Factors affecting clinical and therapeutic outcomes of patients with juvenile rheumatoid arthritis.

OBJECTIVE

To investigate clinical features, medications, and therapeutic responses of juvenile rheumatoid arthritis (JRA) among Taiwanese children.

METHODS

A retrospective chart review was conducted among all children newly diagnosed with JRA at the National Taiwan University Hospital between 1996 and 2001.

RESULTS

Forty boys and 30 girls were enrolled in the study. The mean follow-up was 45 months. Oligoarticular onset was the most common type. A bimodal distribution of age at onset was observed, with peaks at 4 and 10 years. All patients received non-steroidal anti-inflammatory drugs (NSAIDs); 27 (39%) received corticosteroids, and 44 (63%) had second-line drugs during the first course of treatment. Forty-three patients (69%) achieved clinical remission after a mean of 14.8 months of medication, and 19 (31%) were drug-dependent. The major factors related to the failure of first remission were human leukocyte antigen B27 (HLA-B27), high C-reactive protein (CRP) level, and thrombocytosis at diagnosis.

CONCLUSION

There are different phenotypic features among Taiwanese children with JRA. Factors related to the failure of first remission were HLA-B27, high CRP level, and thrombocytosis at diagnosis.