A Comparison of International League of Associations for Rheumatology and Pediatric Rheumatology International Trials Organization Classification Systems for Juvenile Idiopathic Arthritis Among Children in a Canadian Arthritis Cohort.

Autor: Lee JJY; The Hospital for Sick Children (SickKids) and University of Toronto, Toronto, Ontario, Canada., Eng SWM; The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada., Guzman J; BC Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada., Duffy CM; Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ontario, Canada., Tucker LB; BC Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada., Oen K; University of Manitoba, Winnipeg, Manitoba, Canada., Yeung RSM; The Hospital for Sick Children (SickKids) and University of Toronto, Toronto, Ontario, Canada., Feldman BM; The Hospital for Sick Children (SickKids) and University of Toronto, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: Arthritis & rheumatology (Hoboken, N.J.) [Arthritis Rheumatol] 2022 Aug; Vol. 74 (8), pp. 1409-1419. Date of Electronic Publication: 2022 Jun 28.
DOI: 10.1002/art.42113
Abstrakt: Objective: The aim of the Paediatric Rheumatology International Trials Organisation (PRINTO) juvenile idiopathic arthritis (JIA) classification criteria, which is still in development, is to identify homogeneous groups of JIA patients. This study was undertaken to compare International League of Associations for Rheumatology (ILAR) JIA classification criteria and PRINTO JIA classification criteria using data from the ReACCh-Out (Research in Arthritis in Canadian Children, Emphasizing Outcomes) cohort.
Methods: We used clinicobiologic data recorded within 7 months of diagnosis to assign a diagnosis of JIA and identify subcategories of JIA among 1,228 patients according to the 2 JIA classification systems. We compared the proportions of patients classified and the alignment of classification categories with clinicobiologic subtypes and adult arthritis types.
Results: The PRINTO criteria classified 244 patients (19.9%) as having early-onset antinuclear antibody-positive JIA, 157 (12.8%) as having enthesitis/spondylitis-related JIA, 38 (3.1%) as having systemic JIA, and 10 (0.8%) as having rheumatoid factor-positive JIA. A total of 12% of patients were unclassifiable using the ILAR criteria, while 63.3% were unclassifiable using the PRINTO criteria (777 with other JIA and 2 with unclassified JIA). In sensitivity analyses, >50% of patients remained unclassifiable using the PRINTO criteria. Compared to the PRINTO criteria, ILAR JIA categories aligned better with clinicobiologic subtypes in 131 patients (χ 2 = 44, P = 0.005, versus χ 2 = 15, P = 0.07 for PRINTO), and ILAR categories aligned better with adult types of arthritis in 389 evaluable patients.
Conclusion: Currently identified PRINTO disorders can only be used to classify a minority of JIA patients, leaving a large proportion of JIA patients with other disorders requiring further characterization. Current PRINTO JIA classification criteria do not align better with clinicobiologic subtypes or adult forms of arthritis compared with the older ILAR classification system.
(© 2022 American College of Rheumatology.)
Databáze: MEDLINE
Externí odkaz: