Disease activity and treatment in patients with juvenile idiopathic arthritis before transfer to adult care: the first survey in China

Xiya Luo ^1,2,3,4 Xiwen Luo ^1,2,3,4 Qiang Luo ^1,2,3,4 Xuemei Tang ^1,2,3,4*

• ¹ Department of Rheumatology & Immunology, Children's Hospital of Chongqing Medical University, Chongqing, China
• ² National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
• ³ Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
• ⁴ Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, China

To analyze disease activity and treatment in patients with juvenile idiopathic arthritis (JIA) before transfer to adult care. Method. 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.