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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.
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
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 (English)In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 40, no 5, p. 715-724Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
2013. Vol. 40, no 5, p. 715-724
Keywords [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
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-22880DOI: 10.3899/jrheum.120602ISI: 000319171900026PubMedID: 23418376Scopus ID: 2-s2.0-84876926900ISBN: 0315-162X (Print) 0315-162X (Linking) (print)OAI: oai:DiVA.org:hj-22880DiVA, id: diva2:681764
Available from: 2013-12-20 Created: 2013-12-20 Last updated: 2018-10-22Bibliographically approved

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