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

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-o...

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Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6649930/
https://www.ncbi.nlm.nih.gov/pubmed/31431981
http://dx.doi.org/10.1093/rap/rky044
Descripción
Sumario: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.