Frequency of remission achievement in the pre-treat-to-target decade in juvenile idiopathic arthritis
Abstract Background Over the past two decades there has been a remarkable advance in the management of juvenile idiopathic arthritis (JIA), which has led to considerable improvement in prognosis. In 2018, the introduction of the treat-to-target (T2T) strategy in JIA has been advocated to further ame...
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BMC
2025-01-01
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| Series: | Pediatric Rheumatology Online Journal |
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| Online Access: | https://doi.org/10.1186/s12969-025-01057-8 |
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| author | Ana Isabel Rebollo-Giménez Angela Pistorio Silvia Maria Orsi Francesca Ridella Elena Aldera Luca Carlini Valentina Natoli Marco Burrone Silvia Rosina Roberta Naddei Alessandro Consolaro Esperanza Naredo Angelo Ravelli |
| author_facet | Ana Isabel Rebollo-Giménez Angela Pistorio Silvia Maria Orsi Francesca Ridella Elena Aldera Luca Carlini Valentina Natoli Marco Burrone Silvia Rosina Roberta Naddei Alessandro Consolaro Esperanza Naredo Angelo Ravelli |
| author_sort | Ana Isabel Rebollo-Giménez |
| collection | DOAJ |
| description | Abstract Background Over the past two decades there has been a remarkable advance in the management of juvenile idiopathic arthritis (JIA), which has led to considerable improvement in prognosis. In 2018, the introduction of the treat-to-target (T2T) strategy in JIA has been advocated to further ameliorate disease outcome. To provide a benchmark for comparing future outcomes in the “T2T era”, this study investigates the percentage of JIA patients who achieved clinical inactive disease (CID) in the decade that preceded the publication of the T2T recommendations in JIA. Methods The clinical charts of all JIA patients followed at the study center between 2007 and 2017 who were first seen within 6 months after disease onset and had a minimum of 6-month follow-up information available were reviewed retrospectively. The attainment of CID, defined by 2004 Wallace criteria, was assessed cross-sectionally at 6, 12, 24, and 60 months after first observation. Results A total of 394 patients were included. Patients were classified into four “functional phenotypes”: systemic arthritis (7.1%), oligoarthritis (48.2%), polyarthritis (40.4%), and other arthritis (4.3%). The overall frequency of CID was 25.1% at 6 months, 34.5% at 12 months, 44.6% at 24 months, and 49.1% at 60 months. The systemic and oligoarticular subgroups had the highest rates of CID at 6 months (32.1% and 29.5%, respectively) and at 12 months (40% and 41.1%, respectively). At the 60-month evaluation, which was available for 226 out of 394 patients (57.4%), the frequency of CID among patients still followed at study center was 42.9%, 51.7%, 46.7%, and 45.5% for the systemic, oligoarticular, polyarticular, and other arthritis phenotypes, respectively. Conclusion A sizeable proportion of patients treated in the decade preceding the beginning of the “T2T era” and on continued follow-up did not achieve or maintain the state of CID over the long term. Future studies will determine whether the application of the T2T strategy increases the ability to achieve sustained disease quiescence in patients who respond suboptimally to the conventional therapeutic regimens. |
| format | Article |
| id | doaj-art-0618cc47d83a4ffa8748842ed3c12b66 |
| institution | Kabale University |
| issn | 1546-0096 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | Pediatric Rheumatology Online Journal |
| spelling | doaj-art-0618cc47d83a4ffa8748842ed3c12b662025-01-26T12:19:54ZengBMCPediatric Rheumatology Online Journal1546-00962025-01-012311810.1186/s12969-025-01057-8Frequency of remission achievement in the pre-treat-to-target decade in juvenile idiopathic arthritisAna Isabel Rebollo-Giménez0Angela Pistorio1Silvia Maria Orsi2Francesca Ridella3Elena Aldera4Luca Carlini5Valentina Natoli6Marco Burrone7Silvia Rosina8Roberta Naddei9Alessandro Consolaro10Esperanza Naredo11Angelo Ravelli12UOC Reumatologia E Malattie Autoinfiammatorie, IRCCS Istituto Giannina GasliniDirezione Scientifica, Unità Di Biostatistica, IRCCS Istituto Giannina GasliniDipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno- Infantili (DINOGMI), Università Degli Studi Di GenovaDipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno- Infantili (DINOGMI), Università Degli Studi Di GenovaDipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno- Infantili (DINOGMI), Università Degli Studi Di GenovaUOC Reumatologia E Malattie Autoinfiammatorie, IRCCS Istituto Giannina GasliniUOC Reumatologia E Malattie Autoinfiammatorie, IRCCS Istituto Giannina GasliniUOC Reumatologia E Malattie Autoinfiammatorie, IRCCS Istituto Giannina GasliniUOC Reumatologia E Malattie Autoinfiammatorie, IRCCS Istituto Giannina GasliniUOC Reumatologia E Malattie Autoinfiammatorie, IRCCS Istituto Giannina GasliniUOC Reumatologia E Malattie Autoinfiammatorie, IRCCS Istituto Giannina GasliniDepartment of Rheumatology, Hospital General Universitario Gregorio Marañón. Health Research Institute Gregorio Marañón (IiSGM). Autonomous University of Madrid (UAM)Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno- Infantili (DINOGMI), Università Degli Studi Di GenovaAbstract Background Over the past two decades there has been a remarkable advance in the management of juvenile idiopathic arthritis (JIA), which has led to considerable improvement in prognosis. In 2018, the introduction of the treat-to-target (T2T) strategy in JIA has been advocated to further ameliorate disease outcome. To provide a benchmark for comparing future outcomes in the “T2T era”, this study investigates the percentage of JIA patients who achieved clinical inactive disease (CID) in the decade that preceded the publication of the T2T recommendations in JIA. Methods The clinical charts of all JIA patients followed at the study center between 2007 and 2017 who were first seen within 6 months after disease onset and had a minimum of 6-month follow-up information available were reviewed retrospectively. The attainment of CID, defined by 2004 Wallace criteria, was assessed cross-sectionally at 6, 12, 24, and 60 months after first observation. Results A total of 394 patients were included. Patients were classified into four “functional phenotypes”: systemic arthritis (7.1%), oligoarthritis (48.2%), polyarthritis (40.4%), and other arthritis (4.3%). The overall frequency of CID was 25.1% at 6 months, 34.5% at 12 months, 44.6% at 24 months, and 49.1% at 60 months. The systemic and oligoarticular subgroups had the highest rates of CID at 6 months (32.1% and 29.5%, respectively) and at 12 months (40% and 41.1%, respectively). At the 60-month evaluation, which was available for 226 out of 394 patients (57.4%), the frequency of CID among patients still followed at study center was 42.9%, 51.7%, 46.7%, and 45.5% for the systemic, oligoarticular, polyarticular, and other arthritis phenotypes, respectively. Conclusion A sizeable proportion of patients treated in the decade preceding the beginning of the “T2T era” and on continued follow-up did not achieve or maintain the state of CID over the long term. Future studies will determine whether the application of the T2T strategy increases the ability to achieve sustained disease quiescence in patients who respond suboptimally to the conventional therapeutic regimens.https://doi.org/10.1186/s12969-025-01057-8Juvenile idiopathic arthritisTreat-to-targetClinical remissionInactive diseaseDisease outcome |
| spellingShingle | Ana Isabel Rebollo-Giménez Angela Pistorio Silvia Maria Orsi Francesca Ridella Elena Aldera Luca Carlini Valentina Natoli Marco Burrone Silvia Rosina Roberta Naddei Alessandro Consolaro Esperanza Naredo Angelo Ravelli Frequency of remission achievement in the pre-treat-to-target decade in juvenile idiopathic arthritis Pediatric Rheumatology Online Journal Juvenile idiopathic arthritis Treat-to-target Clinical remission Inactive disease Disease outcome |
| title | Frequency of remission achievement in the pre-treat-to-target decade in juvenile idiopathic arthritis |
| title_full | Frequency of remission achievement in the pre-treat-to-target decade in juvenile idiopathic arthritis |
| title_fullStr | Frequency of remission achievement in the pre-treat-to-target decade in juvenile idiopathic arthritis |
| title_full_unstemmed | Frequency of remission achievement in the pre-treat-to-target decade in juvenile idiopathic arthritis |
| title_short | Frequency of remission achievement in the pre-treat-to-target decade in juvenile idiopathic arthritis |
| title_sort | frequency of remission achievement in the pre treat to target decade in juvenile idiopathic arthritis |
| topic | Juvenile idiopathic arthritis Treat-to-target Clinical remission Inactive disease Disease outcome |
| url | https://doi.org/10.1186/s12969-025-01057-8 |
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