Factors determining resistance to conventional disease-modifying anti-rheumatic drug treatment in oligoarticular juvenile idiopathic arthritis

• Published in: Clinical rheumatology 2024-06, Vol.43 (6), p.2021-2026
• Main Authors: Sener, Seher, Aliyev, Emil, Batu, Ezgi Deniz, Balik, Zeynep, Bayindir, Yagmur, Cam, Veysel, Basaran, Ozge, Bilginer, Yelda, Ozen, Seza
• Format: Article
• Language: English
• Subjects: Antinuclear antibodies; Arthritis; C-reactive protein; Corticosteroids; Diagnosis; Disease resistance; Inflammatory bowel diseases; Joint diseases; Medicine; Medicine & Public Health; Nonsteroidal anti-inflammatory drugs; Original Article; Remission; Remission (Medicine); Rheumatology; Steroids; Uveitis
• ISSN: 0770-3198; 1434-9949; 1434-9949
• DOI: 10.1007/s10067-024-06925-4

Objective Our study was designed to investigate the reasons for starting the conventional disease-modifying anti-rheumatic drugs (DMARDs) and the variables that impact the response to DMARD treatment in oligoarticular juvenile idiopathic arthritis (JIA) patients. Methods Oligoarticular JIA patients ( n  = 187) were categorized into two groups: Group A consisted of patients who achieved remission with DMARD, and Group B comprised those who did not respond to DMARD therapy. Results DMARDs were initiated for various reasons: 68 (36.4%) due to active disease despite nonsteroidal anti-inflammatory drugs (± intra-articular corticosteroid) treatment, 59 (31.6%) due to uveitis, 49 (26.2%) due to extended oligoarticular JIA, and 11 (5.9%) due to inflammatory bowel disease. One hundred twenty-three patients (65.8%) achieved remission with DMARDs (Group A), while 64 patients (34.2%) did not respond to DMARD therapy (Group B). In Group B, patients had higher C-reactive protein (CRP) levels as well as higher Juvenile Idiopathic Arthritis Disease Activity Scores-71 (JADAS-71) at diagnosis (both p   1.1 mg/dL) (OR 1.308, 95% CI 1.203–3.574; p   15.8) (OR 1.659, 95% CI 1.179–2.941; p