TY - JOUR
T1 - Changing Patterns in Treatment, Remission Status, and Categories in a Long-Term Nordic Cohort Study of Juvenile Idiopathic Arthritis
AU - Glerup, Mia
AU - Arnstad, Ellen D
AU - Rypdal, Veronika
AU - Peltoniemi, Suvi
AU - Aalto, Kristiina
AU - Rygg, Marite
AU - Nielsen, Susan
AU - Fasth, Anders
AU - Berntson, Lillemor
AU - Nordal, Ellen
AU - Herlin, Troels
AU - Nordic Study Group of Pediatric Rheumatology (NoSPeR)
N1 - © 2022 American College of Rheumatology.
PY - 2022/5
Y1 - 2022/5
N2 - OBJECTIVE: To explore sustainability of achieved remission off medication and defined International League of Associations for Rheumatology (ILAR) categories in juvenile idiopathic arthritis (JIA) and describe the trajectory of disease course over time by comparing treatment, disease activity, and ILAR categories from baseline, 8 years, and 18 years after disease onset.METHODS: A total of 373 of the 510 included patients were initially recruited consecutive cases of JIA from the prospective, longitudinal, population-based Nordic JIA cohort with disease onset during 1997-2000 from Denmark, Norway, Sweden, and Finland in an 18-year follow-up study. Clinical data were collected consecutively at baseline, 8 years, and 18 years after disease onset and were evaluated regarding treatment, disease activity, and ILAR category.RESULTS: Significantly more patients (70%) were off medication after 18 years of follow-up compared to after 8 years (59.7%); nevertheless, the number of patients in remission had not increased (52% off medication versus 51% on medication). Twelve percent of patients changed ILAR category between 8 years and 18 years after disease onset. Almost half of the changes were due to updated information about heredity in a first-degree relative. In the same period, the psoriatic arthritis group increased significantly in number (P < 0.001), in contrast to the oligoarticular category, which decreased (P = 0.02). The undifferentiated group increased 24% from 8 to 18 years of follow-up; however, this increase was not significant (P = 0.06).CONCLUSION: In this Nordic JIA cohort study, the remission rate did not increase even though significantly more patients were off medication at the 18-year follow-up compared to at the 8-year follow-up after disease onset. The distribution of patients in the ILAR categories continued to change significantly throughout the 18-year study period.
AB - OBJECTIVE: To explore sustainability of achieved remission off medication and defined International League of Associations for Rheumatology (ILAR) categories in juvenile idiopathic arthritis (JIA) and describe the trajectory of disease course over time by comparing treatment, disease activity, and ILAR categories from baseline, 8 years, and 18 years after disease onset.METHODS: A total of 373 of the 510 included patients were initially recruited consecutive cases of JIA from the prospective, longitudinal, population-based Nordic JIA cohort with disease onset during 1997-2000 from Denmark, Norway, Sweden, and Finland in an 18-year follow-up study. Clinical data were collected consecutively at baseline, 8 years, and 18 years after disease onset and were evaluated regarding treatment, disease activity, and ILAR category.RESULTS: Significantly more patients (70%) were off medication after 18 years of follow-up compared to after 8 years (59.7%); nevertheless, the number of patients in remission had not increased (52% off medication versus 51% on medication). Twelve percent of patients changed ILAR category between 8 years and 18 years after disease onset. Almost half of the changes were due to updated information about heredity in a first-degree relative. In the same period, the psoriatic arthritis group increased significantly in number (P < 0.001), in contrast to the oligoarticular category, which decreased (P = 0.02). The undifferentiated group increased 24% from 8 to 18 years of follow-up; however, this increase was not significant (P = 0.06).CONCLUSION: In this Nordic JIA cohort study, the remission rate did not increase even though significantly more patients were off medication at the 18-year follow-up compared to at the 8-year follow-up after disease onset. The distribution of patients in the ILAR categories continued to change significantly throughout the 18-year study period.
KW - Arthritis, Juvenile/diagnosis
KW - Cohort Studies
KW - Follow-Up Studies
KW - Humans
KW - Prospective Studies
KW - Rheumatology
UR - http://www.scopus.com/inward/record.url?scp=85126252262&partnerID=8YFLogxK
U2 - 10.1002/acr.24857
DO - 10.1002/acr.24857
M3 - Journal article
C2 - 35015381
SN - 2151-464X
VL - 74
SP - 719
EP - 727
JO - Arthritis Care & Research
JF - Arthritis Care & Research
IS - 5
ER -