Definition and Validation of the American College of Rheumatology 2021 Juvenile Arthritis Disease Activity Score Cutoffs for Disease Activity States in Juvenile Idiopathic Arthritis
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 ol...
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| Veröffentlicht in: | Arthritis & rheumatology (Hoboken, N.J.) N.J.), 2021-11, Vol.73 (11), p.1966-1975 |
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| container_end_page | 1975 |
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| container_issue | 11 |
| container_start_page | 1966 |
| container_title | Arthritis & rheumatology (Hoboken, N.J.) |
| container_volume | 73 |
| creator | Trincianti, Chiara Van Dijkhuizen, Evert Hendrik Pieter Alongi, Alessandra Mazzoni, Marta Swart, Joost F. Nikishina, Irina Lahdenne, Pekka Rutkowska‐Sak, Lidia Avcin, Tadej Quartier, Pierre Panaviene, Violeta Uziel, Yosef Pruunsild, Chris Vargova, Veronika Vilaiyuk, Soamarat Dolezalova, Pavla Ringold, Sarah Garrone, Marco Ruperto, Nicolino Ravelli, Angelo Consolaro, Alessandro |
| description | 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. |
| doi_str_mv | 10.1002/art.41879 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8597164</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2592330545</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4439-e9b6d8c4df62e98b259da4cb8f958275d312a82c3bfb8d60036fed2b285ab5703</originalsourceid><addsrcrecordid>eNp1kt1uFCEUgCdGY5vaC1_AkHhjL7YFZpgZbkw2W39qmjSp1VvCwGGHZgZWYNbs2_gUPoBPJtvtn0a5gXP48uVwOEXxkuBjgjE9kSEdV6Rt-JNin5a0njGK2dO7M-FkrziM8RrnxRtcY_a82Csr1lJC8X7x8xSMdTZZ75B0Gn2Vg9XyJvQGpR7QfIRglXRo4YcBlrDNX_YwjTL5wS83iGJK0KdpDc4OGQ-pD9kX0amNIGPOqGTXNm3QZ-UD_PqxmJI3JiLjwz-YJBNEZN2D8Uxbv5Kpt-pB_qJ4ZuQQ4fB2Pyi-vH93tfg4O7_4cLaYn89UVZV8BryrdasqbWoKvO0o41pWqmsNzw1omC4JlS1VZWe6VtcYl7UBTTvaMtmxBpcHxduddzV1I2gFLgU5iFWwowwb4aUVf94424ulX4uW8YbUVRa8uRUE_22CmMRoo4JhkA78FAVlTVPVjNIt-vov9NpPweXnZYrTssSsYpk62lEq-BgDmPtiCBbbgRB5IMTNQGT21ePq78m778_AyQ74nhu9-b9JzC-vdsrfWw3D8g</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2592330545</pqid></control><display><type>article</type><title>Definition and Validation of the American College of Rheumatology 2021 Juvenile Arthritis Disease Activity Score Cutoffs for Disease Activity States in Juvenile Idiopathic Arthritis</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>Alma/SFX Local Collection</source><creator>Trincianti, Chiara ; Van Dijkhuizen, Evert Hendrik Pieter ; Alongi, Alessandra ; Mazzoni, Marta ; Swart, Joost F. ; Nikishina, Irina ; Lahdenne, Pekka ; Rutkowska‐Sak, Lidia ; Avcin, Tadej ; Quartier, Pierre ; Panaviene, Violeta ; Uziel, Yosef ; Pruunsild, Chris ; Vargova, Veronika ; Vilaiyuk, Soamarat ; Dolezalova, Pavla ; Ringold, Sarah ; Garrone, Marco ; Ruperto, Nicolino ; Ravelli, Angelo ; Consolaro, Alessandro</creator><creatorcontrib>Trincianti, Chiara ; Van Dijkhuizen, Evert Hendrik Pieter ; Alongi, Alessandra ; Mazzoni, Marta ; Swart, Joost F. ; Nikishina, Irina ; Lahdenne, Pekka ; Rutkowska‐Sak, Lidia ; Avcin, Tadej ; Quartier, Pierre ; Panaviene, Violeta ; Uziel, Yosef ; Pruunsild, Chris ; Vargova, Veronika ; Vilaiyuk, Soamarat ; Dolezalova, Pavla ; Ringold, Sarah ; Garrone, Marco ; Ruperto, Nicolino ; Ravelli, Angelo ; Consolaro, Alessandro ; Paediatric Rheumatology International Trials Organisation ; for the Paediatric Rheumatology International Trials Organisation</creatorcontrib><description>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.