医学
纵向研究
关节炎
队列
物理疗法
儿科
队列研究
生活质量(医疗保健)
年轻人
银屑病性关节炎
人口
观察研究
社会心理的
作者
Philomine A van Pelt,Radboud J E M Dolhain,Aike A. Kruize,J. Ammerlaan,J. M. W. Hazes,Johannes W. J. Bijlsma,Nico M Wulffraat
出处
期刊:Clinical and Experimental Rheumatology
日期:2018-01-01
卷期号:36 (1): 163-168
被引量:7
摘要
OBJECTIVES:
Reaching a certain age, juvenile idiopathic arthritis (JIA) patients in paediatric care are transferred to adult care. An increased disease activity after transfer and increased dropout has been suggested, however, evidence is scarce. Our aim is to determine whether the process of transition is associated with increased disease-activity and dropout, and to identify associated factors.
METHODS:
During a 3-year prospective transition cohort study, paediatric patients (14-17yrs) were transferred to adult care. Paediatric (10-13yrs) and adult JIA patients (18-27yrs) were used as control groups. Demographic and disease-related items were obtained yearly. Non-parametric tests were used to compare differences between the groups and mixed models to evaluate disease activity over time, measured by JADAS27 and DAS28. Dropout was defined as not attending the clinic for 2 consecutive visits.
RESULTS:
Groups did not differ regarding baseline variables of subtype, gender, uveitis, ANA-, RF- or HLA B27-positivity and current or past DMARD use. Median disease activity was not different between groups during follow-up. Transfer was not associated with disease activity. Dropout rate was 12%, and was significantly higher in patients under transition (22%) compared with paediatric (3%) and adult care (10%). Patients who dropped out had significantly lower disease activity at baseline and were using less MTX, but did not differ regarding subtype, ANA, RF and HLA-B27.
CONCLUSIONS:
The process of transition in JIA is not associated with an increase in disease activity, however, this period carries a risk for drop out especially in patients with low disease activity.
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