Course of patients with juvenile spondyloarthritis during 4â
years of observation, juvenile part of GESPIC.
RMD Open
; 3(1): e000366, 2017.
Article
en En
| MEDLINE
| ID: mdl-28405472
ABSTRACT
OBJECTIVE:
To describe the course and the 4-year outcome of juvenile spondyloarthritis (jSpA).METHODS:
Patients with a diagnosis of jSpA and an age at onset ≤16â years were included in the German Spondyloarthritis Inception cohort (GESPIC) and followed up prospectively for 4â years.RESULTS:
118 patients (73% men, 66% HLA-B27 positive, mean age 13.5â years, mean symptom duration 2.2â years) were enrolled in 2 study centres 52% of patients with jSpA were captured by the enthesitis-related arthritis subgroup of the International League of Associations for Rheumatology classification criteria. At inclusion, the majority of patients had active peripheral arthritis (75.4%), followed by inflammatory back pain (IBP) (19.5%) and enthesitis (16.1%). There was a significant improvement in clinical manifestations and in patient-reported outcomes over time. During the 4-year follow-up, 85% of the patients had at least 1 period of remission on drug ≥6â months, and 46% of the patients achieved remission ≥12â months without medication, of whom 68% kept this status and 32% worsened. At the end of 4â years of observation, 23% of the patients were in remission without medication, but 57% still suffered from active disease. Patients with peripheral arthritis had a likelihood of 29% for having peripheral arthritis after 4â years, whereas the likelihood of IBP persistence was 53% for those with IBP at enrolment.CONCLUSIONS:
Although 1 quarter of patients with jSpA achieved remission off medication after 4â years, the likelihood of having recurrent or persistent disease into adulthood is substantial, particularly for jSpA with IBP. TRIAL REGISTRATION NUMBER NCT 01277419.
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Base de datos:
MEDLINE
Idioma:
En
Revista:
RMD Open
Año:
2017
Tipo del documento:
Article
País de afiliación:
Alemania