title: Juvenile idiopathic arthritis in adulthood: fulfilment of classification criteria for adult rheumatic diseases, long-term outcomes and predictors of inactive disease, functional status and damage.
abstract: OBJECTIVE
  To determine how adult juvenile idiopathic arthritis (JIA) patients fulfil classification criteria for adult rheumatic diseases, evaluate their outcomes and determine clinical predictors of inactive disease, functional status and damage.
  
  
  METHODS
  Patients with JIA registered on the Rheumatic Diseases Portuguese Register (Reuma.pt) older than 18 years and with more than 5 years of disease duration were included. Data regarding sociodemographic features, fulfilment of adult classification criteria, Health Assessment Questionnaire, Juvenile Arthritis Damage Index-articular (JADI-A) and Juvenile Arthritis Damage Index-extra-articular (JADI-E) damage index and disease activity were analysed.
  
  
  RESULTS
  426 patients were included. Most of patients with systemic JIA fulfilled criteria for Adult Still's disease. 95.6% of the patients with rheumatoid factor (RF)-positive polyarthritis and 57.1% of the patients with RF-negative polyarthritis matched criteria for rheumatoid arthritis (RA). 38.9% of the patients with extended oligoarthritis were classified as RA while 34.8% of the patients with persistent oligoarthritis were classified as spondyloarthritis. Patients with enthesitis-related arthritis fulfilled criteria for spondyloarthritis in 94.7%. Patients with psoriatic arthritis maintained this classification. Patients with inactive disease had lower disease duration, lower diagnosis delay and corticosteroids exposure. Longer disease duration was associated with higher HAQ, JADI-A and JADI-E. Higher JADI-A was also associated with biological treatment and retirement due to JIA disability and higher JADI-E with corticosteroids exposure. Younger age at disease onset was predictive of higher HAQ, JADI-A and JADI-E and decreased the chance of inactive disease.
  
  
  CONCLUSIONS
  Most of the included patients fulfilled classification criteria for adult rheumatic diseases, maintain active disease and have functional impairment. Younger age at disease onset was predictive of higher disability and decreased the chance of inactive disease.
authors.affiliation: Rheumatology Department, Santa Maria Hospital-CHLN, Lisbon Academic Medical Center, Lisbon, Portugal; Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
authors.forename: Filipa
authors.initials: F
authors.lastname: Oliveira-Ramos
authors.affiliation: Portuguese Society of Rheumatology , Lisbon , Portugal.
authors.forename: Mónica
authors.initials: M
authors.lastname: Eusébio
authors.affiliation: Portuguese Society of Rheumatology , Lisbon , Portugal.
authors.forename: Fernando
authors.initials: F
authors.lastname: M Martins
authors.affiliation: Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Rheumatology Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
authors.forename: Ana Filipa
authors.initials: AF
authors.lastname: Mourão
authors.affiliation: Rheumatology Department , Hospital do Divino Espírito Santo , Ponta Delgada , Portugal.
authors.forename: Carolina
authors.initials: C
authors.lastname: Furtado
authors.affiliation: Rheumatology Department, Santa Maria Hospital-CHLN, Lisbon Academic Medical Center, Lisbon, Portugal; Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
authors.forename: Raquel
authors.initials: R
authors.lastname: Campanilho-Marques
authors.affiliation: Rheumatology Department , Hospital Garcia de Orta , Almada , Portugal.
authors.forename: Inês
authors.initials: I
authors.lastname: Cordeiro
authors.affiliation: Rheumatology Department , Centro Universitário Hospitalar de Coimbra , Coimbra , Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Ferreira
authors.affiliation: Rheumatology Department , ULSAM-Hospital Conde de Bertiandos , Ponte de Lima , Portugal.
authors.forename: Marcos
authors.initials: M
authors.lastname: Cerqueira
authors.affiliation: Rheumatology Department , Hospital Dr Nélio Mendonça , Funchal , Portugal.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Figueira
authors.affiliation: Rheumatology Department , Hospital de São João and Faculdade de Medicina da Universidade do Porto , Porto , Portugal.
authors.forename: Iva
authors.initials: I
authors.lastname: Brito
authors.affiliation: Rheumatology Department, Santa Maria Hospital-CHLN, Lisbon Academic Medical Center, Lisbon, Portugal; Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
authors.forename: Helena
authors.identifier: 0000-0003-1894-4870
authors.initials: H
authors.lastname: Canhão
authors.affiliation: Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Santos
authors.affiliation: Instituto Português de Reumatologia , Lisbon , Portugal.
authors.forename: José A
authors.initials: JA
authors.lastname: Melo-Gomes
authors.affiliation: Rheumatology Department, Santa Maria Hospital-CHLN, Lisbon Academic Medical Center, Lisbon, Portugal; Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
authors.forename: João Eurico
authors.initials: JE
authors.lastname: Fonseca
keywords: Disease Activity; Juvenile Idiopathic Arthritis; Outcomes research