Juvenile Idiopathic Arthritis: What’s the Optimal Treatment Target?

Jun 25, 2018

How best to determine clinically inactive disease: Wallace’s preliminary criteria versus the clinical juvenile arthritis disease activity score.

Reference1. Shoop-Worrall SJ, Verstappen SM, McDonagh JE, et al. Long term outcomes following achievement of clinically inactive disease in juvenile idiopathic arthritis: the importance of definition. Arthritis Rheumatol. 2018 Apr 12. doi: 10.1002/art.40519. [Epub ahead of print]

Shoop-Worrall and fellow researchers in the UK found that clinically inactive disease (CID) in juvenile idiopathic arthritis (JIA), as determined by the clinical juvenile arthritis disease activity score (cJADAS10), was preferable as a target for treatment when compared with CID by Wallace’s preliminary criteria.¹

Scroll through the slides for the details of the study and the take-home messages for clinicians.

(Image credit: ©JPC-PROD/Shutterstock.com)

CID, clinically inactive disease; cJADAS10, clinical juvenile arthritis disease activity score; JIA, juvenile idiopathic arthritis.

cJADAS10, clinical juvenile arthritis disease activity score; JIA, juvenile idiopathic arthritis.

CI, confidence interval; CID, clinically inactive disease; cJADAS10, clinical juvenile arthritis disease activity score; MDA, minimal disease activity; OR, odds ratio.

At 1 year, achievement of any state of CID was associated with significantly increased odds of no limited joints at 1 year (Wallace only: OR, 7.5 [95% CI, 2.9 to 19.2]; cJADAS only: OR, 3.9 [95% CI, 2.5 to 6.3]; both CID states: OR, 9.3 [95% CI, 4.9 to 17.7]).

CHAQ, Childhood Health Assessment Questionnaire; CHQ, Childhood Health Questionnaire; CI, confidence interval; CID, clinically inactive disease; cJADAS10, clinical juvenile arthritis disease activity score.

Subjects who had achieved CID on at least the cJADAS10 scored at least five points better on the CHQ psychosocial (cJADAS10 only: coefficient 5.3 [95% CI, 0.5 to 10.1]; both CID: coefficient 5.5 [95% CI, 1.5 to 9.4]) than children with active disease. Children who had achieved CID on the cJADAS10 had 50% lower scores (cJADAS10 only: 95% CI, 20% to 60%; both CID: 95% CI, 30% to 70%). Achievement of CID on the cJADAS10 was associated with better scores on the CHQ psychosocial score (cJADAS only: Î² = 4.1 [95% CI, 1.8 to 6.4]; both CID: Î² = 3.9 [95% CI, 1.6 to 6.2]).

cJADAS10, clinical juvenile arthritis disease activity score; JIA, juvenile idiopathic arthritis.