Health-related Quality of Life in DMARD-treated adults with Juvenile Idiopathic Arthritis Compared to Rheumatoid Arthritis and the General Population.

Abstract

OBJECTIVE To explore health-related quality of life (HRQoL) measured by Short Form 36 (SF-36), SF-36 physical component score (PCS), SF-36 mental component score (MCS) and Short Form 6D (SF-6D) in adults with juvenile idiopathic arthritis (JIA) compared to rheumatoid arthritis (RA) and the general population. METHODS We used six-month follow-up data from the Norwegian disease-modifying antirheumatic drug study (NOR-DMARD), including adult JIA and RA patients starting or switching disease-modifying anti-rheumatic drug (DMARD) treatment. Age- and gender adjusted regression analyses were used to compare outcomes between JIA, RA and the general Norwegian population. RESULTS Register data was available for 232 JIA- and 2764 RA patients at six months follow-up. JIA patients had poorer physical, but similar mental health as RA (adjusted difference (95% CI): PCS -3.58 (-6.09 to -1.08); MCS 2.02 (-0.51 to 4.54)). Compared to the general population, PCS scores were lower in both JIA and RA (adjusted differences; JIA-general population: -15.70 (-18.21 to -13.19), RA-general population: -12.12 (-12.76 to -11.47), but MCS was similar across groups. Average SF-6D utility levels were comparable in JIA and RA, but lower than the general population. Similar proportions of JIA and RA experienced improvements exceeding minimal clinical important difference (MCID) in SF-36 scale scores, PCS, MCS and SF-6D after six months. CONCLUSION Compared to RA and the general population, JIA had lower physical HRQoL six months after DMARD initiation. Mental health composite scores were similar between JIA, RA and the general population. Both disease groups showed similar levels of improvement with treatment.