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Predictors of early inactive disease in a juvenile idiopathic arthritis cohort: Results of a Canadian multicenter,prospective inception cohort study
Authors:Kiem Oen  Lori Tucker  Adam M. Huber  Paivi Miettunen  Rosie Scuccimarri  Sarah Campillo  David A. Cabral  Brian M. Feldman  Shirley Tse  Gaëlle Chédeville  Lynn Spiegel  Rayfel Schneider  Bianca Lang  Janet Ellsworth  Suzanne Ramsey  Paul Dancey  Earl Silverman  Anne‐Laure Chetaille  Bonnie Cameron  Nicole Johnson  Jean Dorval  Ross E. Petty  Karen Watanabe Duffy  Gilles Boire  Elie Haddad  Kristin Houghton  Claire Saint‐Cyr  Stuart E. Turvey  Susanne Benseler  Mary Cheang  Rae S. M. Yeung  Ciarán M. Duffy
Affiliation:1. University of Manitoba, Winnipeg, Manitoba, Canada;2. University of British Columbia, Vancouver, British Columbia, Canada;3. Dalhousie University, Halifax, Nova Scotia, Canada;4. University of Calgary, Calgary, Alberta, Canada;5. McGill University, Montreal, Quebec, Canada;6. The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada;7. Dr. Schneider has received consultant fees and speaking fees (less than $10,000) from Roche.;8. University of Alberta, Edmonton, Alberta, Canada;9. Memorial University, St. John's, Newfoundland, Canada;10. Université Laval, Sainte‐Foy, Quebec, Canada;11. Dr. Duffy has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Bristol‐Myers Squibb and Wyeth Pharmaceuticals.;12. Université de Sherbrooke, Sherbrooke, Quebec, Canada;13. Dr. Boire has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Bristol‐Myers Squibb, Abbott Canada, Hoffman‐La Roche, Amgen Canada, Wyeth Canada, Pfizer Canada, UCB Canada, and Merck Frosst, and owns stock and/or holds stock options in Pfizer, Inc.;14. Université de Montreal, Montreal, Quebec, Canada;15. Dr. Haddad has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Bayer, Novartis, CSL Behring, and Bristol‐Myers Squibb.
Abstract:

Objective

To determine early predictors of 6‐month outcomes in a prospective cohort of patients with juvenile idiopathic arthritis (JIA).

Methods

Patients selected were those enrolled in an inception cohort study of JIA, the Research in Arthritis in Canadian Children Emphasizing Outcomes Study, within 6 months after diagnosis. The juvenile rheumatoid arthritis core criteria set and quality of life measures were collected at enrollment and 6 months later. Outcomes evaluated included inactive disease, Juvenile Arthritis Quality of Life Questionnaire (JAQQ) scores, and Childhood Health Assessment Questionnaire (C‐HAQ) scores at 6 months.

Results

Thirty‐three percent of patients had inactive disease at 6 months. Onset subtype and most baseline core criteria set measures correlated with all 3 outcomes. Relative to oligoarticular JIA, the risks of inactive disease were lower for enthesitis‐related arthritis, polyarthritis rheumatoid factor (RF)–negative JIA, and polyarthritis RF‐positive JIA, and were similar for psoriatic arthritis. In multiple regression analyses, the baseline JAQQ score was an independent predictor of all 3 outcomes. Other independent baseline predictors included polyarthritis RF‐negative and systemic JIA for inactive disease; C‐HAQ score and polyarthritis RF‐positive JIA for the 6‐month C‐HAQ score; and active joint count, pain, and time to diagnosis for the 6‐month JAQQ score.

Conclusion

Clinical measures soon after diagnosis predict short‐term outcomes for patients with JIA. The JAQQ is a predictor of multiple outcomes. Time to diagnosis affects quality of life in the short term.
Keywords:
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