Literature DB >> 12610820

Remission in juvenile chronic arthritis: a cohort study of 683 consecutive cases with a mean 10 year followup.

Flavio Fantini1, Valeria Gerloni, Maurizio Gattinara, Rolando Cimaz, Cristina Arnoldi, Elide Lupi.   

Abstract

OBJECTIVE: As continuity of care in our institution allows longterm followup studies, we reviewed the files of all consecutive patients with juvenile chronic (idiopathic) arthritis (JCA) followed since 1970 to establish the frequency of remission.
METHODS: Charts of all patients with JCA were reviewed. Relevant variables were entered into a customized database. The presence of remission (lack of signs of disease activity in the absence of antirheumatic therapy for at least 6 mo) during the disease course and at the last visit was assessed.
RESULTS: The cohort included 683 patients, 463 females and 220 males. According to the disease onset, 420 had oligoarticular, 108 polyarticular (23 rheumatoid factor positive), and 88 systemic disease; 67 had a juvenile spondyloarthropathy (SpA). For all 4 categories the mean followup period was about 10 years. At the last visit 224 cases were in remission (32.8%). Remission rate was scarcely influenced by age at disease onset, but differed in the different disease categories. Of the total group of 683 patients, 153 (22.4%) were lost to followup (no control for at least 2 years). For all 4 categories the remission rate at the last visit was higher in patients who had been lost to followup: 42.3% versus 29.0% for systemic onset JCA, 20.8% versus 16.5% for polyarticular onset JCA, 44.7% versus 33.6% for pauciarticular onset JCA, and 66.7% versus 26.8% for juvenile SpA. The probability of attaining remission decreased in proportion to delay in entering the tertiary care center (from 35.7% to 22.8%). The rate of remission reached its peak after 5-10 years of followup, after which the trend reversed.
CONCLUSION: Childhood arthritis achieved remission in only about one-third of our cases, with differences among disease categories based on the diagnosis.

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Year:  2003        PMID: 12610820

Source DB:  PubMed          Journal:  J Rheumatol        ISSN: 0315-162X            Impact factor:   4.666


  39 in total

1.  Impact of biologics on disease course in systemic onset juvenile idiopathic arthritis.

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Authors:  V Şen; A Ece; Ü Uluca; A Güneş; S Yel; I Tan; D Karabel; B Yıldırım; K Haspolat
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Authors:  Vanessa Bugni Miotto e Silva; Carolina de Freitas Tavares da Silva; Sônia de Aguiar Vilela Mitraud; Rita Nely Vilar Furtado; Maria Odete Esteves Hilário; Jamil Natour; Maria Teresa Terreri
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6.  Long-term outcome of juvenile idiopathic arthritis following a placebo-controlled trial: sustained benefits of early sulfasalazine treatment.

Authors:  Marion A J van Rossum; Renée M van Soesbergen; Maarten Boers; Aeilko H Zwinderman; Theo J W Fiselier; Marcel J A M Franssen; Rebecca ten Cate; Lisette W A van Suijlekom-Smit; Nico M Wulffraat; Wilma H J van Luijk; Johanna C M Oostveen; Wietse Kuis; Ben A C Dijkmans
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7.  Do patients with juvenile idiopathic arthritis in clinical remission have evidence of persistent inflammation on 3T magnetic resonance imaging?

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10.  The challenges of transferring chronic illness patients to adult care: reflections from pediatric and adult rheumatology at a US academic center.

Authors:  Aimee O Hersh; Shirley Pang; Megan L Curran; Diana S Milojevic; Emily von Scheven
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