Prospective validation of the Juvenile Spondyloarthritis Disease Activity Index in children with enthesitis-related arthritis
Prospective validation of the Juvenile Spondyloarthritis Disease Activity Index in children with enthesitis-related arthritis
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DOI：
10.1093/rheumatology/key246
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发表时间：
2018-12-01
期刊：
影响因子：
5.5
通讯作者：
Aggarwal, Amita
中科院分区：
文献类型：
--
作者：
Zanwar, Abhishek;Phatak, Sanat;Aggarwal, Amita
目标。为了测量青少年脊柱炎相关关节炎儿童的疾病活动性，制定了青少年脊柱关节炎疾病活动性指数(JSpADA)，并进行了回顾性验证。我们前瞻性地验证了JSPADA，并评估了成人水疗评分的表现。根据ILAR标准，18岁以下患有鼻炎相关性关节炎的儿童入选。记录基线特征和不同疾病活动指标(JSpADA、BASDAI、强直性脊柱炎疾病活动评分-ESR、幼年性关节炎DAS-10关节)和儿童时期HAQ、医生总体评估和患者总体评估。在一些儿童中也进行了随访。平均数(S.D.)年龄为14.3(2.4)岁，病程为36.9(3)个月。104例患儿中90例(86.5%)HLAB27阳性。JSPADA与医生总体评分(r=0.87P<；0.0001)、患者总体评分(r=0.8，P<；0.0001)、青少年关节炎DAS-10关节评分(r=0.89；P<；0.0001)、儿童HAQ(r=0.83P<；0.0001)均有较高的相关性。JSPADA评分具有较好的内部一致性、区分效度和变化敏感性。在15%的儿童中，由于腿部活动性关节炎，无法测试背部活动能力。7个变量的JSpADA(不包括背部活动)的表现与最初的JSpADA一样好。成人得分具有较好的结构效度、区分能力和变化敏感性，与JSPADA有较好的相关性(BASDAI，r=0.84；强直性脊柱炎疾病活动评分-ESR，r=0.84)。JSpADA是衡量末端炎性关节炎疾病活动性的有效评分。成年人的分数也表现良好。排除背部移动性需要在未来进行评估，以提高JSpADA性能。
Objective. To measure disease activity in children with enthesitis-related arthritis the Juvenile Spondyloarthritis Disease Activity Index (JSpADA) was developed and retrospectively validated. We prospectively validated JSpADA and also assessed performance of adult SpA scores.Methods. Children with enthesitis-related arthritis (ILAR criteria) less than 18 years of age were enrolled. Baseline characteristics and different disease activity measures (JSpADA, BASDAI, Ankylosing Spondylitis Disease Activity Score-ESR, juvenile arthritis DAS-10 joints), and Childhood HAQ, physician global assessment and patient global assessment were recorded at baseline. In some children follow-up was also done.Results. The mean (S.D.) age of 127 children (116 boys) was 14.3 (2.4) years and disease duration was 36.9 (3) months. Ninety of 104 (86.5%) children were HLA-B27 positive. JSpADA showed high correlation with physician global assessment (r = 0.87; P < 0.0001), patient global assessment (r = 0.80, P < 0.0001), juvenile arthritis DAS-10 joints (r = 0.89; P < 0.0001) and Childhood HAQ (r = 0.83, P < 0.0001). The JSpADA scores showed good internal consistency, discriminative validity and sensitivity to change. In 15% of children back mobility could not be tested due to active arthritis in lower limbs. The 7-variable JSpADA excluding back mobility performed as well as the original JSpADA. Adult scores showed good construct validity, discriminative capacity and sensitivity to change, and had good correlation with JSpADA (BASDAI, r = 0.84; Ankylosing Spondylitis Disease Activity Score-ESR, r = 0.84).Conclusion. JSpADA is a valid score for measuring disease activity in enthesitis-related arthritis. Adult scores also performed well. Excluding back mobility needs to be assessed in future to improve JSpADA performance.