ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2859

Development of New Juvenile Arthritis Disease Activity Score Cut-Offs for Oligoarthritis and RF-Negative Polyarthritis from a Large Multinational Cohort of Children with Juvenile Idiopathic Arthritis

Alessandro Consolaro1,2, Pieter Van Dijkhuizen1, Graciela Espada3, Boriana Varbanova4, Sheila Oliveira5, Paivi Miettunen4, Gaëlle Chédeville5, Michaël Hofer5, Pavla Dolezalová5, Ivan Foeldvari5, Gerd Horneff5, Anne Estmann5, Chris Pruunsild5, Rosa Merino5, Inmaculada Calvo Penades5, Pablo Mesa del Castillo5, Pekka Lahdenne5, Maka Ioseliani5, Maria Trachana5, Olga Vougiouka5, Miroslav Harjacek5, Ilonka Orban5, Tamás Constantin5, Nahid Shafaie5, Violeta Vladislava Panaviene5, Marite Rygg5, Elzbieta Smolewska5, Jose Antonio Melo Gomes5, Jelena Vojinovic5, Ekaterina Alexeeva5, Tadej Avcin5, Veronika Vargova5, Nuray Aktay Ayaz6, Ozgur Kasapcopur5, Yaryna Boyko5, Sarah Ringold5, Mariangela Rinaldi5, Marco Garrone5, Nicolino Ruperto7 and Angelo Ravelli8,9, 1Pediatria II, Reumatologia, Istituto Giannina Gaslini, Genoa, Italy, 2University of Genova, GENOA, Italy, 3Istituto Giannina Gaslini - Pediatria II, Reumatologia - PRINTO, Genova, Italy, 4Istituto Giannina Gaslini - Pediatria II, Reumatologia - PRINTO, GENOA, Italy, 5Istituto Giannina Gaslini - Pediatria II, Reumatologia - PRINTO, Genoa, Italy, 6Istituto Giannina Gaslini - Pediatria II, Reumatologia - PRINTO, Gernoa, Italy, 7Istituto Giannina Gaslini, Genoa, Italy, 8University of Genova, IRCCS Istituto Giannina Gaslini, Genova, Italy, 9University of Genova, Genova, Italy

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: ,

Session Information

Date: Tuesday, November 7, 2017

Title: Pediatric Rheumatology – Clinical and Therapeutic Aspects II: Juvenile Arthritis

Session Type: ACR Concurrent Abstract Session

Session Time: 4:30PM-6:00PM

Background/Purpose:

The measurement of the level of disease activity plays a pivotal role in the care of patients with ju­venile idiopathic arthritis (JIA). To serve this purpose, the Juvenile Arthritis Disease Activity Score (JADAS) was developed in 2009. More recently, a version excluding the acute phase reactant was tested (cJADAS). Cutoff values for the state of remission, low disease activity (LDA), moderate disease activity (MDA) and high disease activity (HDA) were recently developed for the original JADAS score and for the clinical version. These cutoff values are ideally suited for pursuing tight disease control in a treat-to-target strategy, with treatment escalation if the desired JADAS score is not reached. However, although cutoffs were validated in a large and multinational cohort of patients, they were developed in a dataset of patients from a single pediatric rheumatology center an partly before the advent of the so-called biologic era. Aim of the study is to develop the JADAS and cJADAS cut-off values of remission, LDA, MDA, and HDA for oligoarthritis and RF-negative polyarthritis in a large multinational cohort of JIA patients

Methods: The EPidemiology, treatment and Outcome of Childhood Arthritis (EPOCA) study is aimed to obtain information on the frequency of JIA subtypes in different geographic areas, the therapeutic approaches adopted by pediatric rheumatologists practicing in diverse countries or continents, and the disease and health status of children with JIA currently followed worldwide. More than 9.000 patients with JIA from 118 pediatric rheumatology centres in 49 countries were collected so far. For the development of cut-offs, patients with oligoarthritis and polyarthritis followed in the 20 Centres with the highest frequency of these 2 subtypes were retained. In each centre, the 75th centile of JADAS and cJADAS distribution in patients who were subjectively rated by the attending physician as being in remission and LDA, and the 25th centile of JADAS and cJADAS in patients rated as in HDA, were calculated. The obtained values at each centre were then averaged to obtain the prelimary cut-offs for each disease activity state.

