Abstract | OBJECTIVE: To characterize disease activity patterns in a large cohort of children with juvenile idiopathic arthritis (JIA), by applying newly developed preliminary definitions of inactive disease, clinical remission on medication, and clinical remission off medication. METHODS: Children with persistent or extended oligoarthritis, polyarthritis (either rheumatoid factor [RF] positive or RF negative), or systemic JIA who had been followed up for a period of at least 4 years were evaluated for episodes of inactive disease, clinical remission on medication, and clinical remission off medication. Descriptive statistics, correlation analyses, and survival analyses were performed. RESULTS: Four hundred thirty-seven children met the criteria for review. Three hundred ninety-one patients (89%) experienced a total of 878 episodes of inactive disease, with a median episode length of 12.7 months. Two hundred twenty-eight episodes of inactive disease (26%) resulted in clinical remission off medication; it was equally as likely that episodes of inactive disease would or would not follow a period of clinical remission on medication. Thirty-six percent of episodes of clinical remission off medication persisted for at least 2 years, and only 6% of such episodes persisted for 5 years. RF-positive patients were the least likely to achieve clinical remission off medication (5%), and patients with persistent oligoarticular JIA were the most likely (68%). Among patients with persistent oligoarticular JIA, most of the disease course was characterized by inactive disease; in most other patients the majority of the disease course involved active disease. CONCLUSION: Using newly developed preliminary criteria for inactive disease, clinical remission on medication, and clinical remission off medication, we observed that only one-fourth of 878 episodes of inactive disease resulted in clinical remission off medication during followup of at least 4 years. Only a small proportion of episodes of clinical remission off medication were sustained for >5 years. These results highlight the critical need for therapies that have the ability to induce sustained remission of JIA.
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Authors | Carol A Wallace, Bin Huang, Marcia Bandeira, Angelo Ravelli, Edward H Giannini |
Journal | Arthritis and rheumatism
(Arthritis Rheum)
Vol. 52
Issue 11
Pg. 3554-62
(Nov 2005)
ISSN: 0004-3591 [Print] United States |
PMID | 16255044
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Topics |
- Arthritis, Juvenile
(classification, pathology, physiopathology, rehabilitation)
- Child
- Child, Preschool
- Cohort Studies
- Delphi Technique
- Female
- Follow-Up Studies
- Health Status
- Humans
- Male
- Recovery of Function
- Remission Induction
- Remission, Spontaneous
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