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Multicenter Study
. 2024 Sep;76(9):1446-1454.
doi: 10.1002/art.42865. Epub 2024 Jun 11.

Defining Criteria for Disease Activity States in Systemic Juvenile Idiopathic Arthritis Based on the Systemic Juvenile Arthritis Disease Activity Score

Silvia Rosina  1 , Ana I Rebollo-Giménez  1 , Letizia Tarantola  2 , Angela Pistorio  1 , Yulia Vyzhga  1 , Yasser El Miedany  3 , Hala M Lotfy  4 , Hend Abu-Shady  4 , Mervat Eissa  5 , Naglaa S Osman  6 , Waleed Hassan  7 , Marwa Y Mahgoub  7 , Nermeen A Fouad  8 , Doaa M Mosa  9 , Yasmin Adel  9 , Sheren E M Mohamed  10 , Ahmed R Radwan  11 , Mohamed H Abu-Zaid  12 , Samar A A Tabra  12 , Radwa H Shalaby  12 , Samah I Nasef  13 , Raju Khubchandani  14 , Archana Khan  14 , Naziya P Maldar  14 , Seza Ozen  15 , Yagmur Bayindir  15 , Motasem Alsuweiti  16 , Raed Alzyoud  16 , Hiba Almaaitah  16 , Soamarat Vilaiyuk  17 , Butsabong Lerkvaleekul  17 , Ekaterina Alexeeva  18 , Tatyana Dvoryakovskaya  18 , Ivan Kriulin  19 , Claudia Bracaglia  20 , Manuela Pardeo  20 , Fabrizio De Benedetti  20 , Francesco Licciardi  21 , Davide Montin  21 , Francesca Robasto  22 , Francesca Minoia  23 , Giovanni Filocamo  23 , Martina Rossano  23 , Gabriele Simonini  24 , Edoardo Marrani  25 , Sarah Abu-Rumeileh  25 , Mikhail M Kostik  26 , Konstantin E Belozerov  26 , Priyankar Pal  27 , Jigna N Bathia  27 , María M Katsicas  28 , Giselle Villarreal  28 , Achille Marino  29 , Stefania Costi  29 , Flavio Sztajnbok  30 , Rodrigo M Silva  31 , Maria C Maggio  32 , Dalia H El-Ghoneimy  33 , Rasha El Owaidy  33 , Adele Civino  34 , Federico Diomeda  34 , Sulaiman M Al-Mayouf  35 , Fuad Al-Sofyani  35 , Zane Dāvidsone  36 , Elisa Patrone  1 , Claudia Saad-Magalhães  37 , Alessandro Consolaro  38 , Angelo Ravelli  38
Affiliations
Multicenter Study

Defining Criteria for Disease Activity States in Systemic Juvenile Idiopathic Arthritis Based on the Systemic Juvenile Arthritis Disease Activity Score

Silvia Rosina et al. Arthritis Rheumatol. 2024 Sep.

Abstract

Objective: Our objective was to develop and validate cutoff values in the systemic Juvenile Arthritis Disease Activity Score 10 (sJADAS10) that distinguish the states of inactive disease (ID), minimal disease activity (MDA), moderate disease activity (MoDA), and high disease activity (HDA) in children with systemic juvenile idiopathic arthritis, based on subjective disease state assessment by the treating pediatric rheumatologist.

Methods: The cutoff definition cohort was composed of 400 patients enrolled at 30 pediatric rheumatology centers in 11 countries. Using the subjective physician rating as an external criterion, six methods were applied to identify the cutoffs: mapping, calculation of percentiles of cumulative score distribution, the Youden index, 90% specificity, maximum agreement, and receiver operating characteristic curve analysis. Sixty percent of the patients were assigned to the definition cohort, and 40% were assigned to the validation cohort. Cutoff validation was conducted by assessing discriminative ability.

Results: The sJADAS10 cutoffs that separated ID from MDA, MDA from MoDA, and MoDA from HDA were ≤2.9, ≤10, and >20.6, respectively. The cutoffs discriminated strongly among different levels of pain, between patients with and without morning stiffness, and among patients whose parents judged their disease status as remission or persistent activity or flare or were satisfied or not satisfied with current illness outcome.

Conclusion: The sJADAS cutoffs revealed good metrologic properties in both definition and validation cohorts and are therefore suitable for use in clinical trials and routine practice.

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References

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