Background/introduction
Patients and methods
Registry and questionnaires
Definitions of outcome
Statistical analysis
Results
Patient characteristics
At baseline | 4-year follow-up | |
---|---|---|
Total no. of eligible patients with follow-up data available | 400 | 81 |
Female, n (%) | 258 (65.5%) | 47 (58.0%) |
Age at disease onset in years, mean (SD) | 11 years (SD 2.9) | - |
Time between symptom onset and first visit to pediatric rheumatology in months, mean | 5.3 months (SD 5.2) | - |
Inclusion to the registry after first visit to pediatric rheumatology, mean | 5.8 months (SD 3.2) | - |
HLA-B27 positivea | 21 (13.2%) | 5 (13.5%) |
Physician’s global assessment, NRS, mean (SD)b | 2.0 (1.9) | 0.9 (1.7) |
Patient’s global assessment, NRS, mean (SD)b | 2.5 (2.4) | 2.2 (2.5) |
Patients’ pain, NRS, mean (SD)b | 2.6 (2.7) | 1.9 (2.6) |
C-HAQ, NRS, mean (SD)b | 0.3 (0.4) | 0.2 (0.3) |
Arthritis | 79 (20.8%) | 13 (16.9%) |
-Peripheral | 64 (16.9%) | 9 (11.7%) |
-Sacroiliitis | 20 (5.3%) | 4 (5.2%) |
Number of patients (%) meeting the classification criteria for | ||
-Psoriatic arthritis | 5 (1.3%) | 3 (4.0%) |
-Enthesitis-related arthritis | 3 (0.8%) | 3 (4.0%) |
Skin disease (psoriasis, acne, PPP) | 61 (15.6%) | 14 (17.7%) |
IBD | 2 (0.5%) | 5 (6.6%) |
Anthropomorphic data comparison to the national reference cohort during follow-up
Distribution of osteomyelitic lesions during disease course
Long-term therapeutic strategies
At baseline N = 400 | After 4 years N = 81 (all patients) | ||
---|---|---|---|
Any medication | 387 (96.8%) | 59 (72.8%) | p < 0.001 |
NSAIDs | 344 (86%) | 32 (39.5%) | p < 0.001 |
Systemic glucocorticoids, total | 46 (11.5%) | 3 (3.7%) | p = 0.003 |
< 0.2 mg per kg BW | 21 (5.3) | 2 (2.5%) | p = 0.285 |
≥ 0.2 mg per kg BW | 33 (8.3%) | 2 (2.5%) | p = 0.068 |
Bisphosphonates | 34 (8.5%) | 3 (3.7%) | p = 0.140 |
DMARDs, totala | 56 (16.4%) | 21 (28.4%) | p = 0.008 |
csDMARDs | 43 (12.6%) | 13 (17.6%) | p = 0.129 |
Methotrexate | 30 (8.8%) | 10 (13.5%) | p = 0.21 |
Sulfasalazine | 13 (3.8%) | 3 (4.1%) | p = 0.836 |
bDMARD | 21 (6.1%) | 9 (12.2%) | p = 0.003 |
Etanercept | 10 (2.9%) | 3 (4.1%) | p = 0.542 |
Adalimumab | 11 (3.2%) | 6 (8.1%) | p = 0.05 |
Changes in physician- and patient-reported outcomes
Correlations for severe disease course
Baseline | 1st follow-up | 2nd follow-up | 3rd follow-up | 4th follow-up | ||||||
---|---|---|---|---|---|---|---|---|---|---|
N | % | N | % | N | % | N | % | N | % | |
Inactive disease (NRS < 1) | 130 | 33.9 | 148 | 50.0 | 135 | 57.7 | 78 | 57.8 | 54 | 72.0 |
Mild disease activity (NRS 1–3) | 183 | 47.7 | 122 | 41.2 | 83 | 35.5 | 48 | 35.6 | 17 | 22.7 |
Severe disease activity (NRS ≥ 4) | 71 | 18.5 | 26 | 8.8 | 16 | 6.8 | 9 | 6.7 | 4 | 5.3 |
OR2 | 95% CI | p value | |
---|---|---|---|
Female | 1.24 | 0.78; 1.97 | 0.371 |
ESR; one additional mm/h | 1.03 | 1.01; 1.05 | 0.006 |
CRP, one additional mg/l | 1.05 | 0.99; 1.09 | 0.068 |
One additional radiological lesion | 1.19 | 1.08; 1.31 | < 0.001 |
Clavicle | 1.68 | 1.12; 2.53 | 0.012 |
Pelvis | 1.55 | 1.21; 1.97 | 0.005 |
Femur | 1.47 | 1.15; 1.89 | 0.002 |
Tibia | 1.21 | 0.91; 1.61 | 0.184 |
Calcaneus | 1.38 | 0.89; 2.15 | 0.151 |
Multifocal | 2.48 | 1.41; 4.38 | 0.002 |
PedCNO score
PedCNO-score category | 30 | 50 | 70 |
Beck 2010 [10] | 62% | 57% | 54% |
Current analysis: | |||
1-year FU (n = 305) | 149 (49%) | 143 (47%) | 125 (41%) |
2-year FU (n = 240) | 144 (60%) | 132 (55%) | 110 (46%) |
3-year FU (n = 137) | 79 (58%) | 66 (48%) | 59 (43%) |
4-year FU (n = 81) | 58 (72%) | 54 (67%) | 45 (55%) |