Health-Related Quality of Life, Physical Function, Fatigue, and Disease Activity in Children with Established Polyarticular Juvenile Idiopathic Arthritis

Objective. To compare child self-report and parent/proxy report of health-related quality of life (HRQOL), disability, and fatigue in children with active polyarticular juvenile idiopathic arthritis (JIA) to that of children with inactive polyarticular JIA and to previous data from healthy controls. Methods. Cross-sectional survey of children with polyarticular JIA diagnosed and treated between 2000 to 2006 and their parent/proxy. The Childhood Health Assessment Questionnaire, Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales, PedsQL Rheumatology Module, and PedsQL Multidimensional Fatigue Scale were administered. Disease activity data were collected from the physician clinic notes. Comparisons were performed with t tests. Correlations between patient and parent/proxy reports were measured with Pearson correlation coefficients. Results. Sixty children and/or their parents/proxies participated (79% response rate). Disease activity status was available for 52, and 32 met criteria for inactive disease (62%). Participants reported lower scores on the PedsQL Generic Core Scales (range 2.54-9.13 points lower) and the PedsQL Rheumatology Module (range 2.46-6.96 points lower) than those with inactive disease. Participants also reported lower scores on the PedsQL Multidimensional Fatigue Scale than did healthy controls, regardless of disease activity status (range 0.06-9.2 points lower). Conclusion. Although children in this cohort with polyarticular JIA and inactive disease reported HRQOL scores similar to those of healthy controls. children with polyarticular JIA and their parents/proxies tended to report more fatigue than controls, regardless of disease activity. Application of these measures prospectively to larger cohorts of children with JIA is needed to assess these differences. (First Release May 1 2009; J Rheumatol 2009;36:1330-6; doi: 10.3899/jrheum.081028)