The outcomes of juvenile idiopathic arthritis in children managed with contemporary treatments: results from the ReACCh-Out cohort Academic Article uri icon

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abstract

  • OBJECTIVE: To describe clinical outcomes of juvenile idiopathic arthritis (JIA) in a prospective inception cohort of children managed with contemporary treatments. METHODS: Children newly diagnosed with JIA at 16 Canadian paediatric rheumatology centres from 2005 to 2010 were included. Kaplan-Meier survival curves for each JIA category were used to estimate probability of ever attaining an active joint count of 0, inactive disease (no active joints, no extraarticular manifestations and a physician global assessment of disease activity <10 mm), disease remission (inactive disease >12 months after discontinuing treatment) and of receiving specific treatments. RESULTS: In a cohort of 1104 children, the probabilities of attaining an active joint count of 0 exceeded 78% within 2 years in all JIA categories. The probability of attaining inactive disease exceeded 70% within 2 years in all categories, except for RF-positive polyarthritis (48%). The probability of discontinuing treatment at least once was 67% within 5 years. The probability of attaining remission within 5 years was 46-57% across JIA categories except for polyarthritis (0% RF-positive, 14% RF-negative). Initial treatment included joint injections and non-steroidal anti-inflammatory drugs for oligoarthritis, disease-modifying antirheumatic drugs (DMARDs) for polyarthritis and systemic corticosteroids for systemic JIA. CONCLUSIONS: Most children with JIA managed with contemporary treatments attain inactive disease within 2 years of diagnosis and many are able to discontinue treatment. The probability of attaining remission within 5 years of diagnosis is about 50%, except for children with polyarthritis.

authors

  • Guzman, Jaime
  • Oen, Kiem
  • Tucker, Lori B
  • Huber, Adam M
  • Shiff, Natalie
  • Boire, Gilles
  • Scuccimarri, Rosie
  • Berard, Roberta
  • Tse, Shirley ML
  • Morishita, Kimberly
  • Stringer, Elizabeth
  • Johnson, Nicole
  • Levy, Deborah M
  • Duffy, Karen Watanabe
  • Cabral, David A
  • Rosenberg, Alan M
  • Larche, Margaret
  • Dancey, Paul
  • Petty, Ross E
  • Laxer, Ronald M
  • Silverman, Earl
  • Miettunen, Paivi
  • Chetaille, Anne-Laure
  • Haddad, Elie
  • Houghton, Kristin
  • Spiegel, Lynn
  • Turvey, Stuart E
  • Schmeling, Heinrike
  • Lang, Bianca
  • Ellsworth, Janet
  • Ramsey, Suzanne
  • Bruns, Alessandra
  • Campillo, Sarah
  • Benseler, Susanne
  • Chédeville, Gaëlle
  • Schneider, Rayfel
  • Yeung, Rae
  • Duffy, Ciarán M

publication date

  • October 2015

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