Lurati Alfredomaria, Salmaso Alessandra, Gerloni Valeria, Gattinara Maurizio, Fantini Flavio
Gateano Pini Institute, University of Milan, and Fornaroli Hospital, Rheumatology Unit, Magenta, 20013, Italy.
J Rheumatol. 2009 Jul;36(7):1532-5. doi: 10.3899/jrheum.080434. Epub 2009 Jun 1.
To evaluate disease course and clinical usefulness in some categories of juvenile idiopathic arthritis (JIA) by applying newly developed Wallace definitions of remission off drugs.
In a retrospective study, charts of patients with chronic form of primary (idiopathic) arthritis followed from our center since 1970 were reviewed and clinical/laboratory variables were collected for further analysis.
The cohort included 761 eligible patients [516 (67.8%) female, 245 (32.2%) male] with JIA. Mean disease onset age (+/- standard deviation) was 6.25 +/- 4.4 years (range 0.5-15.9). Disease mean duration to last visit was 10.02 +/- 4.31 years. Followup mean period was 7.6 +/- 6.4 years (range 1.5-35 yrs). A total of 247 (32.46%) patients achieved remission according to criteria [persistent oligoarthritis 153 (42.9%); extended oligoarthritis 15 (13.1%); seronegative polyarthritis 21 (22.4%); systemic arthritis 33 (33.7%); enthesitis related arthritis (ERA) plus juvenile psoriatic arthritis (JPsA) 25 (33.4%)]. No patients with seropositive polyarthritis achieved remission status (p < 0.001). In remitted patients the mean survival function (+/- standard error of the mean) before relapse calculated by Kaplan-Meier was of 20.9 (+/- 1.3) months overall: 21.7 (+/- 0.46) in persistent oligoarthritis, 25.0 (+/- 6.6) in extended oligoarthritis, 26.7 (+/- 13.2) in seronegative polyarthritis, and 17.6 (+/- 2.44) in ERA+JPsA (p > 0.1).
In our cohort about one-third of cases obtained a remission episode in 4 decades of observation, with a significant difference between oligoarthritis and other categories (p < 0.001) using the Kaplan-Meier method; the remission status duration before a relapse has been about 20 months, without a significant difference between JIA categories.
通过应用新制定的停药后缓解的华莱士定义，评估某些类型的幼年特发性关节炎（JIA）的病程及临床实用性。
在一项回顾性研究中，对自1970年起在我们中心随访的慢性原发性（特发性）关节炎患者的病历进行审查，并收集临床/实验室变量以进行进一步分析。
该队列包括761例符合条件的JIA患者[516例（67.8%）为女性，245例（32.2%）为男性]。疾病平均发病年龄（±标准差）为6.25±4.4岁（范围0.5 - 15.9岁）。至最后一次就诊时疾病的平均持续时间为10.02±4.31年。平均随访期为7.6±6.4年（范围1.5 - 35年）。根据标准，共有247例（32.46%）患者达到缓解[持续性少关节炎153例（42.9%）；扩展性少关节炎15例（13.1%）；血清阴性多关节炎21例（22.4%）；全身型关节炎33例（33.7%）；附着点炎相关关节炎（ERA）加幼年银屑病关节炎（JPsA）25例（33.4%）]。血清阳性多关节炎患者无达到缓解状态者（p < 0.001）。在缓解的患者中，通过Kaplan-Meier法计算的复发前平均生存函数（±平均标准误）总体为20.9（±1.3）个月：持续性少关节炎为21.7（±0.46）个月，扩展性少关节炎为25.0（±6.6）个月，血清阴性多关节炎为26.7（±13.2）个月，ERA + JPsA为17.6（±2.44）个月（p > 0.1）。
在我们的队列中，经过40年的观察，约三分之一的病例出现缓解期，使用Kaplan-Meier法，少关节炎与其他类型之间存在显著差异（p < 0.001）；复发前缓解状态的持续时间约为20个月，JIA各类型之间无显著差异。
