Journal Article Multicenter Study Ppublish 1 citation
PubMed: 38682570 DOI: 10.1002/art.42865
Defining Criteria for Disease Activity States in Systemic Juvenile Idiopathic Arthritis Based on the Systemic Juvenile Arthritis Disease Activity Score.
Arthritis Rheumatol 76(9):1446-1454
Authors: Silvia Rosina, Ana I Rebollo-Giménez, Letizia Tarantola, Angela Pistorio, Yulia Vyzhga, Yasser El Miedany, Hala M Lotfy, Hend Abu-Shady, Mervat Eissa, Naglaa S Osman, Waleed Hassan, Marwa Y Mahgoub, Nermeen A Fouad, Doaa M Mosa, Yasmin Adel, Sheren E M Mohamed, Ahmed R Radwan, Mohamed H Abu-Zaid, Samar A A Tabra, Radwa H Shalaby, Samah I Nasef, Raju Khubchandani, Archana Khan, Naziya P Maldar, Seza Ozen, Yagmur Bayindir, Motasem Alsuweiti, Raed Alzyoud, Hiba Almaaitah, Soamarat Vilaiyuk, Butsabong Lerkvaleekul, Ekaterina Alexeeva, Tatyana Dvoryakovskaya, Ivan Kriulin, Claudia Bracaglia, Manuela Pardeo, Fabrizio De Benedetti, Francesco Licciardi, Davide Montin, Francesca Robasto, Francesca Minoia, Giovanni Filocamo, Martina Rossano, Gabriele Simonini, Edoardo Marrani, Sarah Abu-Rumeileh, Mikhail M Kostik, Konstantin E Belozerov, Priyankar Pal, Jigna N Bathia … and 18 other authors
Affiliations
- IRCCS Istituto Giannina Gaslini, Genoa, Italy.
- Università degli Studi di Genova, Genoa, Italy.
- Canterbury Christ Church University, United Kingdom, and Egyptian College of Pediatric Rheumatology, Canterbury, Egypt.
- Abu El Reesh Hospital, Cairo University, Cairo, Egypt.
- Kasr Elainy Cairo University, Cairo, Egypt.
- Assiut University, Assiut, Egypt.
- Benha University, Benha, Egypt.
- Fayoum University, Fayoum, Egypt.
- Mansoura University, Mansoura, Egypt.
- Minia University Hospital, Minia, Egypt.
- Sohag University, Sohag, Egypt.
- Tanta University, Tanta, Egypt.
- Suez Canal University, Ismailia, Egypt.
- NH SRCC Children Hospital, Mumbai, India.
- Hacettepe University, Ankara, Turkey.
- Queen Rania Children's Hospital, King Hussein Medical Center, Royal Medical Services, Amman, Jordan.
- Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
- National Medical Research Center of Children's Health and I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
- National Medical Research Center of Children's Health, Moscow, Russian Federation.
- IRCCS Bambino Gesù Children's Hospital, Rome, Italy.
- Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Torino, Italy.
- Università degli studi di Torino, Torino, Italy.
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- IRCCS Meyer Children's Hospital and University of Florence, Florence, Italy.
- IRCCS Meyer Children's Hospital, Florence, Italy.
- Saint-Petersburg State Pediatric Medical University, Saint Petersburg, Russian Federation.
- Pediatric Rheumatology Institute of Child Health, Kolkata, India.
Abstract
OBJECTIVE
Our objective was to develop and validate cutoff values in the systemic Juvenile Arthritis Disease Activity Score 10 (sJADAS10) that distinguish the states of inactive disease (ID), minimal disease activity (MDA), moderate disease activity (MoDA), and high disease activity (HDA) in children with systemic juvenile idiopathic arthritis, based on subjective disease state assessment by the treating pediatric rheumatologist.
METHODS
The cutoff definition cohort was composed of 400 patients enrolled at 30 pediatric rheumatology centers in 11 countries. Using the subjective physician rating as an external criterion, six methods were applied to identify the cutoffs: mapping, calculation of percentiles of cumulative score distribution, the Youden index, 90% specificity, maximum agreement, and receiver operating characteristic curve analysis. Sixty percent of the patients were assigned to the definition cohort, and 40% were assigned to the validation cohort. Cutoff validation was conducted by assessing discriminative ability.
RESULTS
The sJADAS10 cutoffs that separated ID from MDA, MDA from MoDA, and MoDA from HDA were ≤2.9, ≤10, and >20.6, respectively. The cutoffs discriminated strongly among different levels of pain, between patients with and without morning stiffness, and among patients whose parents judged their disease status as remission or persistent activity or flare or were satisfied or not satisfied with current illness outcome.
CONCLUSION
The sJADAS cutoffs revealed good metrologic properties in both definition and validation cohorts and are therefore suitable for use in clinical trials and routine practice.
MeSH
Rheumatic Diseases, Arthritis, Juvenile, Id