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- Title
Oral abstracts 3: RA Treatment and outcomes.
- Authors
McErlane, Flora; Beresford, Michael W.; Baildam, Eileen M.; Thomson, Wendy; Hyrich, Kimme; Chieng, Alice; Davidson, Joyce; Foster, Helen E.; Gardner-Medwin, Janet; Lunt, Mark; Wedderburn, Lucy
- Abstract
Background: Juvenile Arthritis Disease Activity Score (JADAS) is a 4 variable composite disease activity (DA) score for JIA (including active 10, 27 or 71 joint count (AJC), physician global (PGA), parent/child global (PGE) and ESR). The validity of JADAS for all ILAR subtypes in the routine clinical setting is unknown. We investigated the construct validity of JADAS in the clinical setting in all subtypes of JIA through application to a prospective inception cohort of UK children presenting with new onset inflammatory arthritis.Methods: JADAS 10, 27 and 71 were determined for all children in the Childhood Arthritis Prospective Study (CAPS) with complete data available at baseline. Correlation of JADAS 10, 27 and 71 with single DA markers was determined for all subtypes. All correlations were calculated using Spearman’s rank statistic.Results: 262/1238 visits had sufficient data for calculation of JADAS (1028 (83%) AJC, 744 (60%) PGA, 843 (68%) PGE and 459 (37%) ESR). Median age at disease onset was 6.0 years (IQR 2.6-10.4) and 64% were female. Correlation between JADAS 10, 27 and 71 approached 1 for all subtypes. Median JADAS 71 was 5.3 (IQR 2.2-10.1) with a significant difference between median JADAS scores between subtypes (p < 0.01). Correlation of JADAS 71 with each single marker of DA was moderate to high in the total cohort (see Table 1). Overall, correlation with AJC, PGA and PGE was moderate to high and correlation with ESR, limited JC, parental pain and CHAQ was low to moderate in the individual subtypes. Correlation coefficients in the extended oligoarticular, rheumatoid factor negative and enthesitis related subtypes were interpreted with caution in view of low numbers.Conclusions: This study adds to the body of evidence supporting the construct validity of JADAS. JADAS correlates with other measures of DA in all ILAR subtypes in the routine clinical setting. Given the high frequency of missing ESR data, it would be useful to assess the validity of JADAS without inclusion of the ESR.Disclosure statement: All authors have declared no conflicts of interest.Table 1Spearman’s correlation between JADAS 71 and single markers DA by ILAR subtypeILAR SubtypeSystemic onset JIAPersistent oligo JIAExtended oligo JIARheumatoid factor neg JIARheumatoid factor pos JIAEnthesitis related JIAPsoriatic JIAUndifferentiated JIAUnknown subtypeTotal cohortNumber of children2311112577919717262AJC0.540.670.530.750.530.340.590.810.370.59PGA0.630.690.250.730.140.050.500.830.560.64PGE0.510.680.830.610.410.690.710.90.480.61ESR0.280.310.350.40.60.850.430.70.50.53Limited 71 JC0.290.510.230.370.14-0.120.40.810.450.41Parental pain0.230.620.030.570.410.690.70.790.420.53Childhood health assessment questionnaire0.250.57-0.070.36-0.470.840.370.80.660.47
- Subjects
ANTIRHEUMATIC agents; ORTHOPEDIC surgery; HEALTH outcome assessment; QUALITY of life; RHEUMATOID arthritis; JUVENILE idiopathic arthritis; TREATMENT effectiveness; PHARMACODYNAMICS
- Publication
Rheumatology, 2012, Vol 51, Issue suppl_3, piii27
- ISSN
1462-0324
- Publication type
Article