Arthritis in Children Linked to Infections

Limiting steroids when possible may help to lower infection risk, researchers say.

TUESDAY, May 1 (HealthDay News) -- Children with juvenile arthritis have higher rates of bacterial infection when hospitalized than children without arthritis, a new study says.

While taking high-dose steroids was associated with a higher infection risk among kids with arthritis, other arthritis drugs -- methotrexate and tumor necrosis factor alpha (TNF) inhibitors -- were not.

Researchers analyzed Medicaid data on nearly 8,500 children with juvenile idiopathic arthritis and more than 360,000 arthritis-free children. Idiopathic means that a disease occurs without a known cause.

Pharmacy claims were examined to determine arthritis patients' use of drugs that suppress the immune system, including high-dose glucocorticoids (steroids), methotrexate and TNF inhibitors, according to the study published May 1 in the journal Arthritis & Rheumatism.

Kids with arthritis who were not currently treated with methotrexate or TNF inhibitors had a 2-fold increase in bacterial infection rates while hospitalized compared to children without arthritis, study leader Dr. Timothy Beukelman, of the University of Alabama at Birmingham, said in a journal news release. "This finding suggests the inflammatory or autoimmune process may predispose children to infection regardless of therapy," Beukelman said.

Among children with juvenile arthritis, the rate of infection associated with methotrexate or TNF inhibitor treatment was similar.

After they adjusted for methotrexate and TNF inhibitor use among the arthritis patients, the researchers found that the rate of bacterial infection among those who took high-dose steroids (10 milligrams or more of prednisone a day) was more than twice that of those who did not take steroids.

Limiting steroids may reduce the risk of serious infection in children with arthritis, Beukelman concluded.

Nearly 300,000 children in the United States have juvenile idiopathic arthritis, according to the American College of Rheumatology.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about juvenile arthritis.

(SOURCE: Arthritis & Rheumatism, news release, May 1, 2012)

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