Gabriella Giancane- MD
- PhD Student at IRCCS Istituto G. Gaslini
Gabriella Giancane
- MD
- PhD Student at IRCCS Istituto G. Gaslini
About
72
Publications
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Introduction
Current institution
Additional affiliations
September 2013 - August 2014
January 2013 - March 2013
May 2010 - June 2015
Publications
Publications (72)
Background
Little is known about the association between juvenile idiopathic arthritis (JIA) and autoimmune thyroid disease (AITD) and therefore there are no indications for AITD screening in this population, which is possible using standard blood tests. The objective of this study is to determine the prevalence and predictors of symptomatic AITD i...
Background
Little is known about the disposition to autoimmune diseases (ADs) among children diagnosed with JIA. In this study, we provide a comprehensive overview of the prevalence of and factors associated with ADs in parents of children with juvenile idiopathic arthritis (JIA).
Methods
Prevalence rates of ADs and 95% Poisson confidence interval...
Background
Etanercept (ETN) and adalimumab (ADA) are considered equally effective biologicals in the treatment of arthritis in juvenile idiopathic arthritis (JIA) but no studies have compared their impact on patient-reported well-being. The objective of this study was to determine whether ETN and ADA have a differential effect on patient-reported w...
Introduction
Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory rheumatic condition in childhood. The management of JIA has been revolutionized thanks to the development of new powerful drugs and the possibility to conduct controlled clinical trials with support from legislative initiatives and availability of international...
Background
The ACR provisional criteria for defining inactive disease (ID) in Juvenile Idiopathic Arthritis (JIA) requires that the physician’s global assessment of disease activity (PhGA) is marked as 0 on the visual analog scale (VAS). However, some investigators have noticed the tendency of some clinicians to mark the PhGA>0 even on resolution o...
Objective
To investigate the frequency in which the physician provides a global assessment of disease activity (PhGA) >0 and an active joint count (AJC)=0 in children with juvenile idiopathic arthritis (JIA) and search for determinants of divergence between the two measures.
Methods
Data were extracted from a multinational cross-sectional dataset...
Objective:
To evaluate the long-term safety profile of anakinra in patients with systemic juvenile idiopathic arthritis (SJIA).
Methods:
Data from patients with SJIA enrolled in the Pharmachild registry (NCT03932344) before 30 September 2018 and treated with anakinra were analyzed. The study endpoints were the occurrence of non-serious adverse e...
Objective:
To compare clinical features and treatments of patients with systemic juvenile idiopathic arthritis (sIJA) and adult-onset Still's disease (AOSD).
Methods:
The clinical charts of consecutive patients with sJIA by International League of Association of Rheumatology criteria or AOSD by Yamaguchi criteria were reviewed. Patients were see...
Objectives:
Burden of comorbidities are largely unknown in JIA. From 2000, national and international patient registries were established to monitor biologic treatment, disease activity and adverse events in patients with JIA. The aim of this analysis was to investigate in parallel, for the first time, three of the largest JIA registries in Europe...
Objectives
To describe risk factors for inflammatory bowel disease (IBD) development in a cohort of children with juvenile idiopathic arthritis (JIA).
Methods
JIA patients who developed IBD were identified from the international Pharmachild register. Characteristics were compared between IBD and non-IBD patients and predictors of IBD were determin...
Background
Systemic juvenile idiopathic arthritis (SJIA) is characterized by extra-articular manifestations, as fever and rash, and rarely associated by a potentially lethal complication as macrophage activation syndrome (MAS). Anakinra is a recombinant human interleukin (IL)-1 receptor antagonist whose efficacy and safety profile has been studied...
Background
Cryopyrin associated periodic syndromes (CAPS) are a group of ultra-rare autoinflammatory diseases caused by mutations in the NLRP3 gene, leading to overproduction of IL-1β. CAPS includes the following subdiagnoses: familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS) and chronic infantile neurological cutaneous ar...
Objectives:
To search for predictors of polyarticular extension in children with oligoarticular-onset juvenile idiopathic arthritis (JIA) and to develop a prediction model for an extended course.
Methods:
The clinical charts of consecutive patients with oligoarticular-onset JIA and ≥2 years of disease duration were reviewed. Predictor variables...
Purpose of review:
Providing a summary of the latest research on outcome measures in juvenile idiopathic arthritis, childhood -onset systemic lupus erythematosus, and juvenile dermatomyositis.
Recent findings:
A rational management of patients with pediatric rheumatic diseases requires the regular assessment of the level of disease activity and...
Objective
To build a prediction model for uveitis in children with JIA for use in current clinical practice.
