Study Summary
Bertilsson and colleagues evaluated the long-term outcomes in a Swedish cohort of 132 patients with juvenile chronic arthritis (JCA), initially identified in 1984-1986, and of whom 86 were followed for 17 years.
In the 86 patients followed for the full 17 years, the most common subgroup of JCA at initial diagnosis was pauciarticular disease (38%), followed by monarticular (26%) and polyarticular (22%), and then systemic JCA (7%). Psoriasis and ankylosing spondylitis together affected a total of 6 patients (7%). In analyses of the 86 patients who were evaluated at 17 years, 40% were in remission, and 44% had changed subgroups, with 14 (16%) of patients being reclassified as having arthritis associated with psoriasis, ankylosing spondylitis, or inflammatory bowel disease. Of note, factors present at the 5-year mark appeared to be better predictors of remission at 17 years than factors present at baseline, with specific predictors of remission including remission at 5 years, rheumatoid factor at 5 years, and overall function at 5 years as assessed by the SF-36 score. However, of those in remission at the 5-year mark, 39% were no longer in remission when assessed at 17 years.
Bertilsson and colleagues concluded that there was large variability in the clinical course of JCA, and assessments at 5 years lead to a better prediction of longer-term outcomes.
