Outcome in juvenile idiopathic arthritis: a population-based study from Sweden

Abstract

BackgroundAs the treatment arsenal for children with juvenile idiopathic arthritis (JIA) has expanded during the last decades, follow-up studies are needed on children diagnosed in the era of biological treatment to evaluate if this has improved the outcome. Our aim was to study the epidemiology and outcome of JIA in southern Sweden using a population-based cohort of children with a validated diagnosis of JIA collected over 9 years.MethodsPotential cases of JIA between 2002 and 2010 were collected after a database search, using the ICD codes M08-M09. The study area was Skåne, the southernmost county of Sweden (population 1.24 million; 17.6% aged < 16 years). The JIA diagnosis was validated and subcategorized through medical record review based on the criteria defined by the International League of Associations for Rheumatism (ILAR). Parameters on disease activity and pharmacologic treatment were recorded annually until the end of the study period (December 31, 2015).ResultsIn total, 251 cases of JIA were confirmed. The mean annual incidence rate for JIA was estimated to be 12.8/100,000 children < 16 years, with the highest age-specific annual incidence at the age of 2 years (36/100,000). Oligoarthritis was the largest subgroup (44.7%), and systemic JIA was the smallest subgroup (2.8%). Methotrexate was the most common disease-modifying anti-rheumatic drug prescribed (60.6%). Tumor necrosis factor alpha inhibitors were used as treatment for 23.9% of the children. Only 40.0% of the follow-up years, with a median follow-up time of 8 years, were free of arthritis or uveitis. Uveitis occurred in 10.8% of the children (8.0% chronic uveitis), and the need for joint corrective orthopedic surgery was 9.2%.ConclusionsThe incidence of JIA in this well-defined, population-based cohort is slightly lower than in previously published studies from Scandinavia. The need for orthopedic surgery and the presence of uveitis are diminished compared to studies with patients diagnosed more than 20 years ago. Children with JIA however still experience disease activity more than 50% of the time. In conclusion, we still have long-term challenges in the care for children with JIA, in spite of state-of-the-art treatment.

Fatigue in young adults with juvenile idiopathic arthritis 18 years after disease onset: data from the prospective Nordic JIA cohort

“…Juvenile idiopathic arthritis (JIA) is a heterogeneous chronic childhood disease with onset before 16 years of age. JIA is the most common rheumatic disease among children with incidence rates in the Nordic countries of 12.8-23/100,000 children [1][2][3]. Despite efficient modern treatment, including biologics, many patients with JIA experience reduced health-related quality of life (HRQoL) [4][5][6], and suffer from pain, physical disability and reduced participation in school and leisure activities in a long-term perspective [6].…”

Pain sensitivity in young adults with juvenile idiopathic arthritis: a quantitative sensory testing study

“…Juvenile idiopathic arthritis (JIA) is the most common of the pediatric rheumatic diseases, affecting 12.8–23/100,000 children in the Nordic countries [ 1 – 3 ]. JIA is a heterogeneous disease characterized by at least 6 weeks of persistent arthritis of unknown cause with onset before the 16th birthday.…”

Juvenile Idiopathic Arthritis in South Australia

“…Moreover, the point prevalence was estimated to exceed 400 per 100,000 among children aged 10-15 years in their data [14]. Both estimates were far higher than found in other published studies [9][10][11][12][13][15][16][17][18][19]].…”

“…However, it should be noted that the current low reported prevalence in developing countries may be related to limited data sources [14]. Published incidence rates for JIA in European countries ranged between 3.5 and 21.7 per 100,000 children under 16 years old [15][16][17][18][19].…”