Methods
Data from the international observational Pharmachild registry were used. Adjusted risk factors as well as predictors for JIA-associated uveitis (JIA-U) were determined using multivariable logistic regression models. The prediction...
Objectives:
To investigate the frequency of arthritis flare and factors affecting occurrence of flare in children with juvenile idiopathic arthritis (JIA) who achieved inactive disease (ID) with methotrexate (MTX) monotherapy.
Methods:
A total of 217 patients were included. The modality of treatment discontinuation, time of MTX withdrawal, and d...
Background:
Few clinical trials have investigated the prevention of radiographic progression in children with juvenile idiopathic arthritis treated with antirheumatic drugs. This study aimed to investigate radiographic progression in patients with systemic juvenile idiopathic arthritis (sJIA) and patients with polyarticular-course juvenile idiopat...
Objective. To develop a composite disease activity score for systemic JIA (sJIA) and to provide preliminary evidence of its validity. Methods. The systemic Juvenile Arthritis Disease Activity Score (sJADAS) was constructed by adding to the four items of the original JADAS a fifth item that aimed to quantify the activity of systemic features. Valida...
Objective
To assess concordance among criteria for inactive disease (ID) and low disease activity (LDA) in juvenile idiopathic arthritis (JIA) and to seek factors driving discordance.
Methods
The frequency of fulfillment of existing criteria was evaluated in information on 10,186 patients extracted from 3 cross‐sectional data sets. Patients were d...
Background:
To derive a list of opportunistic infections (OI) through the analysis of the juvenile idiopathic arthritis (JIA) patients in the Pharmachild registry by an independent Safety Adjudication Committee (SAC).
Methods:
The SAC (3 pediatric rheumatologists and 2 pediatric infectious disease specialists) elaborated and approved by consensu...
Objective
To investigate the impact of morning stiffness (MS) on parent disease perception in children with juvenile idiopathic arthritis (JIA) with clinical inactive disease (CID).
Methods
652 visits in which patients fulfilled 2004 or 2011 Wallace criteria for CID were examined. Parent-reported outcomes were compared among patients with no MS or...
Le vasculiti sistemiche sono un gruppo eterogeneo di malattie caratterizzate da infiammazione a carico della parete dei vasi sanguigni. Se non adeguatamente controllato, il processo patologico può determinare stenosi, occlusione, aneurismi e rottura dei vasi interessati, con conseguente ipoperfusione e danno dei tessuti irrorati. Le vasculiti siste...
Objective
To study growth and puberty in a multinational longitudinal prospective cohort of children with juvenile dermatomyositis (DM).
Methods
Children from 31 countries who were ages <18 years and had juvenile DM in active phase were studied, and analyses of height, weight, and pubertal development were conducted in those who had follow‐up visi...
Background:
To investigate the frequency of achievement of inactive disease (ID) in children with juvenile idiopathic arthritis (JIA) treated with methotrexate (MTX) as the sole disease-modifyng antirheumatic (DMARD) therapy and to develop a prediction model for lack of attainment of ID.
Methods:
The clinical charts of consecutive patients start...
Objective:
To compare the long-term disease state, in terms of activity and damage, of children with juvenile idiopathic arthritis (JIA) who had their disease onset in methotrexate (MTX) or biologic eras.
Methods:
Patients were included in MTX or biologic era cohort depending on whether their disease presentation occurred before or after January...
Purpose of review:
The present review highlights the advances in disease outcome achieved with currently available biologic medications and future perspectives for JIA management.
Recent findings:
In the last two decades, the management of juvenile idiopathic arthritis (JIA) has been revolutionized by appropriate legislative initiatives, the exi...
Background
After nearly two decades from the start of the Biologic era, systematic analyses of patient with juvenile idiopathic arthritis (JIA) have shown a high frequency of attainment of inactive disease (ID) and satisfactory levels of physical function and quality of life. However, whether and to what extent the disease prognosis has improved in...
Background
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood. Morning stiffness is a major symptom of JIA, and is usually associated with active disease. The 2004 preliminary criteria for inactive disease (ID) in JIA did not include the assessment of morning stiffness, whereas the 2011 revision of the cri...
Background
Juvenile idiopathic arthritis (JIA) affects patients’ well-being as the result of a complex interplay of multiple factors, including disease activity, symptoms, physical and emotional quality of life, and treatment burden. Little evidence exists about the relative contribution of these elements to disease impact.
Objectives
1) To identi...
Background
Juvenile idiopathic arthritis (JIA) has a reported prevalence varying from 16 to 150 per 100,000 patients and it thereby is the most frequent chronic rheumatologic disease presenting in childhood. Inflammatory bowel disease (IBD) is an auto-inflammatory disease that can develop in patients with JIA. Results from multiple studies suggest...
