CLINICAL FEATURES AND EARLY OUTCOMES IN THAI CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children. However, data relating to JIA in Thai children is very limited. The objective of this study was to report baseline clinical features and early outcomes at 6 months following initial presentation in patients diagnosed with JIA. This retrospective descriptive study was-conducted in 54 JIA patients that were followed for at least 6 months at a newly established pediatric rheumatology clinic at Siriraj Hospital during the 2011 to 2015 study period. Inactive disease was defined as clinical Juvenile Arthritis Disease Activity Score (cJADAS) <= 1. Systemic JIA was the most common subtype (33.3%), followed by oligoarticularJlA (22%) and enthesitis-related arthritis (ERA) (22%). The most common presenting symptom was limping (64.8%), with knee joint being the most affected joint (64.8%). The medication most used among JIA patients was NSAIDs (81.5%). Only 2 patients received biologic agents within the 6-month evaluation period. Eighteen (33.3%) JIA patients were inactive after 6 months of treatment. Systemic JIA was the most common subtype in patients who developed inactive disease (61.6%). cJADAS decreased significantly from a median of 15 (IQR 11-20) at initial presentation to 4 (IQR 4-7) at the 6-month follow-up (p<0.001). Systemic JIA subtype showed significant improvement for active joint count (AJC), physician global assessment of disease activity (PGA), patient/parent global assessment of well-being (PGW), and Childhood Health Assessment Questionnaire (CHAQ) scores. Median PGW score for RF-positive polyarticular JIA patients was the only score to increase from initial presentation to the 6-month follow-up. One-third of JIA patients had inactive disease following 6 months of treatment and inactive disease was mostly found in patients with systemic JIA.