Impact of Treatment Changes on Health-Related Quality of Life in Canadian Children with Juvenile Idiopathic Arthritis: Results from ReACCh-Out and CAPRI.

OBJECTIVE We assessed changes in health-related quality of life (HR-QoL) in Canadian patients with juvenile idiopathic arthritis (JIA), comparing inception cohorts from 2017-2023 and 2005-2010. METHODS We included newly-diagnosed patients who completed the Juvenile Arthritis Quality of Life Questionnaire (JAQQ) at both enrollment and one-year later. Mean changes in JAQQ domain scores from baseline to one year were compared between cohorts using Mann-Whitney U-tests. Multivariable linear regression was used to adjust for baseline imbalances between the cohorts. We also compared changes in treatments, the Quality of My Life scale, arthritis pain, Childhood Health Assessment Questionnaire Disability Index, and physician and parent global assessments. RESULTS We included 478 and 663 patients from the 2017-2023 and 2005-2010 cohorts, respectively. By one year, a greater proportion of patients in 2017-2023 cohort had used conventional and biologic DMARDs compared to the 2005-2010 cohort (57.9% vs. 46.2%, and 27.2% vs. 6.3%, respectively). Improvements in total JAQQ score from baseline to one year were similar between the 2017-2023 (0.97; 95% CI 0.85 to 1.09) and 2005-2010 (0.92; 95% CI 0.82 to 1.02) cohorts, with no significant difference observed across JAQQ domains. Pain scores, however, improved significantly (-2.07 vs. -1.62, p=0.03). After adjusting for baseline imbalances, greater improvements were observed in 2017-2023 cohort for all JAQQ domains in patients with ≥5 active joints (β=0.28 for JAQQ psychosocial to 0.62 for Gross Motor). CONCLUSION First-year improvements in HR-QoL measured by JAQQ were similar in 2017-2023 and 2005-2010 cohorts, but adjustment for baseline imbalances suggests greater HR-QoL improvements in those with more severe disease in the later cohort.