Oen Kiem, Tucker Lori, Huber Adam M, Miettunen Paivi, Scuccimarri Rosie, Campillo Sarah, Cabral David A, Feldman Brian M, Tse Shirley, Chédeville Gaëlle, Spiegel Lynn, Schneider Rayfel, Lang Bianca, Ellsworth Janet, Ramsey Suzanne, Dancey Paul, Silverman Earl, Chetaille Anne-Laure, Cameron Bonnie, Johnson Nicole, Dorval Jean, Petty Ross E, Duffy Karen Watanabe, Boire Gilles, Haddad Elie, Houghton Kristin, Saint-Cyr Claire, Turvey Stuart E, Benseler Susanne, Cheang Mary, Yeung Rae S M, Duffy Ciarán M
University of Manitoba, Winnipeg, Manitoba, Canada.
Arthritis Rheum. 2009 Aug 15;61(8):1077-86. doi: 10.1002/art.24539.
To determine early predictors of 6-month outcomes in a prospective cohort of patients with juvenile idiopathic arthritis (JIA).
Patients selected were those enrolled in an inception cohort study of JIA, the Research in Arthritis in Canadian Children Emphasizing Outcomes Study, within 6 months after diagnosis. The juvenile rheumatoid arthritis core criteria set and quality of life measures were collected at enrollment and 6 months later. Outcomes evaluated included inactive disease, Juvenile Arthritis Quality of Life Questionnaire (JAQQ) scores, and Childhood Health Assessment Questionnaire (C-HAQ) scores at 6 months.
Thirty-three percent of patients had inactive disease at 6 months. Onset subtype and most baseline core criteria set measures correlated with all 3 outcomes. Relative to oligoarticular JIA, the risks of inactive disease were lower for enthesitis-related arthritis, polyarthritis rheumatoid factor (RF)-negative JIA, and polyarthritis RF-positive JIA, and were similar for psoriatic arthritis. In multiple regression analyses, the baseline JAQQ score was an independent predictor of all 3 outcomes. Other independent baseline predictors included polyarthritis RF-negative and systemic JIA for inactive disease; C-HAQ score and polyarthritis RF-positive JIA for the 6-month C-HAQ score; and active joint count, pain, and time to diagnosis for the 6-month JAQQ score.
Clinical measures soon after diagnosis predict short-term outcomes for patients with JIA. The JAQQ is a predictor of multiple outcomes. Time to diagnosis affects quality of life in the short term.
确定青少年特发性关节炎（JIA）前瞻性队列中6个月预后的早期预测因素。
入选的患者为在加拿大儿童关节炎研究强调结局研究（一项JIA起始队列研究）中诊断后6个月内入组的患者。在入组时和6个月后收集青少年类风湿关节炎核心标准集和生活质量指标。评估的结局包括6个月时的疾病非活动状态、青少年关节炎生活质量问卷（JAQQ）评分和儿童健康评估问卷（C-HAQ）评分。
33%的患者在6个月时疾病处于非活动状态。起病亚型和大多数基线核心标准集指标与所有3种结局相关。与少关节型JIA相比，附着点炎相关关节炎、多关节型类风湿因子（RF）阴性JIA和多关节型RF阳性JIA达到疾病非活动状态的风险较低，银屑病关节炎的风险与之相似。在多元回归分析中，基线JAQQ评分是所有3种结局的独立预测因素。其他独立的基线预测因素包括：对于疾病非活动状态，多关节型RF阴性和全身型JIA；对于6个月时的C-HAQ评分，C-HAQ评分和多关节型RF阳性JIA；对于6个月时的JAQQ评分，活动关节计数、疼痛和诊断时间。
诊断后不久的临床指标可预测JIA患者的短期预后。JAQQ是多种预后的预测因素。诊断时间在短期内影响生活质量。
