title: Achievement of a state of inactive disease at least once in the first 5 years predicts better outcome of patients with polyarticular juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To investigate whether the achievement of inactive disease in the first 5 years predicts a more favorable outcome of children with juvenile idiopathic arthritis (JIA).
  
  
  METHODS
  We reviewed clinical charts of 123 patients who started taking methotrexate, were followed for at least 5 years, and received a yearly assessment in the first 5 years. At each yearly visit, the presence of inactive disease was assessed. Patients were divided into 3 groups: (1) patients who never reached inactive disease; (2) patients who reached inactive disease in only 1 visit; and (3) patients who reached inactive disease in > or = 2 visits. Outcome was evaluated after 6 to 18 years (median 7.1 yrs) by assessing the following clinical measures: restricted joint count, Childhood Health Assessment Questionnaire (CHAQ), Juvenile Arthritis Damage Index (JADI), and Poznanski score of radiographic damage.
  
  
  RESULTS
  In the first 5 years, 62 patients (50.4%) were noted to have active disease at their yearly visit, 40 patients (32.5%) were noted to have inactive disease only once, and 21 patients (17.1%) were noted to have inactive disease in > or = 2 visits. Patients who achieved inactive disease 1 or more times had lower restricted joint count (p = 0.007) and JADI-Articular score (p = 0.004) at last followup visit than those who never reached such a state. A similar trend, although not significant, was observed for CHAQ and Poznanski score of radiographic damage.
  
  
  CONCLUSIONS
  Attainment of the state of inactive disease at least once in the first 5 years was found to be associated with less longterm joint damage and with a trend toward less functional impairment.
authors.affiliation: Istituto G. Gaslini, Largo G. Gaslini 5, 16147 Genova, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Magnani
authors.forename: Angela
authors.initials: A
authors.lastname: Pistorio
authors.forename: Silvia
authors.initials: S
authors.lastname: Magni-Manzoni
authors.forename: Alessandra
authors.initials: A
authors.lastname: Falcone
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Lombardini
authors.forename: Marcia
authors.initials: M
authors.lastname: Bandeira
authors.forename: Federica
authors.initials: F
authors.lastname: Rossi
authors.forename: Ilaria
authors.initials: I
authors.lastname: Sala
authors.forename: Alberto
authors.initials: A
authors.lastname: Martini
authors.forename: Angelo
authors.initials: A
authors.lastname: Ravelli
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000188:drug therapy* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012074:Remission Induction; D012720:Severity of Illness Index
chemical_list: D018501:Antirheumatic Agents