Health status of patients with juvenile rheumatoid arthritis at 1 and 5 years after diagnosis.
OBJECTIVE
To describe the health and functional status of children with juvenile rheumatoid arthritis (JRA) diagnosed in the early 1990s.


METHODS
Patients were obtained from the Pediatric Rheumatology Disease Registry, a database of patients seen in pediatric rheumatology centers across the United States. Questionnaires designed to be filled out after retrospective chart review were sent to pediatric rheumatologists caring for children diagnosed with JRA between 1992 and 1997.


RESULTS
We studied 703 patients -- 376 with pauciarticular onset (pauci), 232 with polyarticular onset (poly), and 95 with systemic onset JRA (systemic). At 1 year after diagnosis, half of the pauci and systemic patients no longer required medication, compared to 78% of the poly patients; 98% of the patients functioned in Steinbrocker classes I and II. Six percent of pauci, 27% of poly, and 11% of systemic patients had limitations in school function. Nearly 1/3 of poly patients already had joint space narrowing on radiograph. By 5 years after diagnosis, all pauci, 88% of poly, and 70% of systemic patients were in Steinbrocker classes I and II; but 6% of pauci, 28% of poly, and 44% of systemic patients had limitations in school function. Nearly 2/3 of poly and systemic patients had joint space narrowing.


CONCLUSIONS
In these children treated prior to the era of biologic therapy, at 5 years after onset, > 25% of poly and nearly half of systemic patients had functional limitations that required modifications in their school schedule. Radiographically evident joint space damage was seen within a year of onset in poly patients, and by 5 years 2/3 of poly and systemic patients had damage.
Bowyer
Suzanne L
SL
Pediatric Rheumatology Divisions, Indiana University, Indianapolis, Indiana, USA.
Roettcher
Philip A
PA
Higgins
Gloria C
GC
Adams
Barbara
B
Myers
Linda K
LK
Wallace
Carol
C
Rennebohm
Robert
R
Moore
Terry L
TL
Pepmueller
Peri H
PH
Spencer
Charles
C
Wagner-Weiner
Linda
L
Rabinovich
Egla
E
Passo
Murray
M
Lovell
Daniel J
DJ
McCurdy
Deborah
D
Zemel
Lawrence
L
Schikler
Kenneth N
KN
Szer
Ilona
I
Kurtin
Paul
P
Lindsley
Carol
C
D000203:Activities of Daily Living; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000188:drug therapy*; D002648:Child; D015331:Cohort Studies; D004185:Disability Evaluation; D004522:Educational Status; D006304:Health Status; D006801:Humans; D007270:Injections, Intra-Articular; D007596:Joints / Q000254:growth & development / Q000473:pathology; D008727:Methotrexate / Q000008:administration & dosage*; D012042:Registries; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014605:Uveitis / Q000175:diagnosis
D000305:Adrenal Cortex Hormones; D018501:Antirheumatic Agents; D008727:Methotrexate