Quality of life in patients with juvenile arthritis: adalimumab might make a difference

Abstract

Relevancy. Juvenile arthritis (JA) leads to premature impairment of pediatric physical health, psychological and social limitations, that considerably worsen health related quality-of-life of patients. That is why improvement of health related qual-ity-of-life (HRQOL) is one of the main aims of treatment of patients with juvenile arthritis. AIM: Evaluate influence of infliximab therapy on HRQOL of children with different forms of JA. Patients and methods There were examined 97 children (2 - 18 years, median age 6,29±4,08 years, 68 girls, 29 boys) 37 - with oligoarticular J1A, 31-with polyarticular JIA, 15-with systemic JIA and 14 - with Juvenile Enthesitis related arthritis. 65 (67%) from 97 children were treated with infliximab for more than a year in the dose of 6 mg/kg. Evaluation of HRQOL was performed by the questionnaires Ped-sQL Generic Core Scale (PedsQL GCS), PedsQL Rheumatology Module (PedsQL RM) and CHAQ. RESULTS: HRQOL of children with JA before the conducted therapy in all scales of PedsQL GCS was considerably lower in comparison with population norm (p<0,001). To week 54 of infliximab therapy there was detected statistically reliable increase of HRQOL values in all scales of self and proxy-report of PedsQL RM and PedsQL GCS (p<0,001). By CHAQ disability index decreased reliably from 1,43 to 0,28, pain level by VAS - from 7,23 to 0,6, Evaluation of health state by VAS increased from 7,58 to 2,53. To the year of receiving the therapy by self report HRQOL differed from population norm only by the scale of social functioning (p<0,01), and by proxy report HRQOL was lower only by the scales of emotional and social functioning (p<0,001). CONCLUSION: Infliximab administration in pediatric rheumatologic practice increases physical, psychological, social adaptation of patients, allows changing diagnosis of such a severe disabling disease, as JA, stopping steadily progressing disease course and preventing severe disability in such tender age.