Juvenile Arthritis Disease-State Cut-Off Values Established

Key cut-off values established for inactive disease, minimal disease activity, subjective remission

TUESDAY, Jan. 17 (HealthDay News) -- Using the Juvenile Arthritis Disease Activity Score (JADAS), disease-state cut-off values have been established for pediatric patients with juvenile idiopathic arthritis (JIA), according to research published online Jan. 9 in Arthritis & Rheumatism.

Alessandro Consolaro, M.D., of the Istituto di Ricovero e Cura a Carattere Scientifico G. Gaslini in Genova, Italy, and colleagues evaluated data from 618 children with JIA to determine cut-off points using JADAS in key clinical areas, including inactive disease, minimal disease activity, and parent and child rating of remission and acceptable symptom state. Optimal cut-off points were established using the 75th percentile of cumulative score distribution. The method was validated using additional samples from about 1,400 pediatric patients.

The researchers found that the cut-off for inactive disease was 1 for all JADAS versions, and, for minimal disease activity, was 2 and 3.8 for oligoarthritis and polyarthritis, respectively. Using subjective ratings from the child, parent, and physician, the cut-off for remission ranged from 2 to 2.3. The cut-off for acceptable symptom scores ranged from 3.2 to 5.4 (parents) and 3 to 4.5 (children).

"The cut-offs showed good metrologic properties and proved able to predict disease outcome," the authors write. "They represent an additional clinical tool that, if applied regularly in daily practice, may allow tighter control of therapy, support the optimization of treatment on an individual patient basis, and help prevent the development of joint damage and physical disability," the authors write.

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