</description><identifier>ISSN: 2326-5191</identifier><identifier>EISSN: 2326-5205</identifier><identifier>DOI: 10.1002/art.41879</identifier><identifier>PMID: 34582120</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Arthritis ; Arthritis, Juvenile - blood ; Arthritis, Juvenile - diagnosis ; Child ; Children ; Clinical trials ; Epidemiology ; Full Length ; Humans ; Pain ; Patients ; Pediatrics ; Polyarthritis ; Registries ; Rheumatoid factor ; Rheumatoid Factor - blood ; Rheumatology ; Severity of Illness Index ; Special ; Stiffness</subject><ispartof>Arthritis & rheumatology (Hoboken, N.J.), 2021-11, Vol.73 (11), p.1966-1975</ispartof><rights>2021 The Authors. published by Wiley Periodicals LLC on behalf of American College of Rheumatology.</rights><rights>2021 The Authors. Arthritis & Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.</rights><rights>2021. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4439-e9b6d8c4df62e98b259da4cb8f958275d312a82c3bfb8d60036fed2b285ab5703</citedby><cites>FETCH-LOGICAL-c4439-e9b6d8c4df62e98b259da4cb8f958275d312a82c3bfb8d60036fed2b285ab5703</cites><orcidid>0000-0001-8660-0207 ; 0000-0002-0065-7614 ; 0000-0001-8407-7782 ; 0000-0001-9658-0385</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fart.41879$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fart.41879$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34582120$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Trincianti, Chiara</creatorcontrib><creatorcontrib>Van Dijkhuizen, Evert Hendrik Pieter</creatorcontrib><creatorcontrib>Alongi, Alessandra</creatorcontrib><creatorcontrib>Mazzoni, Marta</creatorcontrib><creatorcontrib>Swart, Joost F.</creatorcontrib><creatorcontrib>Nikishina, Irina</creatorcontrib><creatorcontrib>Lahdenne, Pekka</creatorcontrib><creatorcontrib>Rutkowska‐Sak, Lidia</creatorcontrib><creatorcontrib>Avcin, Tadej</creatorcontrib><creatorcontrib>Quartier, Pierre</creatorcontrib><creatorcontrib>Panaviene, Violeta</creatorcontrib><creatorcontrib>Uziel, Yosef</creatorcontrib><creatorcontrib>Pruunsild, Chris</creatorcontrib><creatorcontrib>Vargova, Veronika</creatorcontrib><creatorcontrib>Vilaiyuk, Soamarat</creatorcontrib><creatorcontrib>Dolezalova, Pavla</creatorcontrib><creatorcontrib>Ringold, Sarah</creatorcontrib><creatorcontrib>Garrone, Marco</creatorcontrib><creatorcontrib>Ruperto, Nicolino</creatorcontrib><creatorcontrib>Ravelli, Angelo</creatorcontrib><creatorcontrib>Consolaro, Alessandro</creatorcontrib><creatorcontrib>Paediatric Rheumatology International Trials Organisation</creatorcontrib><creatorcontrib>for the Paediatric Rheumatology International Trials Organisation</creatorcontrib><title>Definition and Validation of the American College of Rheumatology 2021 Juvenile Arthritis Disease Activity Score Cutoffs for Disease Activity States in Juvenile Idiopathic Arthritis</title><title>Arthritis & rheumatology (Hoboken, N.J.)</title><addtitle>Arthritis Rheumatol</addtitle><description>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.</description><subject>Arthritis</subject><subject>Arthritis, Juvenile - blood</subject><subject>Arthritis, Juvenile - diagnosis</subject><subject>Child</subject><subject>Children</subject><subject>Clinical trials</subject><subject>Epidemiology</subject><subject>Full Length</subject><subject>Humans</subject><subject>Pain</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Polyarthritis</subject><subject>Registries</subject><subject>Rheumatoid factor</subject><subject>Rheumatoid Factor - blood</subject><subject>Rheumatology</subject><subject>Severity of Illness