Incidence and Prevalence of Juvenile Idiopathic Arthritis Among Children in a Managed Care Population, 1996-2009

From the Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic, Worcester, Massachusetts; Division of Research, Kaiser Permanente Northern California, Oakland, California; The Permanente Medical Group, Santa Clara, California; Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Department of Dermatology, University of California at San Francisco, San Francisco, California; Departments of Dermatology, Biostatistics, and Epidemiology, and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and Department of Dermatology, Kaiser Permanente Medical Center, Los Angeles, California, USA. Supported by a grant from the National Institute of Allergy and Infectious Disease (1RC1AI086107-01). Dr. Harrold has a consulting role with the Consortium of Rheumatology Researchers of North America (CORRONA) and was supported by K23AR053856 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Herrinton has research contracts with Centocor, Genentech, and Proctor and Gamble; Dr. Asgari with Genentech; and Dr. Wu with Abbott Laboratories, Amgen, and Pfizer. Dr. Gelfand receives grants to the trustees of the University of Pennsylvania from Amgen, Abbott, and Genentech, and has consulting roles with Amgen, Abbott, Centocor, Pfizer, and Merck. Dr. Curtis receives consulting fees/honoraria and research support from Roche/Genentech, UCB/Centocor, CORRONA, Amgen, Pfizer, BMS, Crescendo, and Abbott and receives salary support from the U.S. National Institutes of Health (AR053351) and Agency for Healthcare Research and Quality (R01 R01HS018517). L.R. Harrold, MD, MPH, Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic; C. Salman, BS, Division of Research, Kaiser Permanente Northern California; S. Shoor, MD, The Permanente Medical Group; J.R. Curtis, MD, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; M.M. Asgari, MD, MPH, Division of Research, Kaiser Permanente Northern California, and Department of Dermatology, University of California at San Francisco; J.M. Gelfand, MD, MSCE, Departments of Dermatology, Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania; J.J. Wu, MD, Department of Dermatology, Kaiser Permanente Medical Center; L.J. Herrinton, PhD, Division of Research, Kaiser Permanente Northern California. Address correspondence to Dr. L.R. Harrold, Department of Medicine, University of Massachusetts Medical School, Biotech 4, Suite 315, 377 Plantation Street, Worcester, MA 01605, USA. E-mail: Leslie.Harrold{at}umassmed.edu Accepted for publication March 4, 2013.

From the Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic, Worcester, Massachusetts; Division of Research, Kaiser Permanente Northern California, Oakland, California; The Permanente Medical Group, Santa Clara, California; Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Department of Dermatology, University of California at San Francisco, San Francisco, California; Departments of Dermatology, Biostatistics, and Epidemiology, and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and Department of Dermatology, Kaiser Permanente Medical Center, Los Angeles, California, USA. Supported by a grant from the National Institute of Allergy and Infectious Disease (1RC1AI086107-01). Dr. Harrold has a consulting role with the Consortium of Rheumatology Researchers of North America (CORRONA) and was supported by K23AR053856 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Herrinton has research contracts with Centocor, Genentech, and Proctor and Gamble; Dr. Asgari with Genentech; and Dr. Wu with Abbott Laboratories, Amgen, and Pfizer. Dr. Gelfand receives grants to the trustees of the University of Pennsylvania from Amgen, Abbott, and Genentech, and has consulting roles with Amgen, Abbott, Centocor, Pfizer, and Merck. Dr. Curtis receives consulting fees/honoraria and research support from Roche/Genentech, UCB/Centocor, CORRONA, Amgen, Pfizer, BMS, Crescendo, and Abbott and receives salary support from the U.S. National Institutes of Health (AR053351) and Agency for Healthcare Research and Quality (R01 R01HS018517). L.R. Harrold, MD, MPH, Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic; C. Salman, BS, Division of Research, Kaiser Permanente Northern California; S. Shoor, MD, The Permanente Medical Group; J.R. Curtis, MD, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; M.M. Asgari, MD, MPH, Division of Research, Kaiser Permanente Northern California, and Department of Dermatology, University of California at San Francisco; J.M. Gelfand, MD, MSCE, Departments of Dermatology, Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania; J.J. Wu, MD, Department of Dermatology, Kaiser Permanente Medical Center; L.J. Herrinton, PhD, Division of Research, Kaiser Permanente Northern California. Address correspondence to Dr. L.R. Harrold, Department of Medicine, University of Massachusetts Medical School, Biotech 4, Suite 315, 377 Plantation Street, Worcester, MA 01605, USA. E-mail: Leslie.Harrold{at}umassmed.edu Accepted for publication March 4, 2013.

