title: Long-term outcome of 114 adult JIA patients in a non-pediatric rheumatology institute in Japan.
abstract: OBJECTIVE
  To evaluate the long-term outcome of patients with juvenile idiopathic arthritis (JIA) using data from a large cohort database, Institute of Rheumatology, Rheumatoid Arthritis, managed by the Tokyo Women's Medical University.
  
  
  METHODS
  Of 182 patients identified from the database from 2000 to 2013, 114 were verified as having JIA. The transition of medical care and the contributions of biological DMARDs were evaluated.
  
  
  RESULTS
  The mean age of the patients (93 females, 81.6%) at the latest examination was 36.6 ± 13.3 years. The mean age at disease onset and mean disease duration were 11.6 ± 3.4 and 25.0 ± 13.3 years, respectively. Of the 114 patients, 106 (93.0%) had poly- or oligoarthritis. Only one-fourth transferred from general pediatricians or pediatric rheumatologists. More patients with recent disease onset were treated with biological DMARDs (16.7% in the 1970s, vs. 80.0% in the 2000s). Disease activity assessed with DAS28 was significantly lower when disease onset was more recent (3.9 ± 1.3 for onset in the 1960s vs. 2.2 ± 1.1 for onset in the 2000s, p = 0.04). The percentage of patients requiring orthopedic surgery has decreased (53.8% before the 1970s vs. 10.0% in the 2000s).
  
  
  CONCLUSIONS
  Patients with more recent disease onset showed an improved outcome. Establishing and sharing a transition program among pediatric and non-pediatric rheumatologists is desirable.
authors.affiliation: Institute of Rheumatology, Tokyo Women's Medical University , Shinjuku-ku, Tokyo , Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Miyamae
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tanaka
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kishi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Matsuyama
authors.forename: Tohru
authors.initials: T
authors.lastname: Igarashi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fujikawa
authors.forename: Atsuo
authors.initials: A
authors.lastname: Taniguchi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Momohara
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yamanaka
mesh_terms: D000293:Adolescent; D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000188:drug therapy*; D002648:Child; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012219:Rheumatology; D060305:Transition to Adult Care; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents
keywords: Biologic agents; Juvenile chronic arthritis; Juvenile idiopathic arthritis; Juvenile rheumatoid arthritis; Outcome assessment