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Prognosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Prognosis of JIA has improved significantly in the past 10-20 years due to several factors

  • development of new therapies such as biological therapeutics
  • early aggressive treatment
  • effective intra-articular administration of steroids
  • involvement of multidisciplinary team (1,2)

Despite these factors help in better management of the condition, some patients still have an active disease with a progressive clinical course.

  • In a cohort study of 683 JIA patients, 32.8% were in remission after a mean follow-up of 10 years (remission being defined as no disease activity in the absence of antirheumatic medications for at least 6 months)
    • polyarticular subtype, making up 15.8% of the cohort, attained remission in 24.1% of patients at some time in the disease course
    • none of the RF-positive patients achieved remission during the time course studied
  • a similar study in 392 JIA patients determined the probability of remission (defined as absence of arthritis off treatment for at least 2 years) at 10 years was
    • 23% for RF-negative polyarticular patients
    • 6% for RF-positive polyarticular patients

Poor prognosis is seen in following patients

  • for polyarticular JIA
    • positive RF antibodies
    • positive anti cyclic citrullinated peptide (anti-CCP) antibodies
    • hip arthritis
    • cervical spine arthritis
    • erosions or joint space narrowing on radiographs
  • enthesitis related arthritis
    • family history of the disease
    • early ankle and hip joint involvement
    • a higher number of affected joints at disease onset
  • systemic JIA
    • age of onset less than 6 years
    • disease duration for greater than 5 years, or persistent systemic features at 6 months of disease including fever
    • the need for corticosteroids
    • thrombocytosis (1,2,3).

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