Background
Last year the International League of Associations for Rheumatology (ILAR) classification criteria for juvenile idiopathic arthritis (JIA), [1] were challenged by the provisional Paediatric Rheumatology International Trials Organisation (PRINTO) classification criteria.[2] Four disorders were proposed: (a) systemic JIA; (b) rheumatoid fa...
Background
The choice of an appropriate definition of inactive disease (ID) is important because ID has been identified as the ideal therapeutic goal in the treat-to-target strategy in juvenile idiopathic arthritis (JIA).¹ Several criteria for ID in JIA have been proposed, including Wallace 2004 and 2011 criteria and JADAS10 and clinical JADAS10 (c...
Background
Infections are a major concern for patients affected by juvenile idiopathic arthritis (JIA) treated with immunosuppressive therapy. Evidence is inconsistent as to whether the start of synthetic or biological disease modifying anti-rheumatic drugs (DMARDs) is associated with an increased risk of serious and at least moderate infection.
O...
Abstract Background Prednisone (PDN) in juvenile dermatomyositis (JDM), alone or in association with other immunosuppressive drugs, namely methotrexate (MTX) and cyclosporine (CSA), represents the first-line treatment option for new onset JDM patients. No clear evidence based guidelines are actually available to standardize the tapering and discont...
Background:
To our knowledge, the characteristics and burden of childhood arthritis have never been studied on a worldwide basis. We aimed to investigate, with a cross-sectional study, the prevalence of disease categories, treatment methods, and disease status in patients from across different geographical areas and from countries with diverse wea...
Background
The availability of methotrexate and the introduction of multiple biological agents have revolutionized the treatment of juvenile idiopathic arthritis (JIA). Several international and national drug registries have been implemented to accurately monitor the long-term safety/efficacy of these agents. This report aims to present the combine...
Background
Pharmachild is a pharmacovigilance registry on children with JIA treated mainly with biologics±methotrexate (MTX). Little evidence exists in literature about the role of JIA or its immunosuppressive therapy in determining infections, especially caused by opportunistic pathogens.
Objectives
To provide an update on opportunistic infection...
Background
At present no clear evidence based guidelines exist to standardise the tapering and discontinuation of corticosteroids (CS) in juvenile dermatomyositis (JDM).
Objectives
To provide evidence-based recommendations for CS tapering/discontinuation through the analysis of the patients in the PRINTO new onset JDM trial. Secondary objective of...
Over the past two decades, the management of juvenile idiopathic arthritis (JIA) has been revolutionized by the increased tendency toward early aggressive interventions and the availability of the novel biologic medications. In 2017, three novel randomized controlled trials have evaluated the effectiveness and tolerability of golimumab and tocilizu...
Pain is the major symptom of children with juvenile idiopathic arthritis (JIA) and its reduction is a key goal of treatment. It is widely agreed that assessment of pain is a fundamental component of the rheumatology evaluation and should be carried out at each clinic visit. However, so far there has been insufficient attention to the impact and cau...
This corrects the article DOI: 10.1038/nrrheum.2017.105.
The optimal definition of clinical remission in juvenile idiopathic arthritis is still uncertain. A new study has found that the current criteria for clinically inactive disease do not always identify the same group of patients. Why is there such a discrepancy? And which approach to defining remission is the most advantageous?
P368 Introduction: Idiopathic musculoskeletal pain (IMP) is related to a negative impact in the quality of life of children and adolescents sleep problems and psychosocial factors seem to be involved in its pathogenesis, which is not fully known. Restless legs syndrome (RLS), periodic limb movements (PML) and sleep problems were observed in adults...
Purpose of review:
To provide an overview of recently published studies on pathogenesis and management of juvenile idiopathic arthritis (JIA).
Recent findings:
In the past year, the potential role of network analysis in the understanding of the molecular phenotype of individual JIA subgroups has been highlighted. In addition, potential new targe...
Systemic juvenile idiopathic arthritis (sJIA) is the form of childhood arthritis whose treatment is most challenging. The demonstration of the prominent involvement of interleukin (IL)-1 in disease pathogenesis has provided the rationale for the treatment with biologic medications that antagonize this cytokine. The three IL-1 blockers that have bee...
Information technology in paediatric rheumatology has seen several exciting developments in recent years. The new multidimensional questionnaires for juvenile idiopathic arthritis, juvenile dermatomyositis, and juvenile autoinflammatory diseases integrate all major parent- and child-reported outcomes (PCROs) used in these diseases into a single too...
