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Ann Rheum Dis. 2015 Oct;74(10):1854-60. doi: 10.1136/annrheumdis-2014-205372. Epub 2014 May 19.

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

Author information

1
British Columbia Children's Hospital and the University of British Columbia, Vancouver, Canada.
2
Winnipeg Children's Hospital and University of Manitoba, Winnipeg, Canada.
3
IWK Health Centre and Dalhousie University, Halifax, Canada.
4
Royal University Hospital and University of Saskatchewan, Saskatoon, Canada.
5
Centre Hospitalier Universitaire de Sherbrooke and Université de Sherbrooke, Sherbrooke, Canada.
6
McGill University Health Centre and McGill University, Montreal, Canada.
7
London Health Sciences Centre and Western University, London, Canada.
8
Hospital for Sick Children and University of Toronto, Toronto, Canada.
9
The Alberta Children's Hospital and University of Calgary, Calgary, Canada.
10
Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Canada.
11
McMaster University, Hamilton, Canada.
12
Janeway Children's Health and Rehabilitation Centre and Memorial University, Saint John's, Canada.
13
Centre Hospitalier Universitaire de Laval and Université Laval, Quebec, Canada.
14
CHU Ste. Justine and Université de Montréal, Montréal, Canada.
15
The Stollery Children's Hospital and University of Alberta, Edmonton, Canada.

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.

KEYWORDS:

Epidemiology; Juvenile Idiopathic Arthritis; Outcomes research; Treatment

PMID:
24842571
DOI:
10.1136/annrheumdis-2014-205372
[Indexed for MEDLINE]

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