Index</subject><subject>Special</subject><subject>Stiffness</subject><issn>2326-5191</issn><issn>2326-5205</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp1kt1uFCEUgCdGY5vaC1_AkHhjL7YFZpgZbkw2W39qmjSp1VvCwGGHZgZWYNbs2_gUPoBPJtvtn0a5gXP48uVwOEXxkuBjgjE9kSEdV6Rt-JNin5a0njGK2dO7M-FkrziM8RrnxRtcY_a82Csr1lJC8X7x8xSMdTZZ75B0Gn2Vg9XyJvQGpR7QfIRglXRo4YcBlrDNX_YwjTL5wS83iGJK0KdpDc4OGQ-pD9kX0amNIGPOqGTXNm3QZ-UD_PqxmJI3JiLjwz-YJBNEZN2D8Uxbv5Kpt-pB_qJ4ZuQQ4fB2Pyi-vH93tfg4O7_4cLaYn89UVZV8BryrdasqbWoKvO0o41pWqmsNzw1omC4JlS1VZWe6VtcYl7UBTTvaMtmxBpcHxduddzV1I2gFLgU5iFWwowwb4aUVf94424ulX4uW8YbUVRa8uRUE_22CmMRoo4JhkA78FAVlTVPVjNIt-vov9NpPweXnZYrTssSsYpk62lEq-BgDmPtiCBbbgRB5IMTNQGT21ePq78m778_AyQ74nhu9-b9JzC-vdsrfWw3D8g</recordid><startdate>202111</startdate><enddate>202111</enddate><creator>Trincianti, Chiara</creator><creator>Van Dijkhuizen, Evert Hendrik Pieter</creator><creator>Alongi, Alessandra</creator><creator>Mazzoni, Marta</creator><creator>Swart, Joost F.</creator><creator>Nikishina, Irina</creator><creator>Lahdenne, Pekka</creator><creator>Rutkowska‐Sak, Lidia</creator><creator>Avcin, Tadej</creator><creator>Quartier, Pierre</creator><creator>Panaviene, Violeta</creator><creator>Uziel, Yosef</creator><creator>Pruunsild, Chris</creator><creator>Vargova, Veronika</creator><creator>Vilaiyuk, Soamarat</creator><creator>Dolezalova, Pavla</creator><creator>Ringold, Sarah</creator><creator>Garrone, Marco</creator><creator>Ruperto, Nicolino</creator><creator>Ravelli, Angelo</creator><creator>Consolaro, Alessandro</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8660-0207</orcidid><orcidid>https://orcid.org/0000-0002-0065-7614</orcidid><orcidid>https://orcid.org/0000-0001-8407-7782</orcidid><orcidid>https://orcid.org/0000-0001-9658-0385</orcidid></search><sort><creationdate>202111</creationdate><title>Definition and Validation of the American College of Rheumatology 2021 Juvenile Arthritis Disease Activity Score Cutoffs for Disease Activity States in Juvenile Idiopathic Arthritis</title><author>Trincianti, Chiara ; Van Dijkhuizen, Evert Hendrik Pieter ; Alongi, Alessandra ; Mazzoni, Marta ; Swart, Joost F. ; Nikishina, Irina ; Lahdenne, Pekka ; Rutkowska‐Sak, Lidia ; Avcin, Tadej ; Quartier, Pierre ; Panaviene, Violeta ; Uziel, Yosef ; Pruunsild, Chris ; Vargova, Veronika ; Vilaiyuk, Soamarat ; Dolezalova, Pavla ; Ringold, Sarah ; Garrone, Marco ; Ruperto, Nicolino ; Ravelli, Angelo ; Consolaro, Alessandro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4439-e9b6d8c4df62e98b259da4cb8f958275d312a82c3bfb8d60036fed2b285ab5703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Arthritis</topic><topic>Arthritis, Juvenile - blood</topic><topic>Arthritis, Juvenile - diagnosis</topic><topic>Child</topic><topic>Children</topic><topic>Clinical trials</topic><topic>Epidemiology</topic><topic>Full Length</topic><topic>Humans</topic><topic>Pain</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Polyarthritis</topic><topic>Registries</topic><topic>Rheumatoid factor</topic><topic>Rheumatoid Factor - blood</topic><topic>Rheumatology</topic><topic>Severity of Illness Index</topic><topic>Special</topic><topic>Stiffness</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Trincianti, Chiara</creatorcontrib><creatorcontrib>Van Dijkhuizen, Evert Hendrik Pieter</creatorcontrib><creatorcontrib>Alongi, Alessandra</creatorcontrib><creatorcontrib>Mazzoni, Marta</creatorcontrib><creatorcontrib>Swart, Joost F.