Transition-related outcomes among a cohort of patients with juvenile idiopathic arthritis.

Abstract

A major goal in juvenile idiopathic arthritis (JIA) long-term management is to ensure a successful transition to adult age. This study aims to assess transition outcomes in a group of JIA patients during their passage from pediatric to adult healthcare assistance at a single center. This is a cross-sectional study. All patients with JIA undergoing a transition from the Pediatric Rheumatology Service of the IRCCS "Burlo Garofolo" Hospital, Trieste, to the adult Rheumatology Service of "Santa Maria della Misericordia" Hospital, Udine, between 2017 and 2022, were enrolled. Clinical and laboratory data were collected. A semi-structured survey exploring patients' satisfaction was distributed through email. Numerical variables were compared using Student's t-test or Mann-Whitney test. Categorical variables were compared with Fisher's exact test. We recruited 36 patients (26 female, 72.2%): 9 with polyarticular course JIA, 13 oligoarticular, 8 psoriatic arthritis, 3 systemic JIA, and 3 enthesitis-related arthritis. The mean age at transition was 18.6 (Q1-Q3, 18.3-19.1). JADAS-27 score significantly decreased after the transition, with a mean difference of 2.6 (p = 0.014). No patients were lost to follow-up, and in 8 out of 36 (22.2%), a step-up therapy was needed within the first 12 months. Among these, no correlation was found with the JIA subtype, age at onset, type of involved joints, and other variables explored. Finally, the 15 patients who answered the survey (response rate 50%) were satisfied about the transition process. This study described a real-life transition experience from pediatric to adult rheumatology care, showing good transition outcome measures, with no patients lost to follow-up and a reduction of JADAS-27 score after completing the process.