ArticleEuropean journal of rheumatology2026
Five-Year Outcomes of Systemic-Onset Juvenile Idiopathic Arthritis in India: Insights into Disease Course and Predictive Factors.
Article in European journal of rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveSystemic-onset juvenile idiopathic arthritis (sJIA) follows a variable and unpredictable course, with long-term outcomes remaining inconsistent worldwide despite therapeutic advancements. This study aimed to evaluate the disease course and clinical outcomes of the sJIA cohort after 5-year follow-up.
methodsThe study retrospectively analyzed 100 sJIA patients with at least 5 years of follow-up. Ten patients were excluded due to insufficient data. Data on demographics, clinical features, treatments, outcomes, and complications were collected.
resultsThe mean age at disease onset was 6.75 ± 3.64 years, with a median follow-up of 7 years. Common clinical manifestations included fever (100%), arthritis (96%), rash (55%), and hepatosplenomegaly (32%). Polyarticular arthritis was observed in 70.83% of cases. Treatment modalities included Non-steroidal anti-inflammatory drugs (100%), steroids (89%), methotrexate (86%), thalidomide (31%), lenalidomide (21%), and tocilizumab (13%). While 11% of patients responded to NSAIDs alone,46% achieved remission with glucocorticoids and methotrexate. A total of 46% of the patients exhibited a monocyclic disease course, and 27% of the patients had polycyclic and persistent courses. On multivariate analysis, diagnostic delay (odds ration (OR) = 1.02, 95% CI: 1.01-1.03) and symmetric arthritis (OR = 2.36, 95% CI: 1.65-3.32) were identified as key predictors of persistent disease. Common complications included infections (20%), joint damage (14%), and macrophage activation syndrome (11%). At 5 years, 62% achieved drug-free remission, 16% remained in remission on medication, and 21% had active disease. Mortality was noted in 1 patient due to a suspected cerebrovascular accident or meningitis.
conclusionDelayed diagnosis and symmetric arthritis at onset increased the risk of persistent disease, highlighting the need for early and aggressive treatment for better outcomes. Cite this article as: Rao AP, B A, Kumar A, et al. Five-year outcomes of systemic-onset juvenile idiopathic arthritis in India: insights into disease course and predictive factors. Eur J Rheumatol. 2026, 13(1), 0068, doi: 10.5152/eurjrheum.2026.25068.
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