The pediatric rheumatology research team is focusing on the following areas of research:
- Muscle function and muscle function deficits in rheumatic diseases
- Ultrasound of the musculoskeletal system in children
- Longitudinal studies on short and long-term outcomes in JIA
- Psycho Social Outcomes in rheumatic diseases
- Therapeutic trials of new medication
- The links between exercise, physical activity and pathophysiology in JIA (LEAP study)
- The overarching goal is to provide best possible treatment that has been properly evaluated, improve the diagnostic possibilities and ensure optimal outcomes in all relevant areas (physical and psychosocial) through research
Research Projects
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Development of CARRA/PReS-endorsed consensus Core and Expanded Datasets in childhood-onset systemic lupus erythematosus for international registry-based research
25/01/2025
Children and adolescents with childhood-onset systemic lupus erythematosus (cSLE) generally experience more severe disease manifestations when compared with people with adult-onset SLE (aSLE) [[1], [2], [3]]. Patients with cSLE experience more active and aggressive disease, greater medication burden and more frequent involvement of internal organs, such as renal, haematological and neuropsychiatric manifestations [[4], [5], [6], [7]]. Children with cSLE have a higher standardised mortality rate when compared with people who develop lupus in adulthood (aSLE) [[8], [9]]. Several cSLE registries exist worldwide, each intended to enhance our understanding of the epidemiology, phenotypes and prognosis of cSLE while also providing the opportunity to capture real-world data on medication response rates and toxicities [[2], [10], [11]]. Due to the rarity of cSLE, however, the study of specific disease manifestations remains underpowered using existing individual registries. Treatment paradigms for cSLE are currently based predominantly on adult lupus trial data, supplemented with data from relatively small paediatric clinical trials and observational studies [[11], [12]]. It remains unclear in which instances children with cSLE have similar treatment responses to individuals with aSLE, and many cSLE manifestations, such as neuropsychiatric disease, are still understudied. Furthermore, there is regional variability in the manifestations of cSLE that likely influences diagnosis, surveillance, treatment response and prognosis of the disease [13]. These challenges highlight the need for international clinical research that focuses specifically on cSLE [[2], [14], [15]]. Importantly, registry data from large cohorts serve as a powerful tool for unifying data collection for this rare and clinically heterogeneous disease to establish prognosis and determine optimal treatment and long-term safety.
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Current treatment in macrophage activation syndrome worldwide: a systematic literature review to inform the METAPHOR project
26/07/2024
MAS treatment remains largely empirical and based on expert consensus. Although promising data are emerging, results from large cohorts and standardized trials are still required for most medications used to treat MAS. Multinational data on systemic juvenile idiopathic arthritis (sJIA)-associated MAS highlighted several disparities in its management in relation to geographic location of the treating centre and subspecialty of the caring physicians [10]. Recently, the first international recommendations for the early-stage management of HLH/MAS have been published [11]. Despite their milestone relevance, these guidelines focus on the initial management of the spectrum of haemophagocytic syndromes and do not specifically address the treatment of MAS. Furthermore, there is a particular lack of evidence on the therapeutic approach to MAS associated with rheumatological conditions other than sJIA. It is thus conceivable that a wide heterogeneity in the management of MAS exists, due to differences in treatment strategies, access to medications and involvement of different specialists.
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Mitigating the Denosumab‑Induced Rebound Phenomenon with Alternating Short‑ and Long‑Acting Anti‑resorptive Therapy in a Young Boy with Severe OI Type V
03/03/2023
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Toward Developing a Semiquantitative Whole Body-MRI Scoring for Juvenile Idiopathic Arthritis: Critical Appraisal of the State of the Art, Challenges, and Opportunities.
02/03/2020
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SMAC mimetics and RIPK inhibitors as therapeutics for chronic inflammatory diseases
18/02/2020
This may benefit and guide the development of SMs or selective RIPK inhibitors as anti-inflammatory therapeutics for various chronic inflammatory conditions.
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Prospective Determination of the Incidence and Risk Factors of New-Onset Uveitis in Juvenile Idiopathic Arthritis: The Research in Arthritis in Canadian Children Emphasizing Outcomes Cohort
01/11/2019
Identification of the incidence of juvenile idiopathic arthritis (JIA)-associated uveitis and its risk factors is essential to optimize early detection. Data from the Research in Arthritis in Canadian Children Emphasizing Outcomes inception cohort were used to estimate the annual incidence of new-onset uveitis following JIA diagnosis and to identify associated risk factors.
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Understanding parent perceptions of healthy physical activity for their child with a chronic medical condition: A cross-sectional study
01/06/2019
Over one-third of parents reported having questions about physical activity for their child with a chronic medical condition, suggesting substantial uncertainty even among children reported as active. Presence of parent uncertainty is associated with parent reports of the child being unwell or a history of cardiac arrhythmia
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Health-Related Quality of Life in an InceptionCohort of Children With Juvenile IdiopathicArthritis: A Longitudinal Analysis
02/01/2018
Improvement in HRQoL is slower than for disease activity, pain, and disability. Improvement of a mea- sure based on respondents’ preferences (HRQoML) is more rapid than that of a standardized measure (JAQQ). Higher disease activity at diagnosis heralds an unfavorable HRQoL trajectory.
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The risk and nature of flares in juvenile idiopathic arthritis: results from the ReACCh-Out cohort
01/05/2015
In this real-practice JIA cohort, flares were frequent, usually involved a few swollen joints for an average of 6 months and 60% led to treatment intensification. Children with a severe disease course had an increased risk of flare.
Researchers
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Sasha Carsen
Scientist, CHEO Research Institute
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Ciarán Duffy
Emeritus Scientist, CHEO Research Institute
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Dina El Demellawy
Investigator, CHEO Research Institute
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Kerri Highmore
Investigator, CHEO Research Institute
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Eric LaCasse
Associate Scientist, CHEO Research Institute
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Patricia Longmuir
Senior Scientist, CHEO Research Institute
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Marie-Eve Robinson
Investigator, CHEO Research Institute
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Christiaan Scott
Investigator, CHEO Research Institute
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Kevin Smit
Investigator, CHEO Research Institute
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Leanne Ward
Senior Scientist, CHEO Research Institute
