Proxy-reported health-related quality of life of patients with juvenile idiopathic arthritis: the Pediatric Rheumatology International Trials Organization multinational quality of life cohort study.
OBJECTIVE
To investigate the proxy-reported health-related quality of life (HRQOL) and its determinants in patients with juvenile idiopathic arthritis (JIA).


METHODS
In this multinational, multicenter, cross-sectional study, HRQOL of patients with JIA was assessed through the Child Health Questionnaire (CHQ) and was compared with that of healthy children of similar age from the same geographic area. Potential determinants of HRQOL included demographic data, physician's and parent's global assessments, measures of joint inflammation, Childhood Health Assessment Questionnaire (CHAQ), and erythrocyte sedimentation rate.


RESULTS
A total of 6,639 participants (3,324 with JIA and 3,315 healthy) were enrolled from 32 countries. The mean +/- SD physical and psychosocial summary scores of the CHQ were significantly lower in patients with JIA than in healthy children (physical: 44.5 +/- 10.6 versus 54.6 +/- 4.0, P < 0.0001; psychosocial: 47.6 +/- 8.7 versus 51.9 +/- 7.5, P < 0.0001), with the physical well-being domain being most impaired. Patients with persistent oligoarthritis had better HRQOL compared with other subtypes, whereas HRQOL was similar across patients with systemic arthritis, polyarthritis, and extended oligoarthritis. A CHAQ score >1 and a pain intensity rating >3.4 cm on a 10-cm visual analog scale were the strongest determinants of poorer HRQOL in the physical and psychosocial domains, respectively.


CONCLUSIONS
We found that patients with JIA have a significant impairment of their HRQOL compared with healthy peers, particularly in the physical domain. Physical well-being was mostly affected by the level of functional impairment, whereas the intensity of pain had the greatest influence on psychosocial health.
Oliveira
Sheila
S
IRCCS G. Gaslini, Pediatria II, Reumatologia, Pediatric Rheumatology International Trials Organization, Genoa, Italy.
Ravelli
Angelo
A
Pistorio
Angela
A
Castell
Esteban
E
Malattia
Clara
C
Prieur
Anne Marie
AM
Saad-Magalhães
Claudia
C
Murray
Kevin J
KJ
Bae
Sang-Cheol
SC
Joos
Rik
R
Foeldvari
Ivan
I
Duarte-Salazar
Carolina
C
Wulffraat
Nico
N
Lahdenne
Pekka
P
Dolezalova
Pavla
P
de Inocencio
Jaime
J
Kanakoudi-Tsakalidou
Florence
F
Hofer
Michael
M
Nikishina
Irina
I
Ozdogan
Huri
H
Hashkes
Philip J
PJ
Landgraf
Jeanne M
JM
Martini
Alberto
A
Ruperto
Nicolino
N
D000203:Activities of Daily Living; D000293:Adolescent; D001171:Arthritis, Juvenile / Q000150:complications* / Q000523:psychology* / Q000628:therapy; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007391:International Cooperation; D008297:Male; D010146:Pain / Q000150:complications / Q000209:etiology; D019727:Proxy; D011584:Psychology; D011788:Quality of Life; D012720:Severity of Illness Index