Article

OBJECTIVE: To develop and validate a composite disease activity score for
juvenile idiopathic arthritis (JIA), the Juvenile Arthritis Disease Activity
Score (JADAS). METHODS: The JADAS includes 4 measures: physician global
assessment of disease activity, parent/patient global assessment of well-being,
active joint count, and erythrocyte sedimentation rate. These variables are part
of the American College of Rheumatology (ACR) Pediatric 30 (Pedi 30), Pedi 50,
and Pedi 70 criteria for improvement. Validation analyses were conducted on
>4,500 patients and included assessment of construct validity, discriminant
validity, and responsiveness to change. Three versions of the JADAS were tested
based on 71-joint (range 0-101), 27-joint (range 0-57), or 10-joint (range 0-40)
counts. Statistical performances of the JADAS were compared with those of 2
rheumatoid arthritis composite scores, the Disease Activity Score in 28 joints
(DAS28) and the Clinical Disease Activity Index (CDAI). RESULTS: The JADAS
demonstrated good construct validity, yielding strong correlations with JIA
activity measures not included in the score and moderate correlations with the
Childhood Health Assessment Questionnaire. Correlations obtained for the 3 JADAS
versions were comparable, but superior to those yielded by the DAS28 and CDAI.
The area under the curve of the JADAS predicted long-term disease outcome,
measured as radiographic progression over 3 years. In 2 clinical trials, the
JADAS discriminated well between ACR Pedi 30, Pedi 50, and Pedi 70 response and
revealed strong responsiveness to clinical change. CONCLUSION: The JADAS was
found to be a valid instrument for assessment of disease activity in JIA and is
potentially applicable in standard clinical care, observational studies, and
clinical trials.

Langue : ANGLAIS

Tiré à part : OUI