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Disease course, outcome, and predictors of outcome in a population-based juvenile chronic arthritis cohort followed for 17 years
Department of Rheumatology and Inflammation Research, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd.
Department of Pediatrics, University of Gothenburg.
Department of Orthopedics, Clinical Sciences, and Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund.
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2013 (Engelska)Ingår i: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 40, nr 5, s. 715-724Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: To investigate disease course, outcome, and predictors of outcome in an unselected population-based cohort of individuals diagnosed with juvenile chronic arthritis (JCA) followed for 17 years. METHODS: The cohort consisted of 132 incidence JCA cases identified 1984-1986 according to EULAR criteria. At 5-year followup, 129 individuals underwent joint assessment, laboratory measurements, radiographic examination, and medication and functional assessment. At 17-year followup, 86 were examined with joint assessment, laboratory measurements, medication assessment, Health Assessment Questionnaire (HAQ), Keitel functional test (KFT), and Medical Outcomes Study Short Form-36 (SF-36). RESULTS: At 17-year followup, 40% were in remission, 44% changed subgroups, median HAQ score was 0.0 (range 0.0-1.5), and median KFT was 100 (range 54-100). SF-36 scores were significantly lower compared to a reference group. Thirty-nine percent of those in remission at 5-year followup were not in remission at 17-year followup. In multivariate analyses of variables from the 17-year followup: remission was predicted by remission at 5-year followup (OR 4.8); HAQ > 0 by rheumatoid factor (RF)-positivity at 5-year followup (OR 3.6); KFT < 100 by nonremission (OR 11.3); and RF-positivity (OR 5.6) at 5-year followup; and the SF-36 physical component summary score above average of the reference group by remission at 5-year followup (OR 5.8). CONCLUSION: This longterm study of 86 individuals with JCA showed large variability of disease courses and of impaired health-related quality of life. Sixty percent were not in remission at 17-year followup. Longterm outcome was best predicted by and associated with characteristics at 5-year followup rather than those at onset.

Ort, förlag, år, upplaga, sidor
2013. Vol. 40, nr 5, s. 715-724
Nyckelord [en]
Adolescent, Age of Onset, Antirheumatic Agents/therapeutic use, Arthritis, Juvenile/drug therapy/epidemiology/ pathology/ physiopathology, Cohort Studies, Female, Health Status, Humans, Male, Prognosis, Quality of Life, Recovery of Function, Remission Induction, Sweden/epidemiology, Symptom Assessment, Treatment Outcome, Young Adult
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:hj:diva-22880DOI: 10.3899/jrheum.120602ISI: 000319171900026PubMedID: 23418376Scopus ID: 2-s2.0-84876926900ISBN: 0315-162X (Print) 0315-162X (Linking) (tryckt)OAI: oai:DiVA.org:hj-22880DiVA, id: diva2:681764
Tillgänglig från: 2013-12-20 Skapad: 2013-12-20 Senast uppdaterad: 2018-10-22Bibliografiskt granskad

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Andersson-Gäre, Boel
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The Jönköping Academy for Improvement of Health and WelfareHHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd
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