Clinical remission off medication in greek adults with juvenile idiopathic arthritis during a 17 year follow-up period

Clinical remission off medication (CR) in patients with Juvenile Idiopathic Arthritis (JIA) is the optimal aim of treat -to -target strategies. No relevant data have been published for Greek young adults so far.

To assess the achievement of CR and identify CR’s predictors in adults with JIA over a-long-term disease course.

JIA patients ≥ 18 years, and a ≥5 years disease duration were enrolled in this longitudinal retrospective cohort study. Radiographic damage was based on total modified Sharp/van der Heijde score (TmSvdHS), articular and extra-articular damage on JADI and physical ability on HAQ-DI.

98 patients (69 females) with a mean age at disease onset of 7.8 years, an interval from onset to last visit of 17.1 years and a current age of 24.9 years were studied. 37.8% achieved ≥ 1 episode of CR and 21.6% ≥2. The 7 JIA subtypes differed in respect to CR attainment (p=0.008), the worst being patients with polyarthritis RF positive (0%) and the best those with persistent oligoarthritis (87.5%). In 51.4% of them CR lasted for ≥5 years. Gender, age at disease onset, ANA and anti-CCP positivity were not correlated with CR. CR duration was significantly correlated with lower JADI-A (p=0.008), JADI-E (p<0.001), TmSvdHS (p=0.002) and HAQ-DI (p=0.018), while predictors of shorter CR state were polyarticular subtype (p=0.004) and longer duration of disease activity within the first 5 years (p=0.001).

Shrinking of disease activity periods in long-term JIA induced by improved treatments leads to extended CR periods and avoids structural damage and physical disability.

None declared.

Affiliations

1. 4th Dept of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
   • Despoina Dimopoulou
   • , Athina Theodoridou
   • , Foteini Lada
   •  & Alexandros Garyphallos
2. 1st Dept of Pediatrics, Aristotle University of Thessaloniki, Pediatric Immunology and Rheumatology Referral Center, Hippokration Hospital, Thessaloniki, Greece
   • Maria Trachana
   •  & Polyxeni Pratsidou-Gertsi
3. Dept of Rheumatology, University of Heraklion, Heraklion, Greece
   • Prodromos Sidiropoulos

Corresponding author

Correspondence to Maria Trachana.

Reprints and Permissions