Long-term outcome and prognosis in oligoarticular-onset juvenile idiopathic arthritis

Objective. To describe the long-term outcome and determine predictors of se verity among patients with oligoarticular-onset juvenile idiopathic arthrit is (JIA). Methods. In a longitudinal study, 207 patients with oligoarticular-onset JI A who were referred between 1988 and 1998 were evaluated. At disease onset, selected clinical and laboratory data were collected as independent variab les. A polyarticular disease course, joint erosion, uveitis, and remission were assessed as dependent variables. Longitudinal analyses were performed with the Kaplan-Meier method, and multivariate analysis with the Cox model. Results. After 6 years of followup, the probability of a polyarticular cour se of disease was 50%, joint erosion was 35%, uveitis was 30%, and remissio n was 23% in these patients. Joint erosion was strongly associated with a p olyarticular course. A high erythrocyte sedimentation rate (ESR) as well as involvement of more than 1 joint or involvement of an upper limb at diseas e onset were predictors of disease extension. A high ESR was also a strong predictor of a destructive course, and a family history of psoriasis was pr edictive of uveitis occurrence. No predictive factor for remission could be identified. Conclusion. Oligoarticular-onset JIA is a severe disease with frequent comp lications, Factors predictive of severity in oligoarticular-onset JIA were identified. This could allow early identification of high-risk patient subg roups, warranting a more aggressive therapeutic approach.