Research ArticleArticle
Development and Testing of Reduced Versions of the MMT-8 in Juvenile Dermatomyositis
Silvia Rosina, Giulia C. Varnier, Angela Pistorio, Clarissa Pilkington, Susan Maillard, Adele Civino, Elena Tsitsami, Claudia Bracaglia, Marija Jelusic, Adriana Cespedes-Cruz, Graciela Espada, Rolando Cimaz, Gerard Couillault, Rik Joos, Pierre Quartier, Anand P. Rao, Clara Malattia, Nicolino Ruperto, Alessandro Consolaro and Angelo Ravelli for the Pediatric Rheumatology International Trials Organization (PRINTO)
The Journal of Rheumatology November 2020, jrheum.200543; DOI: https://doi.org/10.3899/jrheum.200543
Silvia Rosina
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Giulia C. Varnier
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Angela Pistorio
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Clarissa Pilkington
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Susan Maillard
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Adele Civino
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Elena Tsitsami
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Claudia Bracaglia
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Marija Jelusic
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Adriana Cespedes-Cruz
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Graciela Espada
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Rolando Cimaz
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Gerard Couillault
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Rik Joos
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Pierre Quartier
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Anand P. Rao
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Clara Malattia
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Nicolino Ruperto
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Alessandro Consolaro
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Angelo Ravelli
S. Rosina, MD, PhD, N. Ruperto, MD, MPH, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy; G.C. Varnier, MD, PhD, Pediatric Rheumatology Department, Royal Manchester Children’s Hospital, Manchester, UK; A. Pistorio, MD, PhD, Dipartimento di Epidemiologia e Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy; C. Pilkington, MD, S. Maillard, PhD, PT, Division of Rheumatology, Great Ormond Street Hospital, London, UK; A. Civino, MD, UOC Pediatria, Ospedale Vito Fazzi, Lecce, Italy; E. Tsitsami, MD, PhD, 1st Department of Pediatrics, School of Medicine, University of Athens, Children’s Hospital Agia Sofia, Athens, Greece; C. Bracaglia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù, Rome, Italy; M. Jelusic, MD, PhD, Department of Pediatrics, University of Zagreb School of Medicine, Zagreb, Croatia; A. Cespedes-Cruz, MD, Division of Rheumatology, UMAE Hospital General La Raza, Mexico City, Mexico; G. Espada, MD, Division of Rheumatology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; R. Cimaz, MD, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; G. Couillault, MD, Immunology, Hematology and Oncology Unit, Children’s Hospital, Dijon, France; R. Joos, MD, Pediatric Rheumatology, Ghent University Hospital, Ghent, Belgium; P. Quartier, MD, Institut IMAGINE, Centre de référence national pour les Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l’Enfant (RAISE), Université de Paris and Unité d’Immunologie, Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; A.P. Rao, MD, Division of Rheumatology, Manipal Hospital, Bangalore, India; C. Malattia, MD, PhD, A. Consolaro, MD, PhD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy; A. Ravelli, MD, UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy and Sechenov First Moscow State Medical University, Moscow, Russian Federation. None of the authors declare any competing interests related to the present manuscript. Address correspondence to Dr. S. Rosina, MD, PhD, Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genova, Italy. Email: silviarosina85@gmail.com. Accepted for publication October 2, 2020
Abstract
Objective To develop and test shortened versions of the Manual Muscle Test-8 (MMT-8) in juvenile dermatomyositis ( JDM).
Methods Construction of reduced tools was based on a retrospective analysis of individual scores of MMT-8 muscle groups in 3 multinational datasets. The 4 and 6 most frequently impaired muscle groups were included in MMT-4 and MMT-6, respectively. Metrologic properties of reduced tools were assessed by evaluating construct validity, internal consistency, discriminant ability, and responsiveness to change.
Results Neck flexors, hip extensors, hip abductors, and shoulder abductors were included in MMT-4, whereas MMT-6 also included elbow flexors and hip flexors. Both shortened tools revealed strong correlations with MMT-8 and other muscle strength measures. Correlations with other JDM outcome measures were in line with predictions. Internal consistency was good (0.88–0.96) for both MMT-4 and MMT-6. Both reduced tools showed strong ability to discriminate between disease activity states, assessed by the caring physician or a parent (P < 0.001), and between patients whose parents were satisfied or not satisfied with illness course (P < 0.001). Responsiveness to change (assessed by both standardized response mean and relative efficiency) of MMT-4 and, to a lesser degree, MMT-6, was slightly superior to that of MMT-8.
Conclusion Overall, the metrologic performance of MMT-4 and MMT-6 was comparable to that of the other established muscle strength tools, which indicates that they may be suitable for use in clinical practice and research, including clinical trials. The measurement properties of these tools should be further tested in other patient populations and evaluated prospectively.
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In this issue
The Journal of Rheumatology
Vol. 48, Issue 4
1 Apr 2021
Development and Testing of Reduced Versions of the MMT-8 in Juvenile Dermatomyositis
Silvia Rosina, Giulia C. Varnier, Angela Pistorio, Clarissa Pilkington, Susan Maillard, Adele Civino, Elena Tsitsami, Claudia Bracaglia, Marija Jelusic, Adriana Cespedes-Cruz, Graciela Espada, Rolando Cimaz, Gerard Couillault, Rik Joos, Pierre Quartier, Anand P. Rao, Clara Malattia, Nicolino Ruperto, Alessandro Consolaro, Angelo Ravelli
The Journal of Rheumatology Nov 2020, jrheum.200543; DOI: 10.3899/jrheum.200543
Development and Testing of Reduced Versions of the MMT-8 in Juvenile Dermatomyositis
Silvia Rosina, Giulia C. Varnier, Angela Pistorio, Clarissa Pilkington, Susan Maillard, Adele Civino, Elena Tsitsami, Claudia Bracaglia, Marija Jelusic, Adriana Cespedes-Cruz, Graciela Espada, Rolando Cimaz, Gerard Couillault, Rik Joos, Pierre Quartier, Anand P. Rao, Clara Malattia, Nicolino Ruperto, Alessandro Consolaro, Angelo Ravelli
The Journal of Rheumatology Nov 2020, jrheum.200543; DOI: 10.3899/jrheum.200543
