PT  - JOURNAL ARTICLE
AU  - MAGNANI, ALESSANDRA
AU  - PISTORIO, ANGELA
AU  - MAGNI-MANZONI, SILVIA
AU  - FALCONE, ALESSANDRA
AU  - LOMBARDINI, GIUSEPPINA
AU  - BANDEIRA, MARCIA
AU  - ROSSI, FEDERICA
AU  - SALA, ILARIA
AU  - MARTINI, ALBERTO
AU  - RAVELLI, ANGELO
TI  - Achievement of a State of Inactive Disease at Least Once in the First 5 Years Predicts Better Outcome of Patients with Polyarticular Juvenile Idiopathic Arthritis
AID  - 10.3899/jrheum.080560
DP  - 2009 Mar 01
TA  - The Journal of Rheumatology
PG  - 628--634
VI  - 36
IP  - 3
4099  - http://www.jrheum.org/content/36/3/628.short
4100  - http://www.jrheum.org/content/36/3/628.full
SO  - J Rheumatol2009 Mar 01; 36
AB  - Objective. To investigate whether the achievement of inactive disease in the first 5 years predicts a more favorable outcome of children with juvenile idiopathic arthritis (JIA). Methods. We reviewed clinical charts of 123 patients who started taking methotrexate, were followed for at least 5 years, and received a yearly assessment in the first 5 years. At each yearly visit, the presence of inactive disease was assessed. Patients were divided into 3 groups: (1) patients who never reached inactive disease; (2) patients who reached inactive disease in only 1 visit; and (3) patients who reached inactive disease in ≥ 2 visits. Outcome was evaluated after 6 to 18 years (median 7.1 yrs) by assessing the following clinical measures: restricted joint count, Childhood Health Assessment Questionnaire (CHAQ), Juvenile Arthritis Damage Index (JADI), and Poznanski score of radiographic damage. Results. In the first 5 years, 62 patients (50.4%) were noted to have active disease at their yearly visit, 40 patients (32.5%) were noted to have inactive disease only once, and 21 patients (17.1%) were noted to have inactive disease in ≥ 2 visits. Patients who achieved inactive disease 1 or more times had lower restricted joint count (p = 0.007) and JADI-Articular score (p = 0.004) at last followup visit than those who never reached such a state. A similar trend, although not significant, was observed for CHAQ and Poznanski score of radiographic damage. Conclusion. Attainment of the state of inactive disease at least once in the first 5 years was found to be associated with less longterm joint damage and with a trend toward less functional impairment.