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Research ArticleAccepted Articles

Non-systemic Juvenile Idiopathic Arthritis: How do the provisional PRINTO criteria shape the classification?

Mehmet Yildiz, Elif Konte Kilic, Esma Aslan, Nergis Akay, Hakan Demir, Aybuke Gunalp, Fatih Haslak, Umit Gul, Ece Aslan, Sezgin Sahin, Amra Adrovic, Kenan Barut and Ozgur Kasapcopur
The Journal of Rheumatology February 2026, jrheum.2025-0551; DOI: https://doi.org/10.3899/jrheum.2025-0551
Mehmet Yildiz
M. Yildiz, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey.
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Elif Konte Kilic
E. Konte Kilic, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey.
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Esma Aslan
E. Aslan, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey.
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Nergis Akay
N. Akay, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey.
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Hakan Demir
H. Demir, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey.
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Aybuke Gunalp
A. Gunalp, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey.
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Fatih Haslak
F. Haslak, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey.
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Umit Gul
U. Gul, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey.
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Ece Aslan
E. Aslan, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey.
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Sezgin Sahin
S. Sahin, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey.
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Amra Adrovic
A. Adrovic, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey.
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Kenan Barut
K. Barut, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey.
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Ozgur Kasapcopur
O. Kasapcopur, MD, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey.
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Abstract

Objective This study aimed to retrospectively evaluate the provisional Paediatric Rheumatology International Trials Organisation (PRINTO) criteria in patients with juvenile idiopathic arthritis (JIA) classified according to the International League of Associations for Rheumatology (ILAR) criteria.

Methods This retrospective cohort study was conducted at a single tertiary pediatric rheumatology center. A total of 310 patients with non-systemic JIA were classified according to both ILAR and provisional PRINTO criteria. Demographic, clinical, and laboratory features were recorded, and the distribution of JIA categories under both classification systems was analyzed.

Results The mean age at study time was 169.8 ± 59.2 months. Using ILAR criteria, 136 patients (43.9%) were categorized as oligoarticular JIA, 73 (23.5%) as enthesitis-related arthritis, 34 (11.0%) as RF-negative polyarticular JIA, 12 (3.9%) as psoriatic arthritis, 7 (2.3%) as RF-positive polyarticular JIA, and 48 (15.5%) as undifferentiated JIA. The provisional PRINTO criteria classified 107 (34.5%) patients as early-onset antinuclear antibody-positive JIA, 93 (30.0%) as other JIA, 88 (28.4%) as enthesitis/spondylitis-related JIA, 17 (5.5%) as RF-positive JIA, and 5 (1.6%) as unclassified JIA. The other JIA category included 93 patients, consisting of oligoarticular JIA (54.8%), RF-negative polyarticular JIA (21.5%), undifferentiated JIA (11.8%), enthesitis-related arthritis (6.5%), and psoriatic arthritis (5.4%) under the ILAR classification system.

Conclusion The provisional PRINTO criteria successfully reclassified a substantial proportion of previously undifferentiated JIA cases, improving diagnostic categorization by addressing some ILAR classification limitations. However, the high number of patients in the "other JIA" group highlights a potential limitation of the new system, warranting further investigation.

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The Journal of Rheumatology: 53 (3)
The Journal of Rheumatology
Vol. 53, Issue 3
1 Mar 2026
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Accepted manuscript
Non-systemic Juvenile Idiopathic Arthritis: How do the provisional PRINTO criteria shape the classification?
Mehmet Yildiz, Elif Konte Kilic, Esma Aslan, Nergis Akay, Hakan Demir, Aybuke Gunalp, Fatih Haslak, Umit Gul, Ece Aslan, Sezgin Sahin, Amra Adrovic, Kenan Barut, Ozgur Kasapcopur
The Journal of Rheumatology Feb 2026, jrheum.2025-0551; DOI: 10.3899/jrheum.2025-0551

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Accepted manuscript
Non-systemic Juvenile Idiopathic Arthritis: How do the provisional PRINTO criteria shape the classification?
Mehmet Yildiz, Elif Konte Kilic, Esma Aslan, Nergis Akay, Hakan Demir, Aybuke Gunalp, Fatih Haslak, Umit Gul, Ece Aslan, Sezgin Sahin, Amra Adrovic, Kenan Barut, Ozgur Kasapcopur
The Journal of Rheumatology Feb 2026, jrheum.2025-0551; DOI: 10.3899/jrheum.2025-0551
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