From the Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic, Worcester, Massachusetts; Division of Research, Kaiser Permanente Northern California, Oakland, California; The Permanente Medical Group, Santa Clara, California; Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Department of Dermatology, University of California at San Francisco, San Francisco, California; Departments of Dermatology, Biostatistics, and Epidemiology, and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and Department of Dermatology, Kaiser Permanente Medical Center, Los Angeles, California, USA. Supported by a grant from the National Institute of Allergy and Infectious Disease (1RC1AI086107-01). Dr. Harrold has a consulting role with the Consortium of Rheumatology Researchers of North America (CORRONA) and was supported by K23AR053856 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Herrinton has research contracts with Centocor, Genentech, and Proctor and Gamble; Dr. Asgari with Genentech; and Dr. Wu with Abbott Laboratories, Amgen, and Pfizer. Dr. Gelfand receives grants to the trustees of the University of Pennsylvania from Amgen, Abbott, and Genentech, and has consulting roles with Amgen, Abbott, Centocor, Pfizer, and Merck. Dr. Curtis receives consulting fees/honoraria and research support from Roche/Genentech, UCB/Centocor, CORRONA, Amgen, Pfizer, BMS, Crescendo, and Abbott and receives salary support from the U.S. National Institutes of Health (AR053351) and Agency for Healthcare Research and Quality (R01 R01HS018517). L.R. Harrold, MD, MPH, Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic; C. Salman, BS, Division of Research, Kaiser Permanente Northern California; S. Shoor, MD, The Permanente Medical Group; J.R. Curtis, MD, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; M.M. Asgari, MD, MPH, Division of Research, Kaiser Permanente Northern California, and Department of Dermatology, University of California at San Francisco; J.M. Gelfand, MD, MSCE, Departments of Dermatology, Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania; J.J. Wu, MD, Department of Dermatology, Kaiser Permanente Medical Center; L.J. Herrinton, PhD, Division of Research, Kaiser Permanente Northern California. Address correspondence to Dr. L.R. Harrold, Department of Medicine, University of Massachusetts Medical School, Biotech 4, Suite 315, 377 Plantation Street, Worcester, MA 01605, USA. E-mail: Leslie.Harrold{at}umassmed.edu Accepted for publication March 4, 2013.

From the Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic, Worcester, Massachusetts; Division of Research, Kaiser Permanente Northern California, Oakland, California; The Permanente Medical Group, Santa Clara, California; Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Department of Dermatology, University of California at San Francisco, San Francisco, California; Departments of Dermatology, Biostatistics, and Epidemiology, and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and Department of Dermatology, Kaiser Permanente Medical Center, Los Angeles, California, USA. Supported by a grant from the National Institute of Allergy and Infectious Disease (1RC1AI086107-01). Dr. Harrold has a consulting role with the Consortium of Rheumatology Researchers of North America (CORRONA) and was supported by K23AR053856 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Herrinton has research contracts with Centocor, Genentech, and Proctor and Gamble; Dr. Asgari with Genentech; and Dr. Wu with Abbott Laboratories, Amgen, and Pfizer. Dr. Gelfand receives grants to the trustees of the University of Pennsylvania from Amgen, Abbott, and Genentech, and has consulting roles with Amgen, Abbott, Centocor, Pfizer, and Merck. Dr. Curtis receives consulting fees/honoraria and research support from Roche/Genentech, UCB/Centocor, CORRONA, Amgen, Pfizer, BMS, Crescendo, and Abbott and receives salary support from the U.S. National Institutes of Health (AR053351) and Agency for Healthcare Research and Quality (R01 R01HS018517). L.R. Harrold, MD, MPH, Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic; C. Salman, BS, Division of Research, Kaiser Permanente Northern California; S. Shoor, MD, The Permanente Medical Group; J.R. Curtis, MD, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; M.M. Asgari, MD, MPH, Division of Research, Kaiser Permanente Northern California, and Department of Dermatology, University of California at San Francisco; J.M. Gelfand, MD, MSCE, Departments of Dermatology, Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania; J.J. Wu, MD, Department of Dermatology, Kaiser Permanente Medical Center; L.J. Herrinton, PhD, Division of Research, Kaiser Permanente Northern California. Address correspondence to Dr. L.R. Harrold, Department of Medicine, University of Massachusetts Medical School, Biotech 4, Suite 315, 377 Plantation Street, Worcester, MA 01605, USA. E-mail: Leslie.Harrold{at}umassmed.edu Accepted for publication March 4, 2013.

