The long-term follow up of patients with oligoarticular juvenile idiopathic arthritis: a single center experience.

Aim
To evaluate the clinical course and outcomes of oligoarticular juvenile idiopathic arthritis(JIA) patients from 2003 to 2021, identifying factors linked to severe disease and complications.

Methods

We analyzed 208 oligoarticular JIA patients followed at Cerrahpaşa Medical School, using medical records. Continuous variables were compared with the Mann-Whitney U test, and logistic regression was applied to identify predictors of severe disease and damage.

Results

Among 208 patients (68.75% female), the average treatment duration was 45 months. The knee was the most affected joint (82.6%), followed by the ankle (50.4%). The initial mean Juvenil Arthritis Disease Activity Score (JADAS) score was 18, decreasing to 3 at the last visit. Juvenile Arthritis Damage Index (JADI) score averaged 0.64. Limited range of motion was observed in 34.13% patients. Uveitis was the most common extra-articular complication (14.9%), with higher biologic use in these patients (p<0.001). Disease severity correlated with initial and final JADAS (p<0.001) and JADI (p<0.001). Regression analysis linked elbow involvement (p=0.000) and adalimumab use (p=0.001) to disease sequelae. MEFV gene mutations were found in 10.9% of patients. Based on Wallace criteria, 85% were in remission with medication, 6.25% had inactive disease, and 8.6% achieved drug-free remission.

Conclusion: Oligoarticular JIA generally has a mild course and good prognosis. However, elbow involvement and biologic use are associated with more severe disease and sequelae. Uveitis is the most common extra-articular complication.

Keywords: arthritis, biologics, damage, oligoarticular JIA

Conceptualization, A.A. and A.A.; Data curation, A.A.; Formal Analysis, A.A.; Investigation, A.A. and A.A.; Project administration, A.A.; Resources, A.A. and O.K.; Software, A.A.; Visualization, A.A.; Writing – original draft, A.A.; Supervision, A.A., F.A., O.K., M.Y., S.S., K.B. and O.K.; Validation, A.A., F.A., O.K., M.Y., S.S., K.B. and O.K.; Writing – review & editing, A.A. All authors have read and agreed to the published version of the manuscript.