Disease activity, treatment and long-term prognosis of adult juvenile idiopathic arthritis patients compared with rheumatoid arthritis patients

Mod Rheumatol. 2020 Jan;30(1):78-84. doi: 10.1080/14397595.2018.1554228. Epub 2019 Jan 9.

Abstract

Objective: To evaluate the difference between adult juvenile idiopathic arthritis (JIA, starting at <16 years) and rheumatoid arthritis (RA).Methods: Data on 128 adult JIA patients were from the National Database of Rheumatic Diseases in Japan (NinJa), 2014, divided into 4 groups by period of disease onset (Group 1: 2000-2013, n = 32; Group 2: 1981-1999, n = 32; Group 3: 1966-1980, n = 31; Group 4: ∼1965, n = 33). Disease activity, treatment and long-term prognosis of adult JIA patients were compared with RA patients matched for sex- and disease duration in each era.Results: In Groups 1 and 2, adult JIA patients had significantly lower clinical disease activity indices (CDAI) (Group 1: adult JIA 1.5 [0.4-6.9]-vs-RA 5.3 [2.5-10.3], p = .001, Group 2: 2.6 [0.6-9.0]-vs-6.9 [3.5-11.0], p = .001, shown as median [quartile range], p-value, respectively), and had higher CDAI remission rates than RA patients (Group 1: 54.8%-vs-28.2%, p = .002, Group 2: 51.7%-vs-17.0%, p < .001). More adult JIA than RA patients in Group 1 used biologics (62.5%-vs-24.7%, p < .001). However, there were no adult JIA-vs-RA differences in joint destruction and physical function in any group.Conclusions: Adult rheumatologists must recognize that adult JIA patients are different from RA patients even when disease duration is the same.

Keywords: Transition; adult Juvenile idiopathic arthritis (JIA); rheumatoid arthritis (RA).

Publication types

  • Comparative Study
  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Juvenile / diagnosis*
  • Arthritis, Juvenile / drug therapy
  • Arthritis, Rheumatoid / diagnosis*
  • Arthritis, Rheumatoid / drug therapy
  • Biological Products / therapeutic use*
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Prognosis
  • Time Factors
  • Young Adult

Substances

  • Antirheumatic Agents
  • Biological Products