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Assessment of Disease Activity in Juvenile Idiopathic Arthritis. The Number and the Size of Joints Matter LILLEMOR BERNTSON, LISA WERNROTH, ANDERS FASTH, KRISTIINA AALTO, TROELS HERLIN, SUSAN NIELSEN, ELLEN NORDAL, MARITE RYGG, and MAREK ZAK, for the Nordic Paediatric Rheumatology Study Group
ABSTRACT. Methods. One randomly chosen hospital visit was studied for each of 312 patients with JIA, with regard to disease activity variables. The physician global assessment score visual analog scale (physician GA) was used as a dependent variable in comparisons between potential disease activity variables. Previous studies have shown this variable to be the most sensitive to changes in JIA disease activity and to be comparable between patients. Results. Based on Spearman's rank order correlation the number of active joints had a strong association with the physician GA. The median physician GA score rose markedly for each active large joint, but less for small joints, although small joints were also statistically important in assessing disease activity. Among the laboratory data, the erythrocyte sedimentation rate, C-reactive protein level, and platelet count showed weak correlations to the physician GA. Conclusion. In preparation of a disease activity score for children with JIA the importance of both the number and size of joints involved needs further evaluation. (First Release Sept 15 2007; J Rheumatol 2007;34:2106-11) Key Indexing Terms:
ARTHRITIS From the Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala University Hospital, Uppsala, Sweden; Department of Paediatrics, Göteborg University, Göteborg, Sweden; Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland; Department of Paediatrics, Århus University Hospital, Skejby, Denmark; University Clinic of Paediatrics II, Rigshospitalet, Copenhagen, Denmark; Department of Paediatrics, University Hospital of North Norway, Tromsø, Norway; Institute of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; and Department of Paediatrics, St. Olavs Hospital, Trondheim, Norway. Dr. Berntson is the senior author of this report. Supported by grants from the Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala; The Queen Silvia Children's University Hospital, Göteborg; the Dalarna Clinical Research Institute, Falun, Sweden; and the Swedish Rheumatism Association and the King Gustaf V 80th Jubilee Fund. L. Berntson, MD, PhD, Department of Women's and Children's Health, Uppsala University Children's Hospital; L. Wernroth, Biostatistician, Uppsala Clinical Research Center; A. Fasth, MD, PhD, Professor of Paediatric Immunology, Department of Paediatrics, Göteborg University; K. Aalto, MD, PhD, Hospital for Children and Adolescents, University of Helsinki; T. Herlin, MD, PhD, Århus University Hospital; S. Nielsen, MD, University Clinic of Paediatrics II, Rigshospitalet, Copenhagen; E. Nordal, MD, Department of Paediatrics, University Hospital of North Norway; M. Rygg, MD, PhD, Institute of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology and Department of Paediatrics, St. Olavs Hospital; M. Zak, MD, University Clinic of Paediatrics II, Rigshospitalet, Copenhagen. Address reprint requests to Dr. L. Berntson, Department of Paediatrics, Akademiska University Hospital, SE-75185 Uppsala, Sweden. E-mail: lillemor.berntson@telia.com Accepted for publication June 20, 2007. |
