A 5-year prospective population-based study of juvenile chronic arthritis: onset, disease process, and outcome

Scand J Rheumatol. 2012 Oct;41(5):379-82. doi: 10.3109/03009742.2012.677472. Epub 2012 May 29.


Objectives: To investigate, in a population-based cohort of patients with juvenile chronic arthritis (JCA), onset characteristics, progression, outcome, and prognostic factors longitudinally for 5 years.

Methods: This cohort consisted of 132 incidence cases identified between 1984 and 1986 in southwestern Sweden followed for 5 years with annual reports of subgroup, joint assessment, disease activity, eye examinations, laboratory measurements, and medication. At the 5-year follow-up, the Childhood Health Assessment Questionnaire (Child-HAQ) was evaluated. European League Against Rheumatism (EULAR) criteria for diagnosis and disease activity were used.

Results: During the 5 years only four patients were lost to follow-up, 34% changed subgroup and 8% developed uveitis. At the 5-year follow-up the disease was active in 12% of the patients, stable in 28%, inactive in 25%, and in remission in 34%. Among those examined, 24% had radiological changes, of whom half had advanced changes. The Child-HAQ median score at the 5-year follow-up was 0.13 (range 0.0-1.9). The number of involved joints at inclusion correlated positively with active disease at the 5-year follow-up. Age at disease onset, the number of involved joints, and the number of joints with arthritis correlated positively with continuous disease and Child-HAQ score. CONCLUSION. Our study shows a diverse disease course during the first 5 years of JCA where one-third changed subgroup and two-thirds did not reach remission. Age of disease onset, the number of involved joints, and the number of joints with arthritis at inclusion were associated with poor outcome at the 5-year follow-up.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age of Onset
  • Arthritis, Juvenile / diagnosis*
  • Arthritis, Juvenile / epidemiology
  • Arthritis, Juvenile / physiopathology
  • Child
  • Disease Progression
  • Female
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Surveys and Questionnaires
  • Sweden
  • Uveitis / diagnosis*
  • Uveitis / etiology
  • Uveitis / physiopathology