From the Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic, Worcester, Massachusetts; Division of Research, Kaiser Permanente Northern California, Oakland, California; The Permanente Medical Group, Santa Clara, California; Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Department of Dermatology, University of California at San Francisco, San Francisco, California; Departments of Dermatology, Biostatistics, and Epidemiology, and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and Department of Dermatology, Kaiser Permanente Medical Center, Los Angeles, California, USA. Supported by a grant from the National Institute of Allergy and Infectious Disease (1RC1AI086107-01). Dr. Harrold has a consulting role with the Consortium of Rheumatology Researchers of North America (CORRONA) and was supported by K23AR053856 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Herrinton has research contracts with Centocor, Genentech, and Proctor and Gamble; Dr. Asgari with Genentech; and Dr. Wu with Abbott Laboratories, Amgen, and Pfizer. Dr. Gelfand receives grants to the trustees of the University of Pennsylvania from Amgen, Abbott, and Genentech, and has consulting roles with Amgen, Abbott, Centocor, Pfizer, and Merck. Dr. Curtis receives consulting fees/honoraria and research support from Roche/Genentech, UCB/Centocor, CORRONA, Amgen, Pfizer, BMS, Crescendo, and Abbott and receives salary support from the U.S. National Institutes of Health (AR053351) and Agency for Healthcare Research and Quality (R01 R01HS018517). L.R. Harrold, MD, MPH, Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic; C. Salman, BS, Division of Research, Kaiser Permanente Northern California; S. Shoor, MD, The Permanente Medical Group; J.R. Curtis, MD, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; M.M. Asgari, MD, MPH, Division of Research, Kaiser Permanente Northern California, and Department of Dermatology, University of California at San Francisco; J.M. Gelfand, MD, MSCE, Departments of Dermatology, Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania; J.J. Wu, MD, Department of Dermatology, Kaiser Permanente Medical Center; L.J. Herrinton, PhD, Division of Research, Kaiser Permanente Northern California. Address correspondence to Dr. L.R. Harrold, Department of Medicine, University of Massachusetts Medical School, Biotech 4, Suite 315, 377 Plantation Street, Worcester, MA 01605, USA. E-mail: Leslie.Harrold{at}umassmed.edu Accepted for publication March 4, 2013.

From the Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic, Worcester, Massachusetts; Division of Research, Kaiser Permanente Northern California, Oakland, California; The Permanente Medical Group, Santa Clara, California; Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Department of Dermatology, University of California at San Francisco, San Francisco, California; Departments of Dermatology, Biostatistics, and Epidemiology, and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and Department of Dermatology, Kaiser Permanente Medical Center, Los Angeles, California, USA. Supported by a grant from the National Institute of Allergy and Infectious Disease (1RC1AI086107-01). Dr. Harrold has a consulting role with the Consortium of Rheumatology Researchers of North America (CORRONA) and was supported by K23AR053856 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Herrinton has research contracts with Centocor, Genentech, and Proctor and Gamble; Dr. Asgari with Genentech; and Dr. Wu with Abbott Laboratories, Amgen, and Pfizer. Dr. Gelfand receives grants to the trustees of the University of Pennsylvania from Amgen, Abbott, and Genentech, and has consulting roles with Amgen, Abbott, Centocor, Pfizer, and Merck. Dr. Curtis receives consulting fees/honoraria and research support from Roche/Genentech, UCB/Centocor, CORRONA, Amgen, Pfizer, BMS, Crescendo, and Abbott and receives salary support from the U.S. National Institutes of Health (AR053351) and Agency for Healthcare Research and Quality (R01 R01HS018517). L.R. Harrold, MD, MPH, Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic; C. Salman, BS, Division of Research, Kaiser Permanente Northern California; S. Shoor, MD, The Permanente Medical Group; J.R. Curtis, MD, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; M.M. Asgari, MD, MPH, Division of Research, Kaiser Permanente Northern California, and Department of Dermatology, University of California at San Francisco; J.M. Gelfand, MD, MSCE, Departments of Dermatology, Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania; J.J. Wu, MD, Department of Dermatology, Kaiser Permanente Medical Center; L.J. Herrinton, PhD, Division of Research, Kaiser Permanente Northern California. Address correspondence to Dr. L.R. Harrold, Department of Medicine, University of Massachusetts Medical School, Biotech 4, Suite 315, 377 Plantation Street, Worcester, MA 01605, USA. E-mail: Leslie.Harrold{at}umassmed.edu Accepted for publication March 4, 2013.

