Patient-reported Outcomes across Categories of Juvenile Idiopathic Arthritis

Abstract

Objective: Although there is increasing reliance on patient-reported outcomes (PRO) for disease management, there is little known about the differences in PRO across juvenile idiopathic arthritis (JIA) categories. The purpose of our study was to assess PRO across JIA categories, including pain, quality of life, and physical function, and to determine clinical factors associated with differences in these measures across categories.

Methods: This was a longitudinal cohort study of patients with JIA at a tertiary care pediatric rheumatology clinic. Subjects, PRO, and clinical variables were identified by querying the electronic medical record. Mixed-effects regression assessed pain, quality of life, and function.

Results: Subjects with enthesitis-related arthritis (ERA) and undifferentiated JIA had significantly more pain, poorer quality of life, and poorer physical function. The ERA and undifferentiated JIA categories, physician's global disease activity assessment, female sex, and nonsteroidal antiinflammatory drug use were significantly associated with more pain, poorer quality of life, and poorer function. In models limited to ERA, female sex and tender enthesis count were significant predictors of decreased function.

Conclusion: ERA and undifferentiated JIA categories had poorer PRO than other JIA categories. Further work is needed to address ways to improve PRO in children with JIA, with a special focus on children with ERA and undifferentiated JIA.

Keywords: JUVENILE ARTHRITIS; PAIN; PATIENT OUTCOME ASSESSMENT; PEDIATRIC; QUALITY OF LIFE; RHEUMATOLOGY.

Figure 1

Box plot of pain scores across JIA categories. RF = rheumatoid factor. ERA = enthesitis related arthritis. Number of visits for oligoarticular: 451; systemic: 91; polyarticular rheumatoid factor positive (RF+): 42; polyarticular rheumatoid factor negative (RF−): 213; psoriatic: 80; enthesitis-related arthritis (ERA): 257; undifferentiated 92.

Figure 2

Box plot of quality of life values across JIA categories. Number of visits for oligoarticular: 449; systemic: 89; polyarticular rheumatoid factor positive (RF+): 43; polyarticular rheumatoid factor negative (RF−): 220; psoriatic: 81; enthesitis-related arthritis (ERA): 250; undifferentiated 94.