Disease evolution in systemic juvenile idiopathic arthritis: an international, observational cohort study through JIRcohort.


Journal

Pediatric rheumatology online journal
ISSN: 1546-0096
Titre abrégé: Pediatr Rheumatol Online J
Pays: England
ID NLM: 101248897

Informations de publication

Date de publication:
07 Sep 2023
Historique:
received: 29 04 2023
accepted: 31 08 2023
medline: 11 9 2023
pubmed: 8 9 2023
entrez: 7 9 2023
Statut: epublish

Résumé

Systemic juvenile idiopathic arthritis (systemic JIA) is a severe disease with both systemic and joint inflammation. This study aims to identify predictors of disease evolution within the systemic JIA population enrolled in the Juvenile Inflammatory Rheumatism cohort (JIRcohort). Observational patient cohort study with 201 recruited children from 4 countries (3 European, 1 North Africa) from 2005 until 2019, using retrospectively (2005-2015) and prospectively (2015-2019) routine care collected data. Sixty-five patients with complete follow-up data for 24 months after first diagnosis were classified as monophasic (n = 23), polyphasic (n = 6) or persistent group (n = 36) corresponding to their evolution (unique flare, recurrent flares, or persistent disease activity respectively). The patients of the persistent group were more likely to have an earlier disease onset, before the age of 6 (OR 2.57, 95%-CI 0.70-9.46), persistence of arthritis at 12-months post-diagnosis (OR 4.45, 95%-CI 0.58-34.20) and higher use of synthetic DMARD (sDMARD, OR 5.28, 95%-CI 1.39-20.01). Other variables like global assessment by physician and by patient and C Reactive Protein levels at 12-months post-diagnosis were assessed but without any predictive value after adjusting for confounding factors. Our results suggest that the earlier disease onset, the persistence of arthritis throughout the first year of disease evolution and the need of sDMARD might predict a persistent disease course.

Sections du résumé

BACKGROUND BACKGROUND
Systemic juvenile idiopathic arthritis (systemic JIA) is a severe disease with both systemic and joint inflammation. This study aims to identify predictors of disease evolution within the systemic JIA population enrolled in the Juvenile Inflammatory Rheumatism cohort (JIRcohort).
METHODS METHODS
Observational patient cohort study with 201 recruited children from 4 countries (3 European, 1 North Africa) from 2005 until 2019, using retrospectively (2005-2015) and prospectively (2015-2019) routine care collected data.
RESULTS RESULTS
Sixty-five patients with complete follow-up data for 24 months after first diagnosis were classified as monophasic (n = 23), polyphasic (n = 6) or persistent group (n = 36) corresponding to their evolution (unique flare, recurrent flares, or persistent disease activity respectively). The patients of the persistent group were more likely to have an earlier disease onset, before the age of 6 (OR 2.57, 95%-CI 0.70-9.46), persistence of arthritis at 12-months post-diagnosis (OR 4.45, 95%-CI 0.58-34.20) and higher use of synthetic DMARD (sDMARD, OR 5.28, 95%-CI 1.39-20.01). Other variables like global assessment by physician and by patient and C Reactive Protein levels at 12-months post-diagnosis were assessed but without any predictive value after adjusting for confounding factors.
CONCLUSIONS CONCLUSIONS
Our results suggest that the earlier disease onset, the persistence of arthritis throughout the first year of disease evolution and the need of sDMARD might predict a persistent disease course.

Identifiants

pubmed: 37679749
doi: 10.1186/s12969-023-00886-9
pii: 10.1186/s12969-023-00886-9
pmc: PMC10485973
doi:

Substances chimiques

Antirheumatic Agents 0

Types de publication

Observational Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

96

Informations de copyright

© 2023. BioMed Central Ltd., part of Springer Nature.

Références

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Auteurs

M Wallimann (M)

Department of Woman, Mother, Child, Unit of Pediatric Immunology, Allergology and Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

K Bouayed (K)

Department of Pediatrics, Unit of Rheumatology and Nephrology, Mother and Child University Hospital A. Harouchi, CHU Ibn Rochd, Casablanca, Morocco.
Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.

E Cannizzaro (E)

Department of Pediatrics, Unit of Pediatric Rheumatology, University Children's Hospital, Zurich, Switzerland.

D Kaiser (D)

Department of Pediatrics, Unit of Pediatric Rheumatology, Childrens Hospital Lucerne, Lucerne, Switzerland.

A Belot (A)

Department of Pediatrics, Unit of Pediatric Nephrology, Rheumatology, Dermatology, Hospital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.

E Merlin (E)

Department of Pediatrics, Clermont-Ferrand University Hospital, Clermont-Ferrand, F-63000, France.

S Poignant (S)

Department of Pediatrics, University Hospital of Nantes, Nantes, France.

C Wouters (C)

Department of Pediatrics, Unit of Pediatric Rheumatology, University Hospital Leuven, Louvain, Belgium.

F Hofer (F)

Fondation Rhumatismes-Enfants-Suisse, Etoy, 1163, Switzerland.

T Saurenmann (T)

Department of Pediatrics, Cantonal Hospital Winterthur, Winterthur, Switzerland.

A Koryllou (A)

Department of Woman, Mother, Child, Unit of Pediatric Immunology, Allergology and Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

R Carlomagno (R)

Department of Woman, Mother, Child, Unit of Pediatric Immunology, Allergology and Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

M Mejbri (M)

Department of Woman, Mother, Child, Unit of Pediatric Immunology, Allergology and Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

M Hofer (M)

Department of Woman, Mother, Child, Unit of Pediatric Immunology, Allergology and Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

K Theodoropoulou (K)

Department of Woman, Mother, Child, Unit of Pediatric Immunology, Allergology and Rheumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. aikaterini.theodoropoulou@chuv.ch.

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