Juvenile idiopathic arthritis managed in the new millennium: one year outcomes of an inception cohort of Australian children

Autor: Roger C. Allen, Jonathan D Akikusa, Angela Cox, Joanne Buckle, Georgina Tiller, Jane E Munro, Peter Gowdie
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Male
musculoskeletal diseases
medicine.medical_specialty
Pediatrics
lcsh:Diseases of the musculoskeletal system
Referral
Adolescent
Arthritis
Outcomes
Severity of Illness Index
03 medical and health sciences
0302 clinical medicine
Rheumatology
Internal medicine
medicine
Immunology and Allergy
Rheumatoid factor
Juvenile
Humans
Prospective Studies
Child
skin and connective tissue diseases
Retrospective Studies
030203 arthritis & rheumatology
Oligoarthritis
business.industry
Australia
Cohort
lcsh:RJ1-570
lcsh:Pediatrics
Juvenile idiopathic arthritis
medicine.disease
Arthritis
Juvenile
030104 developmental biology
Treatment Outcome
Antirheumatic Agents
Child
Preschool
Pediatrics
Perinatology and Child Health
Polyarthritis
Female
lcsh:RC925-935
business
Research Article
Follow-Up Studies
Zdroj: Pediatric Rheumatology Online Journal, Vol 16, Iss 1, Pp 1-10 (2018)
Pediatric Rheumatology Online Journal
ISSN: 1546-0096
DOI: 10.1186/s12969-018-0288-z
Popis: Background The advent of new treatments for Juvenile Idiopathic Arthritis (JIA) has prompted interest in systematically studying the outcomes of patients treated in the ‘modern era’. Such data provide both benchmarks for assessing local outcomes and important information for use in counselling families of newly diagnosed patients. While data are available for cohorts in Europe and North America, no such data exist for Australian patients. The aim was to examine the demographics, treatment and outcomes at 12 months of an inception cohort of newly diagnosed patients with JIA at a single tertiary referral paediatric rheumatology centre in Australia. Methods Retrospective review of prospectively collected data from patients newly diagnosed with JIA between 2010 and 2014 at the Royal Children’s Hospital in Melbourne. Results One hundred thirty four patients were included (62% female). Oligoarthritis was the single largest category of JIA (36%) and rheumatoid factor positive polyarthritis the least common (2%). Undifferentiated JIA accounted for 13% of patients and was the third largest category. Across the cohort 94% received NSAIDs, 53% oral steroids, 62% methotrexate and 15% a biologic DMARD. Intra-articular steroids were used in 62%, most commonly in the oligoarticular subtype (94%). 95% of patients achieved a joint count of zero at a median of 4.1 months, however flares occurred in 42%. At 12 months 65% had no active joint disease, though more than half remained on medication. Conclusion Australian children with JIA managed in the modern era have similar characteristics and achieve short term outcomes comparable to cohorts in Europe and North America, with high rates of joint remission in the first 12 months of follow-up but with a significant relapse rate and requirement for ongoing medication.
Databáze: OpenAIRE
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