Clinical course and prognostic value of disease activity in the first two years in different subtypes of juvenile idiopathic arthritis
Albers, H M × Brinkman, D M C Kamphuis, S S M van Suijlekom-Smit, L W A van Rossum, M A J Hoppenreijs, E P A H Girschick, H J Wouters, Carine Saurenmann, R K Houwing-Duistermaat, J J Huizinga, T W J Schilham, M W ten Cate, R #
John Wiley & Sons, Inc.
Arthritis Care & Research vol:62 issue:2 pages:204-212
OBJECTIVE: Juvenile idiopathic arthritis (JIA) is a heterogeneous disease involving chronic arthritis. The clinical course is characterized by a fluctuating pattern of active and inactive disease. We have described in detail the clinical course in different JIA subtypes during the first 2 years after diagnosis and studied its relationship to disease activity in the following years. METHODS: Detailed clinical data on different parameters describing the disease activity in sequential time periods covering the first 2 years after diagnosis were retrieved from the charts of 311 patients with JIA and compared between subtypes. In a cohort of 146 patients, the relation of these different clinical variables to the course of disease in the following 3 years was evaluated. RESULTS: The percentage of time with active disease in the first 2 years differed significantly between subtypes. In all subtypes, a broad spectrum of activity was observed. The time with active disease in the first 2 years was the most significant factor associated with the duration of active disease in the following years. CONCLUSION: Different percentages of time with active disease have been observed between JIA subtypes in the first 2 years. The cumulative duration of activity varied widely within each subtype. Regarding the prognosis of the individual patient, the clinical course in the first 2 years appears to be predictive of the clinical course in the following years. Patients that have less time with active disease in the first 2 years are not likely to develop an unremitting clinical course later on.