Juvenile chronic arthritis in adult life: A study of long-term outcome in patients with juvenile chronic arthritis or adult rheumatoid arthritis

We compared the prognostic factors and outcome of 30 patients with juvenile chronic arthritis (JCA) extending into adult life with those of 30 patient s with adult rheumatoid arthritis (RA) at a university adult rheumatology c linic; pairs were matched for sex and duration of disease (mean 8 years). O ne-third of JCA patients had seronegative polyarticular disease and another third had oligoarticular disease. In a third of the JCA patients, the clin ical presentation changed during the follow-up. Over half of the RA patient s had seropositive polyarticular and a one-third had seronegative polyartic ular disease. Fewer seropositive patients were recorded in the JCA group th an in the RA group both at the beginning (16.7% versus 56.7%; p=0.003) and at the end of the follow-up (14.3% versus 59.3%; p=0.001). JCA patients dev eloped less radiographic changes than RA patients (46.7% versus 76.7%; p=0. 034); oligoarthritis in the JCA group had the best prognosis whereas seropo sitive polyarthritis in the RA group had the worst prognosis. Significantly more patients, with JCA than RA (60% versus 23% p=0.009) were in remission at the end of the followup. In conclusion when studied in adult life, the longterm prognosis is better in patients with JCA than in those with RA.