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Clinical remission off medication in greek adults with juvenile idiopathic arthritis during a 17 year follow-up period
© Dimopoulou et al; licensee BioMed Central Ltd. 2014
- Published: 17 September 2014
- Juvenile Idiopathic Arthritis
- Disease Onset
- Retrospective Cohort Study
- Clinical Remission
- Improve Treatment
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.
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