</creatorcontrib><creatorcontrib>Nikishina, Irina</creatorcontrib><creatorcontrib>Lahdenne, Pekka</creatorcontrib><creatorcontrib>Rutkowska‐Sak, Lidia</creatorcontrib><creatorcontrib>Avcin, Tadej</creatorcontrib><creatorcontrib>Quartier, Pierre</creatorcontrib><creatorcontrib>Panaviene, Violeta</creatorcontrib><creatorcontrib>Uziel, Yosef</creatorcontrib><creatorcontrib>Pruunsild, Chris</creatorcontrib><creatorcontrib>Vargova, Veronika</creatorcontrib><creatorcontrib>Vilaiyuk, Soamarat</creatorcontrib><creatorcontrib>Dolezalova, Pavla</creatorcontrib><creatorcontrib>Ringold, Sarah</creatorcontrib><creatorcontrib>Garrone, Marco</creatorcontrib><creatorcontrib>Ruperto, Nicolino</creatorcontrib><creatorcontrib>Ravelli, Angelo</creatorcontrib><creatorcontrib>Consolaro, Alessandro</creatorcontrib><creatorcontrib>Paediatric Rheumatology International Trials Organisation</creatorcontrib><creatorcontrib>for the Paediatric Rheumatology International Trials Organisation</creatorcontrib><collection>Wiley Online Library (Open Access Collection)</collection><collection>Wiley Online Library Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Arthritis & rheumatology (Hoboken, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Trincianti, Chiara</au><au>Van Dijkhuizen, Evert Hendrik Pieter</au><au>Alongi, Alessandra</au><au>Mazzoni, Marta</au><au>Swart, Joost F.</au><au>Nikishina, Irina</au><au>Lahdenne, Pekka</au><au>Rutkowska‐Sak, Lidia</au><au>Avcin, Tadej</au><au>Quartier, Pierre</au><au>Panaviene, Violeta</au><au>Uziel, Yosef</au><au>Pruunsild, Chris</au><au>Vargova, Veronika</au><au>Vilaiyuk, Soamarat</au><au>Dolezalova, Pavla</au><au>Ringold, Sarah</au><au>Garrone, Marco</au><au>Ruperto, Nicolino</au><au>Ravelli, Angelo</au><au>Consolaro, Alessandro</au><aucorp>Paediatric Rheumatology International Trials Organisation</aucorp><aucorp>for the Paediatric Rheumatology International Trials Organisation</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Definition and Validation of the American College of Rheumatology 2021 Juvenile Arthritis Disease Activity Score Cutoffs for Disease Activity States in Juvenile Idiopathic Arthritis</atitle><jtitle>Arthritis & rheumatology (Hoboken, N.J.)</jtitle><addtitle>Arthritis Rheumatol</addtitle><date>2021-11</date><risdate>2021</risdate><volume>73</volume><issue>11</issue><spage>1966</spage><epage>1975</epage><pages>1966-1975</pages><issn>2326-5191</issn><eissn>2326-5205</eissn><abstract>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.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>34582120</pmid><doi>10.1002/art.41879</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-8660-0207</orcidid><orcidid>https://orcid.org/0000-0002-0065-7614</orcidid><orcidid>https://orcid.org/0000-0001-8407-7782</orcidid><orcidid>https://orcid.org/0000-0001-9658-0385</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2326-5191 |
| ispartof | Arthritis & rheumatology (Hoboken, N.J.), 2021-11, Vol.73 (11), p.1966-1975 |
| issn | 2326-5191 2326-5205 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8597164 |
| source | MEDLINE; Access via Wiley Online Library; Alma/SFX Local Collection |
| subjects | Arthritis Arthritis, Juvenile - blood Arthritis, Juvenile - diagnosis Child Children Clinical trials Epidemiology Full Length Humans Pain Patients Pediatrics Polyarthritis Registries Rheumatoid factor Rheumatoid Factor - blood Rheumatology Severity of Illness Index Special Stiffness |
| title | Definition and Validation of the American College of Rheumatology 2021 Juvenile Arthritis Disease Activity Score Cutoffs for Disease Activity States in Juvenile Idiopathic Arthritis |
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