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

Arthritis Rheum. 2000 Aug;43(8):1858-65. doi: 10.1002/1529-0131(200008)43:8<1858::AID-ANR23>3.0.CO;2-A.


Objective: To describe the long-term outcome and determine predictors of severity among patients with oligoarticular-onset juvenile idiopathic arthritis (JIA).

Methods: In a longitudinal study, 207 patients with oligoarticular-onset JIA who were referred between 1988 and 1998 were evaluated. At disease onset, selected clinical and laboratory data were collected as independent variables. 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 course of disease was 50%, joint erosion was 35%, uveitis was 30%, and remission was 23% in these patients. Joint erosion was strongly associated with a polyarticular course. A high erythrocyte sedimentation rate (ESR) as well as involvement of more than 1 joint or involvement of an upper limb at disease 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 predictive of uveitis occurrence. No predictive factor for remission could be identified.

Conclusion: Oligoarticular-onset JIA is a severe disease with frequent complications. Factors predictive of severity in oligoarticular-onset JIA were identified. This could allow early identification of high-risk patient subgroups, warranting a more aggressive therapeutic approach.

MeSH terms

  • Adolescent
  • Age of Onset
  • Arthritis, Juvenile / diagnosis*
  • Arthritis, Juvenile / therapy
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Prognosis
  • Proportional Hazards Models
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome