Clin Exp Rheumatol. 2025 Oct;43(10):1823-1829. doi: 10.55563/clinexprheumatol/7k95gj. Epub 2025 Oct 23.
ABSTRACT
OBJECTIVES: To investigate potential predictors of remission and relapse in systemic juvenile idiopathic arthritis (sJIA), in a real-life clinical setting.
METHODS: An observational bicentric cohort study was conducted including patients diagnosed with sJIA between 2017 and 2022 in two tertiary paediatric hospitals.
RESULTS: 64 sJIA patients were included. The time from first symptom to diagnosis (hazard ratio (HR): 0.991) and interleukin 1 (IL1) inhibitors treatment failure (HR: 0.236) resulted predictors of a longer time to achieve remission on therapy. Clinical inactive disease at month 3 (HR: 3.506) predicted a shorter interval of time to remission off medication while anti-IL1 failure (HR: 0.153) was found to be a predictor of longer time to achieve remission off medication. The presence of rash three months after onset (HR: 5.763) resulted significantly associated with a shorter time to relapse, while the male gender resulted a protective factor (HR: 0.247). IL1 inhibitors non-responder patients (15/42, 35.7%) presented a lower age (p=0.040) and a higher frequency of polyarthritis at onset (p=0.029), a non-monophasic disease course (p<0.001), a higher number of relapses (p=0.010), and a longer time to achieve remission on therapy (p<0.001).
CONCLUSIONS: A diagnostic and therapeutic delay predicts a longer time to reach remission in sJIA patients, and seems to affect the response to IL1 inhibition, according to the ‘window of opportunity’ hypothesis in sJIA treatment. A failure to IL1 inhibitors predicts a longer time to reach remission both on and off medications and is associated with an early polyarticular onset and non-monophasic disease course.
PMID:41133354 | DOI:10.55563/clinexprheumatol/7k95gj
