0Consolaro et al. Pediatric Rheumatology 2013, 11(Suppl 2):O11 http://www.ped-rheum.com/content/11/S2/O11
ORAL PRESENTATION
PEDIATRIC RHEUMATOLOGY
Open Access
PReS-FINAL-2176: Declines in levels of disease activity and physical disability in children with juvenile idiopathic arthritis seen in standard clinical care over the last 25 years
1 * 1 11 1 1 7 1 o 10
A Consolaro , S Lanni , F Minoia , S Davi , S Dalpra , B Schiappapietra , V Muratore , A Martini ', A Ravelli '
From 20th Pediatric Rheumatology European Society (PReS) Congress Ljubljana, Slovenia. 25-29 September 2013
Introduction
Over the last 3 decades there have been important advances in the management of juvenile idiopathic arthritis (JIA), which include the introduction of metho-trexate and, later on, the tendency toward its earlier initiation, the widespread use of intra-articular corticos-teroid injections, and, more recently, the availability of the biologic response modifiers. Although this therapeutic progress is likely to have led to a marked improvement in the outlook of children with JIA, the prognostic impact of the newer therapeutic modalities is still poorly documented.
Objectives
To evaluate the change in the measures of disease activty and phisical function in JIA over the last 25 years.
Methods
The clinical information recorded during visits made in children with JIA from January 1987 to March 2012 was retrieved from the study center database. Visits were divided in the following time intervals: 1987-1995 (n = 826), 1996-2000 (n = 1,337), 2001-2005 (n = 2,022), 2006-2012 (n = 2,317). Measures of disease activity included the physician's and parent's global ratings (both made on a 0-10 cm visual analog scale, VAS), the parent's pain rating (made on a 0-10 cm VAS) and the count of joints with swelling, pain on motion/tenderness and active disease. Measures of
1 Pediatria II, Istituto Giannina Gaslini, Genoa, Italy
Full list of author information is available at the end of the article
disability included the count of joints with restricted motion and a physical function tool (the Childhood Health Assessment Questionnaire, CHAQ before March 2007 and the Juvenile Arthritis Functionality Scale, JAFS after that date). To enable comparability of functional ability evaluations, both CHAQ and JAFS scores were converted to a 0-10 scale (0 = best; 10 = worst). Parent's global and pain ratings as well as functional ability assessment were not available for visits made prior to 1995 because before this year these assessments were made on a scale not comparable with those used subsequently.
Results
We observed a progressive decline in the levels of disease activity and physical disability over time among children with JIA seen from the mid of the 1980s to the 2010s. This finding confirms the notion that the recent advances in the management of JIA have led to a substantial improvement in disease prognosis.
Conclusion
We observed a progressive decline in the levels of disease activity and physical disability over time among children with JIA seen from the mid of the 1980s to the 2010s. This finding confirms the notion that the recent advances in the management of JIA have led to a substantial improvement in disease prognosis.
Disclosure of interest
None declared.
Central
© 2013 Consolaro et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Consolaro et al. Pediatric Rheumatology 2013, 11(Suppl 2):O11 http://www.ped-rheum.com/content/11/S2/O11
Page 2 of 2
Table 1
Physician global Active Swollen Tender Restricted Parent global Parent pain Physical function
(0-10) joints jointst joints joints (0-10) (0-10) (0-10)
1988-1996 5.4 (2.8) 8.2 (9.4) 7.9 (8.3) 6.3 (8.0) 8.0 (10.4) - - -
1996-2000 5.0 (3.4) 5.7 (8.4) 4.3 (5.8) 4.3 (7.9) 5.5 (9.5) 2.8 (2.5) 2.5 (2.5) 1.7 (2.0)
2001-2005 4.0 (3.5) 3.8 (5.7) 2.9 (4.2) 3.3 (6.0) 3.1 (6.2) 2.4 (2.5) 2.4 (2.7) 1.3 (1.8)
2006-2012 2 (2.7) 2.2 (4.5) 1.8 (3.8) 1.9 (4) 1.9 (4.2) 2.1 (2.5) 1.9 (2.6) 0.4 (0.9)
Authors' details
1 Pediatria II, Istituto Giannina Gaslini, Genoa, Italy. 2Pediatria, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy. 3University of Genoa, Genoa, Italy.
Published: 5 December 2013
doi:10.1186/1546-0096-11-S2-O11
Cite this article as: Consolaro et al: PReS-FINAL-2176: Declines in levels of disease activity and physical disability in children with juvenile idiopathic arthritis seen in standard clinical care over the last 25 years.
Pediatric Rheumatology 2013 11(Suppl 2):O11.
Submit your next manuscript to BioMed Central and take full advantage of:
• Convenient online submission
• Thorough peer review
• No space constraints or color figure charges
• Immediate publication on acceptance
• Inclusion in PubMed, CAS, Scopus and Google Scholar
• Research which is freely available for redistribution
Submit your manuscript at fpntral
www.biomedcentral.com/submit v-enudi
