A 5-year prospective population-based study of juvenile chronic arthritis: onset, disease process, and outcome.
OBJECTIVE
To investigate, in a population-based cohort of patients with juvenile chronic arthritis (JCA), onset characteristics, progression, outcome, and prognostic factors longitudinally for 5 years.


METHODS
This cohort consisted of 132 incidence cases identified between 1984 and 1986 in southwestern Sweden followed for 5 years with annual reports of subgroup, joint assessment, disease activity, eye examinations, laboratory measurements, and medication. At the 5-year follow-up, the Childhood Health Assessment Questionnaire (Child-HAQ) was evaluated. European League Against Rheumatism (EULAR) criteria for diagnosis and disease activity were used.


RESULTS
During the 5 years only four patients were lost to follow-up, 34% changed subgroup and 8% developed uveitis. At the 5-year follow-up the disease was active in 12% of the patients, stable in 28%, inactive in 25%, and in remission in 34%. Among those examined, 24% had radiological changes, of whom half had advanced changes. The Child-HAQ median score at the 5-year follow-up was 0.13 (range 0.0-1.9). The number of involved joints at inclusion correlated positively with active disease at the 5-year follow-up. Age at disease onset, the number of involved joints, and the number of joints with arthritis correlated positively with continuous disease and Child-HAQ score. CONCLUSION. Our study shows a diverse disease course during the first 5 years of JCA where one-third changed subgroup and two-thirds did not reach remission. Age of disease onset, the number of involved joints, and the number of joints with arthritis at inclusion were associated with poor outcome at the 5-year follow-up.
Department of Rheumatology and Inflammation Research, University of Gothenburg, Sweden. lennart.bertilsson2@comhem.se
L
L
Bertilsson
B
B
Andersson-Gäre
A
A
Fasth
H
H
Forsblad-d'Elia
D000293:Adolescent; D017668:Age of Onset; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D002648:Child; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013548:Sweden; D014605:Uveitis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology