title: Accuracy of Wallace criteria for clinical remission in juvenile idiopathic arthritis: a cohort study of 761 consecutive cases.
abstract: OBJECTIVE
  To evaluate disease course and clinical usefulness in some categories of juvenile idiopathic arthritis (JIA) by applying newly developed Wallace definitions of remission off drugs.
  
  
  METHODS
  In a retrospective study, charts of patients with chronic form of primary (idiopathic) arthritis followed from our center since 1970 were reviewed and clinical/laboratory variables were collected for further analysis.
  
  
  RESULTS
  The cohort included 761 eligible patients [516 (67.8%) female, 245 (32.2%) male] with JIA. Mean disease onset age (+/- standard deviation) was 6.25 +/- 4.4 years (range 0.5-15.9). Disease mean duration to last visit was 10.02 +/- 4.31 years. Followup mean period was 7.6 +/- 6.4 years (range 1.5-35 yrs). A total of 247 (32.46%) patients achieved remission according to criteria [persistent oligoarthritis 153 (42.9%); extended oligoarthritis 15 (13.1%); seronegative polyarthritis 21 (22.4%); systemic arthritis 33 (33.7%); enthesitis related arthritis (ERA) plus juvenile psoriatic arthritis (JPsA) 25 (33.4%)]. No patients with seropositive polyarthritis achieved remission status (p < 0.001). In remitted patients the mean survival function (+/- standard error of the mean) before relapse calculated by Kaplan-Meier was of 20.9 (+/- 1.3) months overall: 21.7 (+/- 0.46) in persistent oligoarthritis, 25.0 (+/- 6.6) in extended oligoarthritis, 26.7 (+/- 13.2) in seronegative polyarthritis, and 17.6 (+/- 2.44) in ERA+JPsA (p > 0.1).
  
  
  CONCLUSIONS
  In our cohort about one-third of cases obtained a remission episode in 4 decades of observation, with a significant difference between oligoarthritis and other categories (p < 0.001) using the Kaplan-Meier method; the remission status duration before a relapse has been about 20 months, without a significant difference between JIA categories.
authors.affiliation: Gateano Pini Institute, University of Milan, and Fornaroli Hospital, Rheumatology Unit, Magenta, 20013, Italy.
authors.forename: Alfredomaria
authors.initials: A
authors.lastname: Lurati
authors.forename: Alessandra
authors.initials: A
authors.lastname: Salmaso
authors.forename: Valeria
authors.initials: V
authors.lastname: Gerloni
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gattinara
authors.forename: Flavio
authors.initials: F
authors.lastname: Fantini
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D012008:Recurrence; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D012720:Severity of Illness Index