Effect of Treatment Changes on Health-Related Quality of Life in Canadian Children With Juvenile Idiopathic Arthritis: Results From ReACCh-Out and CAPRI

Objective We assessed changes in health-related quality of life (HRQOL) in Canadian patients with juvenile idiopathic arthritis (JIA), comparing inception cohorts from 2017 to 2023 and 2005 to 2010.

Methods We included newly diagnosed patients who completed the Juvenile Arthritis Quality of Life Questionnaire (JAQQ) at both enrollment and 1 year later. Mean changes in JAQQ domain scores from baseline to 1 year were compared between cohorts using Mann-Whitney U tests. Multivariable linear regression was used to adjust for baseline imbalances between the cohorts. We also compared changes in treatments, the Quality of My Life scale, arthritis pain, Childhood Health Assessment Questionnaire disability index, and physician and parent global assessments.

Results We included 478 and 663 patients from the 2017-2023 and 2005-2010 cohorts, respectively. By 1 year, a greater proportion of patients in the 2017-2023 cohort had used conventional synthetic and biologic disease-modifying antirheumatic drugs compared to the 2005-2010 cohort (57.9% vs 46.2% and 27.2% vs 6.3%, respectively). Improvements in total JAQQ score from baseline to 1 year were similar between the 2017-2023 (0.97; 95% CI 0.85-1.09) and 2005-2010 (0.92; 95% CI 0.82-1.02) cohorts, with no significant difference observed across JAQQ domains. Pain scores, however, improved significantly (−2.07 vs −1.62, P = 0.03). After adjusting for baseline imbalances, greater improvements were observed in the 2017-2023 cohort for all JAQQ domains in patients with ≥ 5 active joints (β 0.28 for psychosocial to β 0.62 for gross motor).

Conclusion First-year improvements in HRQOL measured by JAQQ were similar in the 2017-2023 and 2005-2010 cohorts, but adjustment for baseline imbalances suggests greater HRQOL improvements in those with more severe disease in the later cohort.