseline or at follow-up, irrespective of treatment arm. A lower BMD at baseline in arm 3, initially treated with methotrexate and etanercept, improved significantly after treatment. TRIAL REGISTRATION:NTR, NL1504 (NTR1574). Registered 01-06-2009.2019-01-01T00:00:00Z2019 Sep2021-02-21T01:17:22Z2019-09-14T07:06:40ZS-EPMC67273443148453910.1186/s12969-019-0362-1