Skip Navigation



Rheumatology Advance Access published online on November 19, 2009
Rheumatology, doi:10.1093/rheumatology/kep352
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrowOA All Versions of this Article:
49/1/116    most recent
kep352v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Hyrich, K. L.
Right arrow Articles by Thomson, W.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hyrich, K. L.
Right arrow Articles by Thomson, W.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author(s) 2009. Published by Oxford University Press on behalf of The British Society for Rheumatology.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.5/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Disease activity and disability in children with juvenile idiopathic arthritis one year following presentation to paediatric rheumatology. Results from the Childhood Arthritis Prospective Study

Kimme L. Hyrich1, Sham D. Lal1, Helen E. Foster2, Judith Thornton1, Navid Adib1, Eileen Baildam3, Janet Gardner-Medwin4, Lucy R. Wedderburn5, Alice Chieng6, Joyce Davidson4 and Wendy Thomson1

1Arthritis Research Campaign Epidemiology Unit, University of Manchester, Manchester, 2Department of Rheumatology, Medical School, Newcastle upon Tyne, 3Department of Rheumatology, Royal Liverpool Children's Hospital, Liverpool, 4Department of Rheumatology, Royal Hospital for Sick Children, Yorkhill, Glasgow, 5Rheumatology Unit, Institute of Child Health, London and 6Department of Rheumatology, Royal Manchester Children's Hospital, Manchester, UK.

Correspondence to: Kimme L. Hyrich, Arthritis Research Campaign Epidemiology Unit, Stopford Building, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester M13 9PT, UK. E-mail: kimme.hyrich{at}manchester.ac.uk


  Abstract

Objective. Inflammatory arthritis in childhood is variable in terms of both presentation and outcome. This analysis describes disease activity in children with juvenile idiopathic arthritis (JIA) during the first year following presentation to a paediatric rheumatologist and identifies predictors of moderate to severe disability [defined using a Childhood HAQ (CHAQ) score >=0.75] at 1 year.

Methods. The Childhood Arthritis Prospective Study recruits children <16 years with new inflammatory arthritis persisting for >=2 weeks from five UK tertiary referral centres. Demographics, disease features, joint count, CHAQ, physician's global assessment, parent's general evaluation of well-being (PGE), ESR and treatment, are collected at first presentation, 6 months and then yearly. Independent predictors of CHAQ >=0.75 at 1 year in children diagnosed with JIA were identified using multivariable logistic regression models.

Results. Seven hundred and forty children with JIA were included; median age at presentation 7.6 years, 64% girls. During the first year, 85% received NSAIDs, 70% IA corticosteroids, 47% MTX and 27% systemic steroids (oral or i.v.). Median presenting CHAQ score was 0.63 and decreased to 0.25 at 1 year; 32% had CHAQ >=0.75 at 1 year. The strongest predictor of CHAQ >=0.75 at 1 year was CHAQ >=0.75 at presentation (odds ratio 3.92; 95% CI 2.17, 7.09). Additional predictors included female gender and higher PGE

Conclusion. Although CHAQ score improved in most children, the strongest predictor of persistent disability at 1 year was moderate to severe disability at first presentation. Follow-up beyond 1 year will assess whether CHAQ at presentation will continue to be a predictor of future poor outcome.

KEY WORDS: Juvenile idiopathic arthritis, Disability, Outcomes, Disease activity

Submitted 29 June 2009; revised version accepted 29 September 2009.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.