JIA health status worsens in adulthood

Patients with juvenile idiopathic arthritis were more likely to report active disease and pain in adulthood than as a child under pediatric care, and physician- and patient-reported outcomes did not agree, according to findings presented recently.

The study included 624 patients enrolled in the BiKer (Biologika in der Kinderrheumatologie/biologics in pediatric rheumatology) study of children with juvenile idiopathic arthritis (JIA) in Germany during an 8.2-year period. Mean disease duration at the time of administration of the first biologic (66%) or disease-modifying anti-rheumatic drug (33.2%) was 5.6 years. Mean time spent in pediatric care was 2.6 years, during which time, patient-reported outcomes, including well-being and pain level scores, improved by several points on a numeric rating scale of 0 to 10. Functional status scores improved by 0.4 on the Children’s Health Assessment Questionnaire, according to the researchers.

A follow-up study, JuMBO (Juvenile arthritis MTX/Biologics long-term Observation), ensued, in which patients were followed into adulthood at mean age 23 years and mean disease duration of 14.2 years. Patient-reported outcomes worsened after discharge from pediatric care by nearly 2 points in disease activity, overall well-being and pain level. More than half reported active disease, pain and activity restriction compared to the last visit in the BiKer study, according to the researchers.

Further, health care providers of the adults in the JuMBO study rated patient disease activity lower than pediatric rheumatologists in the BiKer study did, in contrast to patients’ self-reports. The researchers found physicians in the JuMBO study rated disease activity lower than patients did, whereas correlation between physician and patient scores was higher during the pediatric study. – by Shirley Pulawski

Reference:

Minden K, et al. Paper #2902. Presented at: American College of Rheumatology Annual Meeting. Nov. 14-19, 2014; Boston.

Disclosure: Minden has no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.