Juvenile idiopathic arthritis outcome and prognosis according to catamnesis evaluation

Objective. To study outcome and prognosis in pts with juvenile idiopathic arthritis (JIA). Material and methods. 239 JIA pts with disease duration of 10 years and more were analyzed. 80 children and adolescents before 18 years old (66 girls and 14 boys) were included in group 1. Arthritis clinical and laboratory activity, radiological stage and functional status according to Steinbroker and CHAQ questionnaire were assessed. 159 grown up pts (109 female and 50 male) suffering from JIA from childhood were included in group 2. They were examined using Stanford Health Assessment Questionnaire (HAQ) and a specially developed social status questionnaire. Results. Half pts of group 1 had recurrence of the disease during examination but activity in most cases did not exceed stage I or 2 (54% and 31% respectively). Joint destructive changes were revealed in 50% of pts. 80% of pts had radiological signs of secondary osteoarthritis. Amyloidosis was revealed in 2 from 27 pts with systemic type of JIA. 68% of pts had 1 or 2 functional class. 1/3 of pts did not have functional limitations (CHAQ=0). 13% of pts had maximal disability with CHAQ ranging from 2,1 to 3,0 (pts with polyarticular and systemic types of JIA. Most grown up pts (59%) considered their health as good. Substantial part of them worked or learned. 10 pts did not worked because of the disease (1,5%). 61% of pts did not have functional limitations (HAQ=0). 32% of pts were disabled. Most of them had 3 or 2 disability degree and had possibility to work. Conclusion. Substantial part of pts with longstanding JIA have stabilization of the disease or remission. Recurrent course of the disease was characterized by decrease of activity. Most children and grown ups with longstanding disease have relatively benign functional outcome. Pts with polyarticular and systemic types of JIA require especial attention because they have maximal risk of joint destruction with severe disability.

Juvenile idiopathic arthritis, outcome, prognosis, functional status

1. <div><p>Рациональная фармакотерапия ревматических заболеваний. Рук-водля практик, врачей. Под ред. В.А. Насоновой, ЕЛ. Насонова. Том III. М, 2003.</p><p>Логинова Е.Ю. Ювенильный артрит во взрослой ревматологической клинике: клинико-функциональная характеристика и исходы. Автореф. дисс. к.м.н. М., 2000</p><p>Ravelli A. Toward ап understanding of the long-term outcome of juvenile idiopathic arthritis. Clin. Exp. Rheumat., 2004, 22, 271275</p><p>Andersson Gare B., Fasth A. The natural history of juvenile chronic arthritis: a population based cohort study. I. Onset and disease process. J. Rheumatol., 1995, 22, 295-307</p><p>Andersson Gare B., Fasth A. The natural history of juvenile chronic arthritis: a population based cohort study. II. Outcome. J. Rheumatol., 1995, 22(2), 308-319</p><p>Каратссв Д.Е. Эволюция и прогноз ревматоидного артрита при многолетнем наблюдении. Автореф. дисс. д.м.н., М., 2002</p><p>Ansell В.М. Chronic arthritis in childhood. Ann; Rheum. Dis., 1978, 37, 107-120</p><p>Ansell B.M., Wfood P.H.N. Prognosis in juvenile chronic polyarthritis. Clin. Rheum. Dis., 1976, 2, 397-412</p><p>Baum J„ Gutowska G. Death in JRA. Arthr. Rheum., 1977, 20, suppl., 253-255</p><p>Calabro J.J., Holgerson WB., Sonpal G.M. et al. JRA: a general review and report of 100 patients observed for 15 years. Semin. Arthr. Rheum., 1976, 5, 257-298</p><p>Cassidy J.T., Petty R.E. Textbook of Pediatric Rheumatology. 4th Edition. 2002</p><p>Guillaume S., Prieur A.M., Coste J. et al. Long-term outcome and prognosis in oligoarticular-onset juvenile idiopathic arthritis. Arthr. Rheum., 2000, 43(8), 1858-1865</p><p>Minden K., Niewerth М., Listing J. et al. Long-term outcome in patients with juvenile idiopathic arthritis. Arthr. Rheum., 2002,46, 2392-2401</p><p>Yarosova К., Nemcova D., Vencovsky J. Long-term outcomes of patients with JIA. EULAR 2002 July, abstr., 311</p><p>David J., Cooper C., Hickey L. et al. The functional and psychological outcomes of juvenile chronic arthritis in young adulthood. Br. J. Rheumatol., 33, 9, 876-881</p><p>LomaterC., Gerloni V., Gattinara M. et al. Systemic onset JIA: a retrospective study of 80 consecutive patients followed for 10 years. J. Rheumatol., 2000, 27, 491-496</p><p>Oen K, Reed М., Malleson P.N. et al. Radiologic outcome and its relationship to functional disability in JRA. J. Rheumatol., 2003, 30, 832-840</p><p>Spiegel L.R., Schneider R., Lang B.A. et al. Early predictors of poor functional outcome in systemic-onset JRA. A multicenter cohort study. Arthr. Rheum., 2000, 43, 2402-2409</p><p>Fantini F., Gerloni V., Gattinara M. et al. Remission in juvenile chronic arthritis: a cohort study of 683 consecutive cases with a mean 10 year followup. J. Rheumatol., 2003, 30(3), 579-584</p><p>Rato B., Aaslend A., Odd V. et al. Outcome and predictive factors in JRA and juvenile spondiloarthropathy. J. Rheumatol., 1998, 25, 366-375</p><p>Foster H.E., Marshall N., Myers A. et al. Outcome in adults with juvenile idiopathic arthritis: a quality of life study. Arthr. Rheum., 2003,48(3), 767-775</p><p>Van Rossum M.J.A., Zwinderman A.H., Boers M. et al. Radiologic features in JIA. Arthr. Rheum., 2003, 48, 507-515</p><p>Minden K., Kiessling U., Listing J. et al. Prognosis of patients with juvenile chronic arthritis and juvenile spondyloarthropathy. J. Rheumatol., 2000, 27(9), 2256-2263</p><p>Oen K. Long-term outcomes and predictors of outcomes for patients with JIA. Best Pract. Clin. Rheumat., 2002, 16 (3), 347360</p><p>PackhamJ.C., Hall M.A. Long-term follow-up of 246 adults with JIA: functional outcome. Rheumatology, 2002, 41, 1428-1435</p><p>Prier A.M., Hayem E, Tursz A. Functional, social and professional outcome of patients with JCA seen again 12 years after a 1st evaluation. Rev. Rhum. Mai. Osteoartic., 1985, 52 (3), 185190</p><p>Ruperto N., Levinson J.E., Ravelli A. et al. Long-term health outcomes and quality of life in American and Italian inception cohorts of patients with juvenile rheumatoid arthritis. 1. Outcome status. J. Rheumatol., 1997, 24 (5), 945-951</p></div><br />