Accuracy of preliminary remission criteria some JIA category
2008
To evaluate disease course in juvenile idiopathic arthritis (JIA) by applying newly developed preliminary definitions of remission, to assess probability of relapse of disease. Charts of patients with JIA followed since 1970 were reviewed. First episode of remission off medication status, as defined by Wallace et al., has been focused. The cohort included 761 patients (67.8% females, 32.2% males) with JIA. Mean disease onset age (± SD) was 6.25 ± 4.4 years (range 0.5–15.9). Disease mean duration to last visit was 10.02 ± 4.31 years. Follow up mean period was 7.6 ± 6.4 years (range 1.5–35 years). A total of 263 (34.56%) patients achieved remission according to criteria (persistent oligoarthritis 42.9%, extended oligoarthritis 13.1%, seronegative polyarthritis 22.4%, systemic arthritis 33.7%, enthesitis related arthritis (ERA) plus juvenile psoriatic arthritis (JPsA) 33.4%. No patients with seropositive polyarthritis achieved remission status (p < 0.001). In remitted patients the mean survival function (± SEM) before relapse calculated by life table survival curve was of 20.9 (± 1.3) months overall: 21.7 (± 0.46) in persistent oligoarthritis, 25.0 (± 6.6) in extended oligoarthritis, 26.7 (± 13.2) in seronegative polyarthritis and 17.6 (± 2.44) in ERA+JPsA. The log rank test did not show a significant difference between the JIA categories survival curves (p = 0.1). In our cohort about one-third of cases obtained a remission episode in 4 decades of observation. Finally, if a remission was achieved, the mean duration before a relapse was about 20 months.
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