A retrospective study on 158 Thai patients with juvenile idiopathic arthritis followed in a single center over a 15‐year period

Abstract

Aim: To determine the outcomes of juvenile idiopathic arthritis (JIA) in Thai children.Methods: A retrospective cohort study. All JIA patients in a rheumatology clinic, Ramathibodi Hospital, between July 1997 and December 2012 were enrolled. The patient data were reviewed from medical records. At the most recent follow-up visit, patient outcomes were assessed in three aspects: disease status, functional outcomes and structural damage.Results: Of 168 patients, 158 (94.0%) were assessed in disease status and functional outcomes, with 114 patients (67.9%) assessed in three aspects over 4 years of disease. The most common JIA category was systemic JIA (SJIA) (33.8%), followed by enthesitis-related arthritis (ERA) (24.8%), oligoarthritis (18.5%), rheumatoid factor (RF)-negative polyarthritis (15.3%), RF-positive polyarthritis (7.6%) and one undifferentiated arthritis. SJIA had the highest remission rate due to early diagnosis and prompt treatment compared to other categories, whereas RF-positive polyarthritis carried the worst prognosis in three aspects, followed by ERA. Moreover, ERA patients had the highest failure rate in conventional therapy, half of whom had combined treatment with biologic agents and presence of human leukocyte antigen (HLA)-B27 was a predictor for biologic treatment in ERA patients. In addition, disease duration > 2 years or failure of conventional therapy was a predictor of structural bone damage.Conclusions: SJIA had the highest remission rate, whereas RF-positive polyarthritis had the worst outcome in three aspects. Prolonged disease duration or failure of conventional therapy was a predictor of structural bone damage, while HLA-B27 was a predictor for biologic treatment in ERA patients.

Aporte del uso de herramientas básicas de Telemedicina en la atención de niños y adolescentes con Artritis idiopática juvenil, en el Hospital de Puerto Montt. Chile

“…The second objective is to show cases of JIA and their characteristics in our region, and finally to evaluate the perception of parents and patients with JIA about the care received. The predominance of the polyarticular RF (-) form stands out in our cases, reported, to our knowledge, only in a cohort of Germany 13 , which contrasts with what has been published in other western countries, including national data, where the oligoarticular form predominates 3,4,5,[14][15][16] , and in Asian countries where systemic and enthesitis-related forms predominate 16,17 . The reasons for the predominance of the polyarticular form RF (-) are not clear, and although there was German colonization in this region, there is no history of patients with German ancestors in our cohort.…”

Improving musculoskeletal health for children and young people – A ‘call to action’

“…Worse outcomes in JIA are reported in Hispanic, African American and Asian studies [ 33 , [66] , [67] , [68] ], and in countries with low GDP [ 36 ]. Such observations have multifactorial explanations, including higher prevalence of poor prognosis subtypes in these populations [ 68 ], paucity and poor access to specialist care [ 5 , 36 , 37 , 69 ] with delay to diagnosis and inequity being widely reported [ 5 , 33 , 37 , [69] , [70] , [71] ]. There have been considerable advances in JIA, including biological therapies, and the condition is now regarded as treatable although many treatments are not always affordable or accessible [ 3 , 59 ].…”

Cost–utility and budget impact analysis of tocilizumab for the treatment of refractory systemic juvenile idiopathic arthritis in Thailand

“…The prevalence and incidence rates for JIA were 0.02% and 0.002% per year, respectively. The proportion of sJIA to JIA in Thailand was 33.8% according to a retrospective study from 1997 to 2012, 12 while the proportion of refractory sJIA was around 20.09% based on our data collection from seven tertiary hospitals. Thus, the number of patients with refractory sJIA was 171 cases in 2017, with 17 new cases annually.…”

“…11 In Thailand, a retrospective study over a 15-year period from 1997 to 2012 in a single referral centre indicated that sJIA contributes to 33.8% of JIA. 12 …”