Overlap of International League of Associations for Rheumatology and Preliminary Pediatric Rheumatology International Trials Organization Classification Criteria for Nonsystemic Juvenile Idiopathic Arthritis in an Established UK Multicentre Inception Cohort

Stephanie J W Shoop-Worrall; Vanessa G Macintyre; Coziana Ciurtin; Gavin Cleary; Flora McErlane; Lucy R Wedderburn; Childhood Arthritis Prospective Study (CAPS) Principal Investigators; Kimme L Hyrich

doi:10.1002/acr.25296

Overlap of International League of Associations for Rheumatology and Preliminary Pediatric Rheumatology International Trials Organization Classification Criteria for Nonsystemic Juvenile Idiopathic Arthritis in an Established UK Multicentre Inception Cohort

Arthritis Care Res (Hoboken). 2024 Jan 11. doi: 10.1002/acr.25296. Online ahead of print.

Authors

Stephanie J W Shoop-Worrall¹, Vanessa G Macintyre¹, Coziana Ciurtin², Gavin Cleary³, Flora McErlane⁴, Lucy R Wedderburn⁵; Childhood Arthritis Prospective Study (CAPS) Principal Investigators; Kimme L Hyrich⁶

Collaborators

Childhood Arthritis Prospective Study (CAPS) Principal Investigators:
Alice Chieng, Coziana Ciurtin, Eileen Baildam, Flora McErlane, Gavin Cleary, Helen Foster, Joyce Davidson, Lucy R Wedderburn, Yiannis Ioannou

Affiliations

¹ The University of Manchester, Manchester, UK.
² University College London, University College London Hospital, and Great Ormond Street Hospital, London, UK.
³ Alder Hey Children's Hospital, Liverpool, UK.
⁴ Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
⁵ University College London, University College London Hospital, Great Ormond Street Hospital, and Great Ormond Street Hospital NHS Foundation Trust, London, UK.
⁶ The University of Manchester and Manchester University Hospitals NHS Foundation Trust, Manchester, UK.

PMID: 38212149
DOI: 10.1002/acr.25296

Abstract

Objective: The goal was to assess the degree of overlap between existing International League of Associations for Rheumatology (ILAR) and preliminary Paediatric Rheumatology International Trials Organisation (PRINTO) classification criteria for juvenile idiopathic arthritis (JIA).

Methods: Participants from the Childhood Arthritis Prospective Study, a multicenter UK JIA inception cohort, were classified using the PRINTO and ILAR classification criteria into distinct categories. Systemic JIA was excluded because several classification items were not collected in this cohort. Adaptations to PRINTO criteria were required to apply to a UK health care setting, including limiting the number of blood biomarker tests required. The overlap between categories under the two systems was determined, and any differences in characteristics between groups were described.

Results: A total of 1,223 children and young people with a physician's diagnosis of JIA were included. Using PRINTO criteria, the majority of the patients had "other JIA" (69.5%). There was a high degree of overlap (91%) between the PRINTO enthesitis/spondylitis- and ILAR enthesitis-related JIA categories. The PRINTO rheumatoid factor (RF)-positive category was composed of 48% ILAR RF-positive polyarthritis and 52% undifferentiated JIA. The early-onset antinuclear antibodies-positive PRINTO category was largely composed of ILAR oligoarthritis (50%), RF-negative polyarthritis (24%), and undifferentiated JIA (23%). A few patients were unclassified under PRINTO (n = 3) and would previously have been classified as enthesitis-related JIA (n = 1) and undifferentiated JIA (n = 2) under ILAR.

Conclusion: Under the preliminary PRINTO classification criteria for childhood arthritis, most children are not yet classified into a named category. These data can help support further delineation of the PRINTO criteria to ensure homogenous groups of children can be identified.

Abstract

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