Assessment of disease activity in juvenile idiopathic arthritis

BACKGROUND: Recently Juvenile idiopathic Arthritis ( JIA) Disease Activity
Score (JADAS) was developed to measure disease activity. There is still discussion
what additional measures should be included in such score.
OBJECTIVES: To determine associations between JADAS and clinical and laboratory findings.
Methods. Data from 34 patients with JIA were recorded from one visit, including JADAS, joint assessment, morning stiffness, Childhood Health Assessment
Questionnaire (CHAQ), C-reactive protein, antinuclear antibodies, rheumatoid
factor (RF), degree of radiologic and ultrasonographic changes. Correlation of the
JADAS with above mentioned measures was examined. Physican’s, parent’s and
patient’s 10-cm VAS was statisticaly analysed. Pearson’s and Spearman’s correlations, T-test was performed using Windows Excel 2007 and SPSS 14.
RESULTS: For the JADAS the strongest correlation was with patient’s VAS for
wellbeing and active joint count; moderate with physician’s VAS for disease activity, parent’s VAS for wellbeing, patient’s VAS for pain, CHAQ, morning stiffness,
radiologic changes; week with RF. There where no statistical differencies between
physician’s, parent’s and patient’s VAS measures (p>0,5).
CONCLUSIONS: 1. Active joint count and patient’s VAS are the most important
measures in assessing disease acitivity. 2. CHAQ, morning stiffness, radiologic
changes are also important in assessing disease activity and some of them could be
included in disease activity score. 3.There where no statistical differencies between
different VAS, but there where tendency for the parents to overrate child’s disease
activity 2 times more than patients.
REFFERENCES: Consolaro A; Ruperto N; Bazso A; Pistorio A; Magni-Manzoni
S; Filocamo G; Malattia C; Viola S; Martin iA; Ravelli A. Development and Validation of a Composite Disease Activity Score for Juvenile Idiopathic Arthritis. Arthritis & Rheumatism. 2009 May 15 Vol.61, No 5, pp 658-666.