Treating Juvenile Idiopathic Arthritis According to JADAS- Based Targets

The measurement of the level of disease activity plays a pivotal role in the care of patients with ju venile idiopathic arthritis ( JIA). To serve this purpose, the Juvenile Arthritis Disease Activity Score ( JADAS) was developed. It was developed as the simple sum of four components: physician’s global assessment, parents’ global assessment, active joints count and erythrocyte sedimentation rate (ESR). Different versions of the original score are available, which vary according to the type of active joints count incorporated. More recently, a version including the C-reactive protein (CRP) instead of ESR and a version excluding the acute phase reactant were tested. Cutoff values for the state of inactive disease, low disease activity, moderate disease activity and high disease activity were recently developed for the original JADAS score and for the clinical version. These cutoff values are ideally suited for pursuing tight disease control in a treat-to-target strategy, with treatment escalation if the desired JADAS score is not reached.