Development and validation of a composite disease activity score for juvenile idiopathic arthritis

Consolaro, Alessandro; Ruperto, Nicolino; Bazsó, Anna; Pistorio, Angela; Magni‐Manzoni, Silvia; Filocamo, G; Malattia, Clara; Viola, Stefania; Martini, Alberto; Ravelli, Angelo

doi:10.1002/art.24516

Cited by 634 publications

(506 citation statements)

References 23 publications

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“…All JIA patients fulfilled the revised International League of Associations for Rheumatology classification criteria for JIA [1]. Disease activity at the time of joint injection was calculated using juvenile arthritis disease activity scores JADAS 100 [14]. The study was approved by the Women's and Children's Hospital Research Ethics Committee (REC2101/9/11) and written informed consent was obtained for all participants.…”

Section: Patientsmentioning

confidence: 99%

Comparison of Blood and Synovial Fluid Th17 and Novel Peptidase Inhibitor 16 Treg Cell Subsets in Juvenile Idiopathic Arthritis

Grose

Millard²,

Mavrangelos³

et al. 2012

J Rheumatol

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and an increased ratio of Th17 to Treg. Although Treg were increased in SF compared with the PB, we found a significant decrease in the numbers of PI16+ Treg in active joints compared with peripheral blood. Coexpression of CCR4 and CCR6 was reduced on PI16+Treg in PB and SF of JIA subjects compared with healthy children, however the ability of these cells to migrate towards their ligands was unaffected.

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Section: Patientsmentioning

confidence: 99%

Comparison of Blood and Synovial Fluid Th17 and Novel Peptidase Inhibitor 16 Treg Cell Subsets in Juvenile Idiopathic Arthritis

Grose

Millard²,

Mavrangelos³

et al. 2012

J Rheumatol

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“…A series of propensity scores stratified into deciles were used to adjust for potential confounding effects of baseline differences between the cohorts (ETN plus MTX combination versus MTX, ETN only versus MTX, and ETN plus MTX combination versus ETN only) including age, sex, disease severity (determined using baseline scores on the Childhood Health Assessment Questionnaire [C-HAQ] [18] and the Juvenile Arthritis Disease Activity Score in 71 joints [19]), disease duration, baseline oral steroid use, and ILAR category (systemic versus nonsystemic). In this context, logistic regression is used to calculate the probability of a person being assigned to one of two treatment groups given a set of observed covariates.…”

Section: Methodsmentioning

confidence: 99%

287. Medically Significant Infections are Increased in Patients with Juvenile Idiopathic Arthritis Treated with Etanercept: Results from the British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study

et al. 2014

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Objective. The association between anti-tumor necrosis factor therapy and increased rates of infection is widely documented in adults with rheumatoid arthritis. Findings in children with juvenile idiopathic arthritis (JIA) have been less well documented. The aims of this analysis were to compare the rates of medically significant infections (MSIs) in children with JIA treated with etanercept (ETN) versus methotrexate (MTX) and to compare the rates between combination therapy with ETN plus MTX and monotherapy with ETN. Methods.A total of 852 ETN-treated children and 260 MTX-treated children had been recruited to the British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study (BSPAR-ETN). MSIs included infections that resulted in death or hospitalization or were deemed medically significant by the clinician. This on-drug analysis followed the patients until the first MSI, treatment discontinuation, the last followup, or death. Cox proportional hazards models, which were adjusted using propensity deciles, were used to compare rates of MSI between cohorts. Sensitivity analyses were conducted specifically with regard to serious infections (SIs), which were defined as those requiring hospitalization or treatment with intravenous antibiotics/antivirals.Results. The ETN-treated cohort was older and had a longer disease duration, but the disease activity was similar between the cohorts. A total of 133 first MSIs were reported (109 with ETN and 24 with MTX). Patients receiving ETN had higher rates of MSI than did the controls (propensity decile adjusted hazard ratio 2.13 [95% confidence interval 1.22-3.74]). The risk of MSI was higher whether patients were receiving combination or monotherapy. Sensitivity analysis showed no between-group difference in the rate of SIs, which were much less common.Conclusion. ETN therapy is associated with an increased risk of MSI; however, this increased risk disappears when considering only SIs, which suggests that either there were differences in the severity of infections and/or there was a possible reporting bias.Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory disease in children. The term describes a group of disorders characterized by joint The British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study (BSPAR-ETN) is supported by a research grant from BSPAR to the University of Manchester. BSPAR has received restricted income from Pfizer that finances an entirely separate contract between BSPAR and the University of Manchester to provide and oversee the data collection and analysis as well as the management of the study. The principal investigators and their team have full academic freedom and are able to work independently of pharmaceutical industry influence. All decisions concerning the analysis, interpretation, and publication of the study data are made autonomously of any industrial contribution.

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“…A recently developed composite score, the Juvenile Arthritis Disease Activity Score, was designed to better characterize the absolute level of disease activity in JIA patients and consists of 4 measures: PGA, PGW, number of joints with active arthritis, and erythrocyte sedimentation rate. Initial validation studies have been performed (40).…”

Section: Validitymentioning

confidence: 99%

Psychometric characteristics of outcome measures in juvenile idiopathic arthritis: A systematic review

Mater

Williams

Coeytaux

et al. 2012

Arthritis Care & Research

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Objective. To review the performance characteristics of the instruments most commonly used to measure clinical outcomes in juvenile idiopathic arthritis (JIA), including global assessments, articular indices, functional/disability assessments, and quality of life measures. Methods. As part of an Agency for Healthcare Research and Quality comparative effectiveness review of antirheumatic drugs, we explored the characteristics of commonly used outcome measures for JIA. English-language studies of children with JIA were identified from Medline and Embase. Two independent reviewers screened titles and abstracts, with subsequent full-text review of studies selected based on predetermined criteria. Results. We included 35 publications describing 34 unique studies and involving 14,831 patients. The Childhood Health Assessment Questionnaire (C-HAQ) was the most extensively studied instrument and had high reliability, but only moderate correlations with other indices of disease activity and poor responsiveness to change in disease status. The physician global assessment of disease activity (PGA) and articular indices had the strongest association with disease activity and were the most responsive to change. Measures of psychosocial function and quality of life were moderately associated with measures of disease activity, but were less responsive to changes in disease status. Conclusion. In children with JIA, no single instrument was superior in reliability or validity or in describing the impact of JIA. Although the C-HAQ has been extensively evaluated, the PGA and articular indices appear to have the highest responsiveness to change and, therefore, the highest potential for detecting important differences in treatment response.

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Development and validation of a composite disease activity score for juvenile idiopathic arthritis

Cited by 634 publications

References 23 publications

Comparison of Blood and Synovial Fluid Th17 and Novel Peptidase Inhibitor 16 Treg Cell Subsets in Juvenile Idiopathic Arthritis

Comparison of Blood and Synovial Fluid Th17 and Novel Peptidase Inhibitor 16 Treg Cell Subsets in Juvenile Idiopathic Arthritis

287. Medically Significant Infections are Increased in Patients with Juvenile Idiopathic Arthritis Treated with Etanercept: Results from the British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study

Psychometric characteristics of outcome measures in juvenile idiopathic arthritis: A systematic review

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