Results: The cutoffs validation cohorts were made of 930 patients with oligoarthritis from 20 pediatric rheumatology Centres and 1.004 patients with RF-neg polyarthritis from 20 pediatric rheumatology Centres. Preliminary cut offs values for each versions of JADAS and cJADAS are presented in table.

JADAS10

JADAS27

JADAS71

cJADAS10

cJADAS27

cJADAS71

Oligoarthritis

Remission

1.5

1.5

1.5

1.2

1.2

1.2

LDA

3.9

3.7

3.9

3.4

3.3

3.4

HDA

16.4

16.2

16.4

14.3

14.1

14.3

Polyarthritis

Remission

2.6

2.6

2.6

2.4

2.3

2.4

LDA

5.1

4.9

5.1

5.1

4.9

5.1

HDA

18.9

18.9

22.7

19.0

20.0

25.3

Conclusion: New JADAS and cJADAS temptative cut-offs for remission, LDA, and HDA were calculated. Obtained values will be tested in the validation analysis. The preliminary values are higher than currently available cut-offs.

Disclosure: A. Consolaro, None; P. Van Dijkhuizen, None; G. Espada, None; B. Varbanova, None; S. Oliveira, None; P. Miettunen, None; G. Chédeville, None; M. Hofer, Novartis and AbbVie, 5; P. Dolezalová, None; I. Foeldvari, AbbVie and Novartis, 9; G. Horneff, AbbVie, Pfizer, Novartis, and Roche, 2,AbbVie, Novartis, Sobi, Pfizer, and Roche, 9; A. Estmann, None; C. Pruunsild, None; R. Merino, None; I. Calvo Penades, None; P. Mesa del Castillo, None; P. Lahdenne, None; M. Ioseliani, None; M. Trachana, None; O. Vougiouka, None; M. Harjacek, None; I. Orban, None; T. Constantin, None; N. Shafaie, None; V. V. Panaviene, None; M. Rygg, None; E. Smolewska, None; J. A. Melo Gomes, None; J. Vojinovic, AbbVie, 8; E. Alexeeva, None; T. Avcin, None; V. Vargova, None; N. Aktay Ayaz, None; O. Kasapcopur, Novartis Pharmaceutical Corporation, 8,Roche Pharmaceuticals, 8; Y. Boyko, None; S. Ringold, Crescendo Bioscience, 2; M. Rinaldi, None; M. Garrone, None; N. Ruperto, BMS, Hoffman-La Roche, Janssen, Novartis, Pfizer and Sobi, 2,Abbvie, Ablynx, AstraZeneca, Baxalta Biosimilars, Biogen Idec, Boehringer, Bristol Myers Squibb, Eli-Lilly, EMD Serono, Gilead Sciences, Janssen, Medimmune, Novartis, Pfizer, Rpharm, Roche, Sanofi., 5,Abbvie, Ablynx, AstraZeneca, Baxalta Biosimilars, Biogen Idec, Boehringer, Bristol Myers Squibb, Eli-Lilly, EMD Serono, Gilead Sciences, Janssen, Medimmune, Novartis, Pfizer, Rpharm, Roche, Sanofi., 8; A. Ravelli, None.

To cite this abstract in AMA style:

Consolaro A, Van Dijkhuizen P, Espada G, Varbanova B, Oliveira S, Miettunen P, Chédeville G, Hofer M, Dolezalová P, Foeldvari I, Horneff G, Estmann A, Pruunsild C, Merino R, Calvo Penades I, Mesa del Castillo P, Lahdenne P, Ioseliani M, Trachana M, Vougiouka O, Harjacek M, Orban I, Constantin T, Shafaie N, Panaviene VV, Rygg M, Smolewska E, Melo Gomes JA, Vojinovic J, Alexeeva E, Avcin T, Vargova V, Aktay Ayaz N, Kasapcopur O, Boyko Y, Ringold S, Rinaldi M, Garrone M, Ruperto N, Ravelli A. Development of New Juvenile Arthritis Disease Activity Score Cut-Offs for Oligoarthritis and RF-Negative Polyarthritis from a Large Multinational Cohort of Children with Juvenile Idiopathic Arthritis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/development-of-new-juvenile-arthritis-disease-activity-score-cut-offs-for-oligoarthritis-and-rf-negative-polyarthritis-from-a-large-multinational-cohort-of-children-with-juvenile-idiopathic-arthritis/. Accessed .

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