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. 2021 Dec;73(12):1722-1729.
doi: 10.1002/acr.24415. Epub 2021 Oct 11.

Determinants of Discordance Between Criteria for Inactive Disease and Low Disease Activity in Juvenile Idiopathic Arthritis

Gabriella Giancane  1 , Chiara Campone  2 , Maria Francesca Gicchino  2 , Alessandra Alongi  2 , Cecilia Bava  3 , Silvia Rosina  2 , Yaryna Boyko  4 , Neil Martin  5 , Yasser El Miedany  6 , Miroslav Harjacek  7 , Soad Hashad  8 , Maka Ioseliani  9 , Ruben Burgos-Vargas  10 , Rik Joos  11 , Christiaan Scott  12 , Mejbri Manel  13 , Zoilo Morel Ayala  14 , Maria Ekelund  15 , Safiya Al-Abrawi  16 , Maya-Feriel Aiche  17 , Ximena Norambuena  18 , Jose Antonio Melo-Gomes  19 , Nicolino Ruperto  2 , Alessandro Consolaro  1 , Angelo Ravelli  20 ; Paediatric Rheumatology International Trials Organisation
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Determinants of Discordance Between Criteria for Inactive Disease and Low Disease Activity in Juvenile Idiopathic Arthritis

Gabriella Giancane et al. Arthritis Care Res (Hoboken). 2021 Dec.

Abstract

Objective: To assess concordance among criteria for inactive disease (ID) and low disease activity (LDA) in juvenile idiopathic arthritis (JIA) and to seek factors driving discordance.

Methods: The frequency of fulfillment of existing criteria was evaluated in information on 10,186 patients extracted from 3 cross-sectional data sets. Patients were divided up according to the functional phenotypes of oligoarthritis and polyarthritis. Concordance between criteria was examined using weighted Venn diagrams. The role of each individual component in explaining discordance between criteria was assessed by calculating the absolute number and percentage of instances in which the component was responsible for discrepancy between definitions.

Results: Criteria for ID were met by 28.6-41.1% of patients with oligoarthritis and by 24.0-33.4% of patients with polyarthritis. Criteria for LDA were met by 44.8-62.4% of patients with oligoarthritis and by 44.6-50.4% of patients with polyarthritis. There was a 57.9-62.3% overlap between criteria for ID and a 67.9-85% overlap between criteria for LDA. Parent and physician global assessments and acute-phase reactants were responsible for the majority of instances of discordance among criteria for ID (8.7-15.5%, 10.0-12.3%, and 10.8-17.3%, respectively).

Conclusion: We found fair concordance between criteria for ID and LDA in JIA, with the main drivers of discordance for ID being physician and parent global assessments and acute-phase reactants. This observation highlights the need for further studies aimed to evaluate the impact of subjective physician and parent perception of disease remission and of laboratory measures of inflammatory activity on the definition of ID.

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References

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