Patients with juvenile idiopathic arthritis undergo a significant deterioration in physical health-related quality of life over time, a 30-year follow-up study shows.
The study “Physical Functioning, Pain and Health-Related Quality of Life in Adults with Juvenile Idiopathic Arthritis: A Longitudinal 30-Year Follow-Up Study” was published in the journal Arthritis Care & Research.
With the objective of investigating how physical activity, perception of pain and health-related quality of life changes over time in patients diagnosed with juvenile idiopathic arthritis (JIA), a team of researchers at Oslo University, Norway performed a long-term prospective study.
They followed a group of 176 JIA patients up to 30 years, and compared patients’ parameters to those of 90 control volunteers from the general population, matched for age and gender. Patients clinically examined after 15 years were reassessed after 23 and 30 years.
The evaluation was performed using the Health Assessment Questionnaire Disability Index (HAQ-DI), Visual Analogue Scale Pain (VAS pain), and Medical Outcome Study 36-item Short Form (SF-36). SF-36 is used to assess health-related quality of life.
Patients reported that their health-related quality of life had deteriorated at 30-year follow-up when compared to matched controls from the general population. All the parameters evaluated in the SF-36 were lower, with the exception of mental health.
Patients had lower physical activity scores relative to controls, with impairments observed in both patients with and without clinical remission. The physical activity scores worsened significantly from the 15- to the 30-year follow-up.
Overall, the results from this longitudinal study using a representative group of JIA patients shows that the disease has detrimental effects to patients’ physical health-related quality of life.
Additionally, “physical limitations, fatigue and low well-being assessed at 15-year follow-up predicted poorer physical HRQOL [health-related quality of life] at the 30-year follow-up,” the researchers wrote.
Receiving a disability or social living allowance also was associated with lower physical scores.
“Employment status can play an important role in daily life and a strong indicator of the consequences of JIA in adulthood. Helping patients with potential occupational challenges may be an area for further focus,” the team wrote.
The patients assessed in the group were diagnosed before the use of biological therapies, so future longitudinal studies are needed to understand how these new therapies will impact patient-reported outcomes.