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Mortality rates are increased in patients with systemic juvenile idiopathic arthritis
  1. Rebecca Davies1,
  2. Taunton Southwood2,
  3. Lianne Kearsley-Fleet1,
  4. Mark Lunt1,
  5. Eileen Baildam3,
  6. Michael W Beresford3,4,
  7. Helen E Foster5,
  8. Sharon Douglas6,7,
  9. Wendy Thomson8,9,
  10. Diederik De Cock1,
  11. BCRD Study Group1,
  12. BSPAR-ETN Study Group1,
  13. Kimme L Hyrich1,9
  1. 1Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
  2. 2Institute of Child Health, University of Birmingham and Birmingham Children's Hospital, Birmingham, UK
  3. 3Clinical Academic Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
  4. 4Institute of Translational Medicine (Child Health), University of Liverpool, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
  5. 5Musculoskeletal Research Group, Institute Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
  6. 6BSPAR Parent Group, British Society for Rheumatology, London, UK
  7. 7Scottish Network for Arthritis in Children, Edinburgh, UK
  8. 8Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
  9. 9NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust and University of Manchester Partnership, Manchester, UK
  1. Correspondence to Professor Kimme L Hyrich, Arthritis Research UK Centre for Epidemiology, Room 2.800 Stopford Building, Manchester Academic Health Sciences Centre, The University of Manchester, Oxford Road, Manchester M13 9PT, UK; kimme.hyrich{at}

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Juvenile idiopathic arthritis (JIA) represents the most common chronic inflammatory musculoskeletal disease in children. It is characterised by the onset of inflammatory arthritis prior to the 16th birthday and can follow many patterns ranging from oligoarthritis to polyarthritis to the most severe subtype, systemic juvenile idiopathic arthritis (sJIA).1 The disease course can be variable with many children achieving drug-free remission. It is estimated that at least 60% of children will require systemic drug therapy with methotrexate, primarily but not limited to those with polyarthritis and systemic arthritis, and of these at least 20% will go on to require additional treatment with a biologic.2

Mortality rates in JIA are reported to be increased when compared with the general population, but likely vary by subtype and disease severity.3–5 …

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