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

Alessandra Magnani, Angela Pistorio, Silvia Magni-Manzoni, Alessandra Falcone, Giuseppina Lombardini, Marcia Bandeira, Federica Rossi, Ilaria Sala, Alberto Martini, Angelo Ravelli

Research output: Contribution to journalArticle

Abstract

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. The Journal of Rheumatology

Original languageEnglish
Pages (from-to)628-634
Number of pages7
JournalJournal of Rheumatology
Volume36
Issue number3
DOIs
Publication statusPublished - Mar 2009

Keywords

  • Inactive disease
  • Juvenile chronic arthritis
  • Juvenile idiopathic arthritis
  • Juvenile rheumatoid arthritis
  • Longterm outcome
  • Physical disability
  • Radiographic assessment
  • Remission

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Rheumatology

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