THU0319 Disease course, outcome and predictors of outcome in an unselected cohort of individuals with juvenile chronic arthritis followed for 17 years. (23rd January 2014)

• Record Type: Journal Article
• Authors: Bertilsson, L.; Andersson-Gäre, B.; Fasth, A.; Petersson, I.F.; Forsblad-d'Elia, H.
• Is Part Of: Annals of the rheumatic diseases. Volume 71(2012)Supplement 3
• Page Start: 263
• Page End: 264
• Publication Date: 2014-01-23
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2012-eular.2284
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Juvenile chronic/idiopathic arthritis (JCA/JIA) is a heterogeneous disease. Some long-term studies are published, but few are population based and predictions of long-term outcome are incompletely defined. Objectives: The aim of this study was to investigate disease course, outcome and predictors of outcome in an unselected population based cohort diagnosed with JCA followed for 17 years. Methods: This cohort consists of 132 incidence patients identified 1984 to 1986 in southwestern Sweden according to EULAR criteria for JCA. At 5-year follow-up 129 individuals were examined with joint assessment, laboratory measurements, radiographic examinations, as well as medication and functional assessment. At 17-year follow-up the individuals were examined with joint assessment, laboratory measurements, medication, Health Assessment Questionnaire (HAQ), Keitel functional test (KFT) and short form 36 health survey (SF-36). Results: At 17-year follow-up 86 out of 132 individuals (65%) were examined. The individuals lost to follow-up did not significantly differ with respect to baseline and 5-year data from the individuals examined at 17 years. Forty percent of the individuals were in remission. The median HAQ score was 0.0 (0.0 – 1.5) and the median KFT 100 (54 – 100). Fifty one (59%) individuals had HAQ score >0 and/or KFT <100. SF-36 was significantly lower in all domains compared to a reference group. During the 17 years 44% changed subgroups. Thirty-nine percent of the individuals in remission at 5-year follow-up were not in remission at 17-year follow-up. In multivariate analyses, remission at 17-year follow-up was predicted by remission at 5-year follow-up (OR 4.8, 95% CI 1.8 – 12.5). At 17-year follow-up disability defined by HAQ >0 was predicted by RF-positivity at 5-year follow-up (OR 3.6, 95% CI 1.0 – 13.3) and disability defined by KFT<100 was predicted by non-remission at 5-year follow-up (OR 11.3, 95% CI 2.7 – 47.9) and RF-positivity at 5-year follow-up (OR 5.6, 95% CI 1.0 – 30.6). At 17-year follow-up the physical summation score in SF-36 better than the average of the reference group was predicted by remission at 5-year follow-up (OR 5.8, 95% CI 2.2 – 15.4). Long-term outcome was not predicted by any baseline variables in multiple logistic regression. Conclusions: In a population based cohort of patients with JCA, 40% were in remission but more than half of the individuals had some physical disability and the cohort had lower health related quality of life compared to a reference population. Many individuals changed subgroups and disease activity. Long-term outcome was best predicted by and associated with characteristics at 5-year follow-up and not by onset variables. Disclosure of Interest: None Declared