Shoop-Worrall, SJW;
Verstappen, SMM;
Baildam, E;
Chieng, A;
Davidson, J;
Foster, H;
Ioannou, Y;
... Hyrich, KL; + view all
(2017)
How common is clinically inactive disease in a prospective cohort of patients with juvenile idiopathic arthritis? The importance of definition.
Annals of the Rheumatic Diseases
, 76
(8)
pp. 1381-1388.
10.1136/annrheumdis-2016-210511.
Preview |
Text
Wedderburn_how common is clinically inactive disease_.pdf - Published Version Download (714kB) | Preview |
Abstract
Objectives Many criteria for clinically inactive disease (CID) and minimal disease activity (MDA) have been proposed for juvenile idiopathic arthritis (JIA). It is not known to what degree each of these criteria overlap within a single patient cohort. This study aimed to compare the frequency of MDA and CID across different criteria in a cohort of children with JIA at 1 year following presentation. Methods The Childhood Arthritis Prospective Study recruits children at initial presentation to paediatric or adolescent rheumatology in seven UK centres. Children recruited between October 2001 and December 2013 were included. The proportions of children with CID and MDA at 1 year were calculated using four investigator-defined and eight published composite criteria. Missing data were accounted for using multiple imputation under different assumptions. Results In a cohort of 1415 children and adolescents, 67% patients had no active joints at 1 year. Between 48% and 61% achieved MDA and between 25% and 38% achieved CID using published criteria. Overlap between criteria varied. Of 922 patients in MDA by either the original composite criteria, Juvenile Arthritis Disease Activity Score (JADAS) or clinical JADAS cut-offs, 68% were classified as in MDA by all 3 criteria. Similarly, 44% of 633 children with CID defined by either Wallace's preliminary criteria or the JADAS cut-off were in CID according to both criteria. Conclusions In a large JIA prospective inception cohort, a majority of patients have evidence of persistent disease activity after 1 year. Published criteria to capture MDA and CID do not always identify the same groups of patients. This has significant implications when defining and applying treat-to-target strategies.
| Type: | Article |
|---|---|
| Title: | How common is clinically inactive disease in a prospective cohort of patients with juvenile idiopathic arthritis? The importance of definition |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/annrheumdis-2016-210511 |
| Publisher version: | http://doi.org/10.1136/annrheumdis-2016-210511 |
| Language: | English |
| Additional information: | This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Rheumatology, DIFFERENT TREATMENT STRATEGIES, RHEUMATOID-ARTHRITIS, ACTIVITY SCORE, PEDIATRIC RHEUMATOLOGY, SELECT CATEGORIES, ACTIVITY INDEXES, OUTCOME MEASURES, FOLLOW-UP, CRITERIA, REMISSION |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1567640 |
Archive Staff Only
 |
View Item |
