Abstract
OBJECTIVES: To analyze disease activity and treatment in patients with juvenile idiopathic arthritis (JIA) before transfer to adult care. METHODS: We retrospectively collected the clinical data of 230 JIA patients (range 14-18 years) in our center from January 2013 to December 2022. We evaluated the clinical features, disease activity, and medication use across various JIA subtypes. RESULTS: 230 patients with JIA were included, and 144 (63%) were male. The distribution of JIA subtypes was dominated by enthesitis-related arthritis (32%), polyarthritis (31%), systemic JIA (27%), and oligoarthritis (10%). Disease activity assessment showed that 87 JIA (38%) were in active disease; while 143 JIA (62%) were in inactive disease, of which 59 patients achieved clinical remission on medicine and 13 patients achieved clinical remission off medicine. Conventional synthetic disease-modifying anti-rheumatic drugs were used in 83% of JIA patients, and biologics in 56%. Clinical characteristics and medication use differed between different subtypes of JIA. The oligoarthritis group had earlier disease onset (P = 0.020) and longer disease duration (P = 0.009) compared to other subtypes. Patients in the RF-positive polyarthritis group had a significantly lower rate of disease inactivity (39%, P = 0.004) than the other subtypes, and a relatively lower proportion of patients achieved clinical remission on medication or discontinuation of medication (18%, P = 0.024). CONCLUSIONS: Some JIA patients were still in active disease before transfer to adult clinics, failing to achieve clinical remission and discontinuation of medication, and required continued treatment. Patients in the RF-positive polyarthritis group were less likely to achieve clinical remission.