RT Journal Article
SR Electronic
T1 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
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 628
OP 634
DO 10.3899/jrheum.080560
VO 36
IS 3
A1 ALESSANDRA MAGNANI
A1 ANGELA PISTORIO
A1 SILVIA MAGNI-MANZONI
A1 ALESSANDRA FALCONE
A1 GIUSEPPINA LOMBARDINI
A1 MARCIA BANDEIRA
A1 FEDERICA ROSSI
A1 ILARIA SALA
A1 ALBERTO MARTINI
A1 ANGELO RAVELLI
YR 2009
UL http://www.jrheum.org/content/36/3/628.abstract
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.