Prognosis of patients with juvenile chronic arthritis and juvenile spondyloarthropathy

Objective, Evaluation of the course and the prognosis of juvenile chronic a rthritis (JCA) and juvenile spondyloarthropathy (JSpA). Methods. The entire medical histories of 171 patients with JCA or JSpA were reviewed, The study cohort comprised 102 patients with oligoarticular, 17 with systemic, and 24 with polyarticular onset of JCA; 28 patients had a Sp A; 91 patients with JCA from a population based cohort were included in tha t study cohort. The mean period of followup was 7.4 years. The probability of remission was estimated by survival analysis methods (Kaplan-Meier metho d). Results. After a disease duration of 10 years the highest probability of co mplete remission was estimated for patients with oligoarticular or systemic onset of JCA (54% and 38%, respectively). In the oligoarthritis group with late onset of JCA, a lower probability of remission was found fur the HLA- B27+ patients compared with HLA-B27- patients. Patients with polyarticular onset of JCA had the poorest prognosis, with a significantly lower probabil ity of complete remission (15%) within 10 years, more secondary injuries, a nd a lower functional capacity at followup, Patients with JSpA showed a 17% probability of remission after a disease duration of 5 years and ranged be tween the remission rates for oligoarticular and polyarticular JCA. The est imated remission rates for the patients with JCA in the population based co hort and in the whole cohort were quite similar. Conclusion, Our data suggest a favorable prognosis for JCA and JSpA in gene ral, but with differences among the subtypes, It seems that more than 50% o f the patients with JCA and JSpA reach adulthood with active arthritis and need further rheumatological care.