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. 2018 Nov 9;16(1):69.
doi: 10.1186/s12969-018-0288-z.

Juvenile idiopathic arthritis managed in the new millennium: one year outcomes of an inception cohort of Australian children

Georgina Tiller  1 , Joanne Buckle  2   3 , Roger Allen  2 , Jane Munro  2   3 , Peter Gowdie  2 , Angela Cox  2 , Jonathan Akikusa  2   3
Affiliations

Juvenile idiopathic arthritis managed in the new millennium: one year outcomes of an inception cohort of Australian children

Georgina Tiller et al. Pediatr Rheumatol Online J. .

Abstract

Background: The advent of new treatments for Juvenile Idiopathic Arthritis (JIA) has prompted interest in systematically studying the outcomes of patients treated in the 'modern era'. Such data provide both benchmarks for assessing local outcomes and important information for use in counselling families of newly diagnosed patients. While data are available for cohorts in Europe and North America, no such data exist for Australian patients. The aim was to examine the demographics, treatment and outcomes at 12 months of an inception cohort of newly diagnosed patients with JIA at a single tertiary referral paediatric rheumatology centre in Australia.

Methods: Retrospective review of prospectively collected data from patients newly diagnosed with JIA between 2010 and 2014 at the Royal Children's Hospital in Melbourne.

Results: One hundred thirty four patients were included (62% female). Oligoarthritis was the single largest category of JIA (36%) and rheumatoid factor positive polyarthritis the least common (2%). Undifferentiated JIA accounted for 13% of patients and was the third largest category. Across the cohort 94% received NSAIDs, 53% oral steroids, 62% methotrexate and 15% a biologic DMARD. Intra-articular steroids were used in 62%, most commonly in the oligoarticular subtype (94%). 95% of patients achieved a joint count of zero at a median of 4.1 months, however flares occurred in 42%. At 12 months 65% had no active joint disease, though more than half remained on medication.

Conclusion: Australian children with JIA managed in the modern era have similar characteristics and achieve short term outcomes comparable to cohorts in Europe and North America, with high rates of joint remission in the first 12 months of follow-up but with a significant relapse rate and requirement for ongoing medication.

Keywords: Cohort; Juvenile idiopathic arthritis; Outcomes.

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Conflict of interest statement

Ethics approval and consent to participate

The Royal Children’s Hospital (RCH) Human Research Ethics Committee approved the study.

Consent for publication

All authors have consented to publication of the manuscript. Individual person’s data: not applicable.

Competing interests

None to declare.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Time to methotrexate commencement by JIA category
Fig. 2
Fig. 2
Time to first intra-articular corticosteroid injection by JIA category
Fig. 3
Fig. 3
Arthritis activity status by medication use at 1 year according to JIA category
See this image and copyright information in PMC

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