Early outcomes and improvement of patients with juvenile idiopathic arthritis enrolled in a Canadian multicenter inception cohort.
OBJECTIVE
To determine early outcomes and early improvements in a prospective inception cohort of children with juvenile idiopathic arthritis (JIA) treated with current standard therapies.


METHODS
Patients selected were enrolled in an inception cohort of JIA, the Research in Arthritis in Canadian Children Emphasizing Outcomes Study. The juvenile rheumatoid arthritis core criteria set measures were completed at enrollment and 6 months later. Frequencies of normal values for each of the core set measures and the American College of Rheumatology (ACR) Pediatric 30, 50, and 70 (Pedi 70) criteria response rates achieved at 6 months after enrollment were calculated for each JIA-onset subtype group.


RESULTS
Among 354 patients in the study, the median interval between diagnosis and enrollment was 0.7 months. At 6 months after enrollment, median values of active joint counts were highest in patients with rheumatoid factor (RF)-positive polyarthritis (4) and RF-negative polyarthritis (2), but were 0 or 1 for other subtypes. Fifty percent or more of patients with oligoarthritis, systemic arthritis, enthesitis-related arthritis, and undifferentiated arthritis had no active joints, and the ACR Pedi 70 criteria response rate was 48% or more in those with oligoarthritis, RF-negative polyarthritis, and systemic arthritis.


CONCLUSIONS
With current management strategies in clinical practice, improvement in disease activity was noted in considerable proportions of patients in all of the JIA subtype groups, but low levels of disease activity persisted in many. We expect that these early outcomes will prove to be significant predictors of long-term outcomes.
Oen
Kiem
K
University of Manitoba, Winnipeg, Manitoba, Canada. koen@exchange.hsc.mb.ca
Duffy
Ciarán M
CM
Tse
Shirley M L
SM
Ramsey
Suzanne
S
Ellsworth
Janet
J
Chédeville
Gaëlle
G
Chetaille
Anne-Laure
AL
Saint-Cyr
Claire
C
Cabral
David A
DA
Spiegel
Lynn R
LR
Schneider
Rayfel
R
Lang
Bianca
B
Huber
Adam M
AM
Dancey
Paul
P
Silverman
Earl
E
Rosenberg
Alan M
AM
Cameron
Bonnie
B
Johnson
Nicole
N
Dorval
Jean
J
Scuccimarri
Rosie
R
Campillo
Sarah
S
Petty
Ross E
RE
Duffy
Karen N Watanabe
KN
Boire
Gilles
G
Haddad
Elie
E
Houghton
Kristin
K
Laxer
Ronald
R
Turvey
Stuart E
SE
Miettunen
Paivi
P
Gross
Katherine
K
Guzman
Jaime
J
Benseler
Susanne
S
Feldman
Brian M
BM
Espinosa
Victor
V
Yeung
Rae S M
RS
Tucker
Lori
L
D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000175:diagnosis / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D015796:HLA-B27 Antigen / Q000032:analysis; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D011241:Prednisone / Q000008:administration & dosage; D011446:Prospective Studies; D012217:Rheumatoid Factor / Q000097:blood; D012720:Severity of Illness Index; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D015796:HLA-B27 Antigen; D012217:Rheumatoid Factor; D011241:Prednisone