Factors affecting clinical and therapeutic outcomes of patients with juvenile rheumatoid arthritis

Objective: To investigate clinical features, medications, and therapeutic responses of juvenile rheumatoid arthritis (JRA) among Taiwanese children. Methods: A retrospective chart review was conducted among all children newly diagnosed with JRA at the National Taiwan University Hospital between 1996 and 2001. Results: Forty boys and 30 girls were enrolled in the study. The mean follow‐up was 45 months. Oligoarticular onset was the most common type. A bimodal distribution of age at onset was observed, with peaks at 4 and 10 years. All patients received non‐steroidal anti‐inflammatory drugs (NSAIDs); 27 (39%) received corticosteroids, and 44 (63%) had second‐line drugs during the first course of treatment. Forty‐three patients (69%) achieved clinical remission after a mean of 14.8 months of medication, and 19 (31%) were drug‐dependent. The major factors related to the failure of first remission were human leukocyte antigen B27 (HLA‐B27), high C‐reactive protein (CRP) level, and thrombocytosis at diagnosis. Conclusion: There are different phenotypic features among Taiwanese children with JRA. Factors related to the failure of first remission were HLA‐B27, high CRP level, and thrombocytosis at diagnosis.

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