Determining Predictive Factors for Refractory Disease in Oligoarticular Juvenile Idiopathic Arthritis

Authors : Emine Nur Sunar Yayla, Elif Arslanoğlu Aydın

Pages : 142-146

Doi:10.20492/aeahtd.1533033

View : 23 | Download : 54

Publication Date : 2025-01-22

Article Type : Research Paper

Abstract :Aim: This study aims to compare the clinical and demographic characteristics of patients diagnosed with oligoarticular juvenile idiopathic arthritis (JIA) treated with conventional disease-modifying antirheumatic drugs (cDMARDs) versus those requiring additional biologic DMARDs (bDMARDs). Additionally, it aims to identify the factors that necessitate the inclusion of bDMARDs in the treatment regimen and to determine predictors of long-term treatment resistance. Materials and Methods: Patients diagnosed with oligoarticular JIA were classified into two groups based on their response to cDMARDs: responders and resistant. Results: The study included 71 patients with oligoarticular JIA on DMARDs. Knee joint complaints were most common (83.1%), followed by ankle joint (29.6%). All patients were started on non-steroidal anti-inflammatory drugs (NSAIDs) at diagnosis, and cDMARDs were initiated at a median of one month (IQR: 3 months). The most commonly initiated treatment in these patients was methotrexate (MTX) (97.2%). cDMARDs were effective in 21 patients (29.5%), while 50 patients (70.4%) were resistant to cDMARDs and required the initiation of bDMARDs. In comparing cDMARD-responsive and resistant groups starting bDMARDs, family history was more common in responders (23.6%, p=0.044), while ankle involvement was higher in resistant group (38%, p=0.016). Univariate analysis highlighted ankle/toe joint involvement as a risk factor for resistance (p=0.027, CI 95%), and family history as protective (p=0.043, CI 95%). When multivariate analysis was performed with the variables that were significant in univariate analysis, there was statistical significance only in the involvement of ankle/toe joints (ankle/toe joints OR=5.29 CI 95% (1.08-25.83), p=0.040, family history OR=0.24 CI 95% (0.05-1.19), p=0.080). Conclusion: In patients with oligoarticular JIA, the involvement of ankle/toe joints at diagnosis increases the risk of resistance to cDMARD therapy. Therefore, careful monitoring of these patients is warranted during follow-up.
Keywords : Hastalığı modifiye edici antiromatizmal ilaçlar, oligoartiküler juvenil idiyopatik artrit, öngörücü faktörler, dirençli hastalık