A1 Refereed original research article in a scientific journal

Defining new clinically derived criteria for high disease activity in non-systemic juvenile idiopathic arthritis: a Finnish multicentre study




AuthorsMaria Backström, Pirjo Tynjälä, Kristiina Aalto, Heikki Ylijoki, Anne Putto-Laurila, Minna-Maija Grönlund, Johanna Kärki, Paula Keskitalo, Sirja Sard, Heini Pohjankoski, Maiju Hietanen, Silke Witter, Helena Lehto, Eliisa Löyttyniemi, Paula Vähäsalo

PublisherOxford University Press

Publication year2018

JournalRheumatology Advances in Practice

Journal name in sourceRheumatology advances in practice

Journal acronymRheumatol Adv Pract

Volume2

Issue2

ISSN2514-1775

eISSN2514-1775

DOIhttps://doi.org/10.1093/rap/rky044

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/45534348


Abstract
Objectives

To redefine criteria for high disease activity (HDA) in JIA, to establish HDA cut-off values for the 10-joint Juvenile Arthritis Disease Activity Score (JADAS10) and clinical JADAS10 (cJADAS10) and to describe the distribution of patients’ disease activity levels based on the JADAS cut-off values in the literature.

Methods

Data on 305 treatment-naïve JIA patients were collected from nine paediatric units treating JIA. The median parameters of the JADAS were proposed to be the clinical criteria for HDA. The cut-off values were assessed by using two receiver operating characteristics curve–based methods. The patients were divided into disease activity levels based on currently used JADAS cut-off values.

Results

We proposed new criteria for HDA. At least three of the following criteria must be satisfied in both disease courses: in oligoarthritis, two or more active joints, ESR above normal, physician global assessment (PGA) of disease activity ≥2 and parent/patient global assessment (PtGA) of well-being ≥2; in polyarthritis, six or more active joints, ESR above normal, PGA of overall disease activity ≥4 and PtGA of well-being ≥2. The HDA cut-off values for JADAS10 (cJADAS) were ≥6.7 (6.7) for oligoarticular and ≥15.3 (14.1) for polyarticular disease. The distribution of the disease activity levels based on the JADAS cut-off values in the literature varied markedly based on which cut-offs were used.

Conclusion

New clinically derived criteria for HDA in JIA and both JADAS and cJADAS cut-off values for HDA were proposed.


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