Clinically Inactive Disease in a Cohort of Children with New-onset Polyarticular Juvenile Idiopathic Arthritis Treated with Early Aggressive Therapy: Time to Achievement, Total Duration, and Predictors

Abstract

Shorter disease duration prior to treatment, a robust response at 4 months, and more aggressive therapy result in a higher likelihood and longer duration of CID in patients with poly-JIA. The original trial from which data for this analysis were obtained is registered on www.clinicaltrials.gov NCT 00443430.

Time spent in inactive disease before MTX withdrawal is relevant with regard to the flare risk in patients with JIA

“…Foell et al applied the Wallace criteria,18 whereas our definition relies on the cJADAS10,15 because of the non-availability of the report about uveitis activity for each visit. At the beginning of BiKeR in early 2001, the American College of Rheumatology pediatric response criteria (PedACR) criteria were used as outcome measure, the documentation of uveitis activity at each visit was added to the register later (and after publication of the Wallace criteria).…”

Intravoxel incoherent motion magnetic resonance imaging of the knee joint in children with juvenile idiopathic arthritis

“…MRI is more sensitive than physical examination in detecting active joint inflammation [4]. In early juvenile idiopathic arthritis, detection of joint inflammation is essential because early initiation of an aggressive therapy improves clinical outcome [5]. Routine MRI techniques available to date all rely on intravenous application of gadolinium-based contrast agents for visualisation of inflamed synovial tissue [6].…”

Cytokine Biomarkers of Disease Activity and Therapeutic Response after Initiating Methotrexate Therapy in Patients with Juvenile Idiopathic Arthritis

“…Left untreated or poorly controlled, JIA continues to be a significant cause of irreversible joint damage and long‐term disability in children. Recognizing the need for early control of disease activity to prevent long‐term sequelae, early initiation of disease‐modifying antirheumatic drug (DMARD) therapy has become the standard of care in patients with high disease activity or features of a poor prognosis . However, therapeutic response to this class of drugs is characterized by a high level of interindividual variability that is unpredictable and has resulted in a trial‐and‐error approach to finding the most effective therapeutic regimen for each patient .…”