Rheumatology advances in practice · 2018
Defining new clinically derived criteria for high disease activity in non-systemic juvenile idiopathic arthritis: a Finnish multicentre study.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Backström Maria, Tynjälä Pirjo, Aalto Kristiina, Ylijoki Heikki, Putto-Laurila Anne, Grönlund Minna-Maija, Kärki Johanna, Keskitalo Paula, Sard Sirja, Pohjankoski Heini, Hietanen Maiju, Witter Silke, Lehto Helena, Löyttyniemi Eliisa, Vähäsalo Paula
Аннотация
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.
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.