Division of Rheumatology, Department of Pediatrics, McMaster University, Hamilton, Ontario.
Division of Rheumatology, Department of Pediatrics, Western University, London, Ontario.
Rheumatology (Oxford). 2020 Oct 1;59(10):2796-2805. doi: 10.1093/rheumatology/keaa006.
The aim was to describe the design, methods and initial findings of a new Canadian inception cohort of children with JIA, The Canadian Alliance of Pediatric Rheumatology Investigators (CAPRI) JIA Registry.
The CAPRI JIA Registry was started in 2017 to collect information prospectively on children enrolled within 3 months of JIA diagnosis across Canada. The registry has a non-traditional modular design, with no artificially set times for registry visits to occur, streamlined multi-method data collection that requires 2-4 min per visit, and reports cumulative incidence of treatments, outcomes and adverse events calculated by Kaplan-Meier survival methods.
A total of 166 patients, enrolled a median of 6 weeks after JIA diagnosis at 10 centres, were included. The median age at diagnosis was 9 years [interquartile range (IQR) 3, 13], 61% were female and 51% had oligoarticular JIA. The median three-variable clinical Juvenile Arthritis Disease Activity Score was 6.5 (IQR 4, 10) at enrolment, and the median time to first attainment of clinically inactive disease (CID) was 24 weeks (by 1 year, 81%). Within 1 year of diagnosis, 70% of patients had started a DMARD and 35% a biologic agent. The rates of adverse events and serious adverse events were 60 and 5.8 per 100 patient-years, respectively.
This streamlined and flexible registry minimizes the burden of data collection and interference with clinic operations. Initial findings suggest that treatments for newly diagnosed patients with JIA in Canada have intensified, and now 81% of patients attain CID within 1 year of diagnosis.
描述加拿大幼年特发性关节炎(JIA)新起始队列儿童的设计、方法和初步发现,该队列为加拿大儿科风湿病研究人员联盟(CAPRI)JIA 登记处。
CAPRI JIA 登记处于 2017 年开始,前瞻性收集加拿大各地 JIA 确诊后 3 个月内入组的儿童信息。该登记处采用非传统的模块化设计,没有人为设定登记访问时间,简化了多方法数据收集,每次访问需要 2-4 分钟,通过 Kaplan-Meier 生存方法报告累积治疗、结局和不良事件发生率。
共纳入 166 例患者,中位年龄为 9 岁(四分位距 3 岁,13 岁),中位 JIA 确诊后 6 周(10 个中心)入组。61%为女性,51%为少关节型 JIA。入组时,中位三变量临床幼年特发性关节炎疾病活动评分(CDAI)为 6.5(四分位距 4,10),中位首次达到临床无活动疾病(CID)时间为 24 周(1 年时为 81%)。在确诊后 1 年内,70%的患者开始使用 DMARD,35%的患者开始使用生物制剂。不良事件和严重不良事件的发生率分别为 60/100 患者年和 5.8/100 患者年。
这种简化和灵活的登记处最大限度地减少了数据收集的负担和对临床操作的干扰。初步结果表明,加拿大新诊断 JIA 患者的治疗已得到强化,现在 81%的患者在确诊后 1 年内达到 CID。