From the Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic, Worcester, Massachusetts; Division of Research, Kaiser Permanente Northern California, Oakland, California; The Permanente Medical Group, Santa Clara, California; Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Department of Dermatology, University of California at San Francisco, San Francisco, California; Departments of Dermatology, Biostatistics, and Epidemiology, and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and Department of Dermatology, Kaiser Permanente Medical Center, Los Angeles, California, USA. Supported by a grant from the National Institute of Allergy and Infectious Disease (1RC1AI086107-01). Dr. Harrold has a consulting role with the Consortium of Rheumatology Researchers of North America (CORRONA) and was supported by K23AR053856 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Herrinton has research contracts with Centocor, Genentech, and Proctor and Gamble; Dr. Asgari with Genentech; and Dr. Wu with Abbott Laboratories, Amgen, and Pfizer. Dr. Gelfand receives grants to the trustees of the University of Pennsylvania from Amgen, Abbott, and Genentech, and has consulting roles with Amgen, Abbott, Centocor, Pfizer, and Merck. Dr. Curtis receives consulting fees/honoraria and research support from Roche/Genentech, UCB/Centocor, CORRONA, Amgen, Pfizer, BMS, Crescendo, and Abbott and receives salary support from the U.S. National Institutes of Health (AR053351) and Agency for Healthcare Research and Quality (R01 R01HS018517). L.R. Harrold, MD, MPH, Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic; C. Salman, BS, Division of Research, Kaiser Permanente Northern California; S. Shoor, MD, The Permanente Medical Group; J.R. Curtis, MD, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; M.M. Asgari, MD, MPH, Division of Research, Kaiser Permanente Northern California, and Department of Dermatology, University of California at San Francisco; J.M. Gelfand, MD, MSCE, Departments of Dermatology, Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania; J.J. Wu, MD, Department of Dermatology, Kaiser Permanente Medical Center; L.J. Herrinton, PhD, Division of Research, Kaiser Permanente Northern California. Address correspondence to Dr. L.R. Harrold, Department of Medicine, University of Massachusetts Medical School, Biotech 4, Suite 315, 377 Plantation Street, Worcester, MA 01605, USA. E-mail: Leslie.Harrold{at}umassmed.edu Accepted for publication March 4, 2013.

From the Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic, Worcester, Massachusetts; Division of Research, Kaiser Permanente Northern California, Oakland, California; The Permanente Medical Group, Santa Clara, California; Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Department of Dermatology, University of California at San Francisco, San Francisco, California; Departments of Dermatology, Biostatistics, and Epidemiology, and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and Department of Dermatology, Kaiser Permanente Medical Center, Los Angeles, California, USA. Supported by a grant from the National Institute of Allergy and Infectious Disease (1RC1AI086107-01). Dr. Harrold has a consulting role with the Consortium of Rheumatology Researchers of North America (CORRONA) and was supported by K23AR053856 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Herrinton has research contracts with Centocor, Genentech, and Proctor and Gamble; Dr. Asgari with Genentech; and Dr. Wu with Abbott Laboratories, Amgen, and Pfizer. Dr. Gelfand receives grants to the trustees of the University of Pennsylvania from Amgen, Abbott, and Genentech, and has consulting roles with Amgen, Abbott, Centocor, Pfizer, and Merck. Dr. Curtis receives consulting fees/honoraria and research support from Roche/Genentech, UCB/Centocor, CORRONA, Amgen, Pfizer, BMS, Crescendo, and Abbott and receives salary support from the U.S. National Institutes of Health (AR053351) and Agency for Healthcare Research and Quality (R01 R01HS018517). L.R. Harrold, MD, MPH, Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic; C. Salman, BS, Division of Research, Kaiser Permanente Northern California; S. Shoor, MD, The Permanente Medical Group; J.R. Curtis, MD, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham; M.M. Asgari, MD, MPH, Division of Research, Kaiser Permanente Northern California, and Department of Dermatology, University of California at San Francisco; J.M. Gelfand, MD, MSCE, Departments of Dermatology, Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania; J.J. Wu, MD, Department of Dermatology, Kaiser Permanente Medical Center; L.J. Herrinton, PhD, Division of Research, Kaiser Permanente Northern California. Address correspondence to Dr. L.R. Harrold, Department of Medicine, University of Massachusetts Medical School, Biotech 4, Suite 315, 377 Plantation Street, Worcester, MA 01605, USA. E-mail: Leslie.Harrold{at}umassmed.edu Accepted for publication March 4, 2013.