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Definition and Validation of the American College of Rheumatology 2021 Juvenile Arthritis Disease Activity Score Cutoffs for Disease Activity States in Juvenile Idiopathic Arthritis
C. Trincianti, EHP. Van Dijkhuizen, A. Alongi, M. Mazzoni, JF. Swart, I. Nikishina, P. Lahdenne, L. Rutkowska-Sak, T. Avcin, P. Quartier, V. Panaviene, Y. Uziel, C. Pruunsild, V. Vargova, S. Vilaiyuk, P. Dolezalova, S. Ringold, M. Garrone, N....
Language English Country United States
Document type Journal Article, Validation Study
PubMed
34582120
DOI
10.1002/art.41879
Knihovny.cz E-resources
- MeSH
- Child MeSH
- Arthritis, Juvenile blood diagnosis MeSH
- Humans MeSH
- Registries MeSH
- Rheumatoid Factor blood MeSH
- Rheumatology * MeSH
- Severity of Illness Index MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Validation Study MeSH
OBJECTIVE: To develop and validate new Juvenile Arthritis Disease Activity Score 10 (JADAS10) and clinical JADAS10 (cJADAS10) cutoffs to separate the states of inactive disease (ID), minimal disease activity (MiDA), moderate disease activity (MoDA), and high disease activity (HDA) in children with oligoarthritis and with rheumatoid factor-negative polyarthritis, based on subjective disease assessment by the treating pediatric rheumatologist. METHODS: The cutoffs definition cohort was composed of 1,936 patients included in the multinational Epidemiology, Treatment and Outcome of Childhood Arthritis (EPOCA) study. Using the subjective physician rating as an external criterion, 4 methods were applied to identify the cutoffs: mapping, Youden index, 90% specificity, and maximum agreement. The validation cohort included 4,014 EPOCA patients, patients from 2 randomized trials, and 88 patients from the PharmaChild registry. Cutoff validation was conducted by assessing discriminative and predictive ability. RESULTS: The JADAS10 cutoffs were 1.4, 4, and 13, respectively, for oligoarthritis and 2.7, 6, and 17, respectively, for polyarthritis. The cJADAS10 cutoffs were 1.1, 4, and 12, respectively, for oligoarthritis and 2.5, 5, and 16, respectively, for polyarthritis. The cutoffs discriminated strongly among different levels of pain and morning stiffness, between patients who were and those who were not prescribed a new medication, and between different levels of improvement in clinical trials. Achievement of ID and MiDA according to the new JADAS cutoffs at least twice in the first year of disease predicted better outcome at 2 years. CONCLUSION: The 2021 JADAS and cJADAS cutoffs revealed good metrologic properties in both definition and validation samples, and are therefore suitable for use in clinical trials and routine practice.
5 A Nasonova Research Institute of Rheumatology Moscow Russia
Charles University Prague and General University Hospital Prague Czech Republic
Istituto Giannina Gaslini IRCCS and Clinica Pediatrica e Reumatologia Genoa Italy
Meir Medical Centre and Kfar Saba and Sackler School of Medicine Tel Aviv University Tel Aviv Israel
National Institute of Geriatrics Rheumatology and Rehabilitation Warsaw Poland
New Children's Hospital and Helsinki University Hospital Helsinki Finland
Pavol Jozef Šafárik University in Košice Kosice Slovakia
Ramathibodi Hospital and Mahidol University Bangkok Thailand
Seattle Children's Hospital Seattle Washington
Università degli Studi di Genova Genoa Italy
University Children's Hospital and University Medical Centre Ljubljana Ljubljana Slovenia
References provided by Crossref.org
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