Juvenile idiopathic arthritis is a broad term that describes a clinically heterogeneous group of arthritides of unknown cause, which begin before 16 years of age. This term encompasses several disease categories, each of which has distinct presentation, clinical manifestations, and, presumably, genetic background and etiopathogenesis. Although none...
Objective:
To evaluate the demographic, disease activity, disability, and health-related quality of life (HRQOL) differences between children with juvenile idiopathic arthritis (JIA) and their healthy peers, and between children with JIA with and without clinical temporomandibular joint (TMJ) involvement and its determinants.
Methods:
This study...
Background
The Pharmachild study is aimed at observing children with JIA undergoing treatment primarily with biologics±methotrexate (MTX). It is conducted by the participating centres of over 60 countries belonging to PRINTO and PReS.
Objectives
Primary endpoint of the study is safety in JIA patients undergoing immunosuppressive therapy. A prelimi...
Juvenile idiopathic arthritis (JIA), as a chronic condition, is associated with significant disease- and treatment-related morbidity, thus impacting children’s quality of life. In order to optimize JIA management, the paediatric rheumatologist has begun to regularly use measurements of disease activity developed, validated and endorsed by internati...
Familial Mediterranean fever (FMF) is the most common monogenic autoinflammatory disease, but many rheumatologists are not well acquainted with its management. The objective of this report is to produce evidence-based recommendations to guide rheumatologists and other health professionals in the treatment and follow-up of patients with FMF. A multi...
A rational management of children and adolescents with rheumatic and autoinflammatory diseases requires the regular assessment of the level of disease activity and of child health and well-being through the use of well-validated outcome measures. Ideally, such instruments should be simple and feasible and easily applicable in standard clinical prac...
In Juvenile Idiopathic Arthritis (JIA) the temporomandibular joint (TMJ) can be involved leading to pain, dysfunction and growth disturbances of the mandible and associated structures. There may be value to a three minute screening protocol allowing the rheumatologist to detect TMJ involvement systematically. Reliability and validity of the TMJ pro...
Familial Mediterranean fever (FMF) is a disease of early onset which can lead to significant morbidity. In 2012, Single Hub and Access point for pediatric Rheumatology in Europe (SHARE) was launched with the aim of optimising and disseminating diagnostic and management regimens for children and young adults with rheumatic diseases. The objective wa...
Objective
To evaluate the presence and progression of radiographic joint damage, as assessed with the adapted Sharp/van der Heijde score (SHS), in individual joints in the hand and wrist in patients with juvenile idiopathic arthritis (JIA) and to compare progression of damage among different JIA categories. MethodsA total of 372 radiographs of both...
Objective
To evaluate agreement among musculoskeletal pediatric specialists in assessing radiographic joint damage in juvenile idiopathic arthritis (JIA). Methods
Two pediatric rheumatologists, 2 pediatric radiologists, and 2 pediatric orthopedic surgeons evaluated independently 60 radiographs of both wrists and hands of children with polyarticular...
The management of children juvenile idiopathic arthritis (JIA) is ideally conducted through the establishment of a multidisciplinary team of musculoskeletal pediatric specialists. Some therapeutic decisions, either medical or surgical, are made through discussion and consensus between specialists by viewing patient radiographs. However, it is unkno...
Sublingual-specific immunotherapy (SLIT) is considered as a valid treatment of respiratory allergies.
We performed a case-control study to evaluate the effect of SLIT in children with allergic asthma and rhinitis.
The study plan included 140 patients (age 6-14 yr, 43% girls and 57% boys) presenting allergic rhinitis and/or asthma, 70 treated with S...
La febbre è una manifestazione molto comune in pediatria e generalmente associata a infezioni. Tuttavia, quando ricorre frequentemente, deve far pensare anche a febbri periodiche su base autoinfiammatoria che, nonostante siano rare, sono in aumento parallelamente alle possibilità diagnostiche e terapeutiche nei loro confronti. Le febbri periodiche...
A tutt’oggi non esiste un test diagnostico per le diverse malattie reumatologiche, ma gli esami di laboratorio possono fornire un valido supporto per la gestione della malattia e della terapia. Solo nel forte sospetto clinico sostenuto da solidi dati anamnestici vanno richiesti esami ematochimici, che altrimenti possono risultare fuor- vianti. È op...
IVIG (Intravenous immunoglobulin) have significantly improved the prognosis and the quality of life of immunodeficient patients and are routinely used as substitutive therapy. Transient hypogammaglobulinemia of infancy (THI) is a primary humoral immunodeficiency characterized by a transient IgG defect, but is not considered as a disease that justif...
