Juvenile idiopathic arthritis (JIA) refers to a group of diseases that share the common feature of chronic joint inflammation. Some of the disease-modifying antirheumatic drugs and the biologic agents used to treat JIA have been able to induce periods of disease remission. In November 2005, an international team of scientists released results in Arthritis & Rheumatism showing that although remission can be achieved, relapse can be expected in up to 85 percent of children.

During a follow-up period of at least four years, children with JIA spent between 16 percent and 60 percent of their time in inactive disease, depending on the type of JIA they had. Patients with persistent oligoarticular (few joints) JIA spent the least amount of time in a heightened disease state, whereas children with rheumatoid factor-positive polyarticular (many joints) JIA spent the most time with active disease. Unfortunately, once a child achieved clinical remission off medication (defined as having 12 months of inactive disease without anti-arthritis medications), that child had a 40 percent to 69 percent chance of having a disease flare within the next two years. That same child’s chances of having a flare increased to 49 percent to 85 percent in the next five years.

The study’s lead author, Carol A. Wallace, MD, voiced her concerns in the article’s summary. “The small percentage of time spent in clinical remission off medication was disappointing, as was the lack of durability of this state. These data highlight the urgent need for improved treatments of JIA that are capable of inducing extended periods of clinical remission off medication.”