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Study: Published criteria to identify inactive JIA do not always overlap
Published criteria to identify inactive disease or low disease activity do not always identify the same patients, according to a recently published study.
“The current study highlights that even published targets intended to capture the same construct identify different groups of children,” Kimme L. Hyrich, MD, PhD, FRCPC, professor at the University of Manchester, and colleagues wrote. “Results from studies using different outcome criteria therefore cannot be compared directly. In addition, if used as targets in clinical practice, using different targets may result in overtreatment or undertreatment.”
Hyrich and colleagues recruited 1,415 children at initial presentation for juvenile idiopathic arthritis at seven centers between 2001 and 2013. Researchers calculated the percentage of children with clinically inactive disease (CID) and minimal disease activity (MDA) after 1 year with four investigator-defined and eight published composite criteria.
Researchers found 67% of patients had no active joints after 1 year. With published criteria, between 48% and 61% achieved MDA and between 25% and 38% achieved CID. Of the 922 patients in MDA — for either the original composite criteria, juvenile arthritis disease activity score (JADAS) criteria or clinical JADAS cut-offs — 68% were classified in MDA by all three measures. In addition, 44% of 633 children in CID were in both Wallace’s preliminary criteria or the JADAS cut-off.
“Future work needs to explore which treatment target predicts better long-term prognoses in JIA,” the researchers wrote. – by Will A. Offit
Disclosure: The researchers report funding by the Medical Research Council, Arthritis Research UK and National Institute for Health Research.