The objective is to describe the treatment and 1-year clinical outcomes of an inception cohort of newly diagnosed Australian children with juvenile idiopathic arthritis (JIA) followed at a tertiary paediatric centre.

Methods:  Retrospective review of prospectively collected clinical data from a specifically designed electronic rheumatology database on all patients newly diagnosed with JIA at the Royal Children’s Hospital, Melbourne, between October 2010 and October 2014.

Results:

134 patients were included. Sixty two percent were female. The mean age at diagnosis was 8.3 years. The distribution of patients by subtype was:Oligoarticular 36%; RF + Polyarticular 2%; RF – Polyarticular 25%; Systemic 7%; Enthesitis Related 10%; Psoriatic 7% and Undifferentiated 13%. Ninety five percent of patients achieved a zero joint count at least once in the first year of follow-up, however, just 66% had a zero joint count at 1 year. The median time to a zero joint count was 4.1 months in patients achieving this outcome in the first year of follow-up. The systemic subtype had the shortest time to zero joint count at 1.7 months, psoriatic the longest at 7.6 months. For the 11% of patients who did not achieve a zero joint count in the first year of follow-up, the median time to this outcomewas 18.5 months.

Sixty two percent of patients were commenced on a conventional DMARD (cDMARD), most commonly methotrexate. The median time to commencement of a cDMARD was 0.9 months. 15% were commenced on a biologic DMARD (bDMARD). The median time to commencement of a bDMARD was 4.9 months. 55% were treated with oral corticosteroids. 17% were on oral corticosteroids at 1 year. 62% were treated with intra-articular steroids, most commonly the oligoarticular subtype, of whom 94% had at least one joint injection. 7% of children developed uveitis, with the highest incidence in the oligoarticular subtype, 17%.

Of patients with inactive arthritis at 12 months, 61% were on and 39% were off treatment.

Conclusion:  This study demonstrates that children with JIA in Australia have demographic features and short term outcomes similar to those described in international cohorts. At twelve months, two thirds of the cohort had a zero joint count and over a third of these were on no medications. When compared to international cohorts there was some variation in management, with a higher proportion having intra-articular steroid therapy.