Predictors of 2 year outcomes of juvenile idiopathic arthritis in a multicenter Canadian cohort: the ReACCh out experience

Natalie J Shiff,Adam Huber,Rae Sm Yeung,Ciaran M Duffy,Jaime Guzman,Lori B Tucker,Nicole A Johnson,Shirley Tse,Kiem G Oen

doi:10.1186/1546-0096-10-s1-a40

Abstract

Purpose The ability to predict which children with Juvenile idiopathic Arthritis (JIA) are likely to have worse outcomes would allow a more targeted aggressive approach to initial therapy. We used data from the Research on Arthritis in Canadian Children Emphasizing Outcomes (ReACCh Out), a 16-centre prospective inception cohort of children with newly diagnosed JIA, to identify predictors of 2-year outcomes present during the first 6 months after enrollment. Methods Data was available on 223 to 291 children depending on the analysis. The 2-year clinical outcomes were remission, a Childhood Health Assessment questionnaire (CHAQ) score of ≥0.75, and the Juvenile Arthritis Quality of Life Questionnaire (JAQQ) score. Remission was defined according to Wallace criteria (without ESR or CRP), and combined patients on and off medication. The candidate predictors listed in Table 1 were selected for their clinical relevance and forced in a stepwise manner into regression models. They underwent natural logarithmic transformation (Ln) if not normally distributed. Logistic regression was used for prediction of remission and CHAQ outcomes, and linear regression for the JAQQ score.

Highlights

The ability to predict which children with Juvenile idiopathic Arthritis (JIA) are likely to have worse outcomes would allow a more targeted aggressive approach to initial therapy
Logistic regression was used for prediction of remission and Childhood Health Assessment questionnaire (CHAQ) outcomes, and linear regression for the Juvenile Arthritis Quality of Life Questionnaire (JAQQ) score
The only significant independent predictor of remission at both month 0 and 6 was the number of active joints, Conclusion As hypothesized, most measures at 6 months were better than the baseline measures at predicting 2 year outcomes

Summary

Introduction

The ability to predict which children with Juvenile idiopathic Arthritis (JIA) are likely to have worse outcomes would allow a more targeted aggressive approach to initial therapy. Predictors of 2 year outcomes of juvenile idiopathic arthritis in a multicenter Canadian cohort: the ReACCh out experience Natalie J Shiff8*, Kiem G Oen7, Jaime Guzman6, Nicole A Johnson1, Adam Huber4, Shirley Tse3, Lori B Tucker2, Rae SM Yeung3, Ciaran M Duffy1, ReACCh Out Investigators5

Results

Conclusion