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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 …
Contributors RD and KLH were the lead authors and take overall responsibility for the full manuscript. All the other authors assisted in the analysis, writing and approval of the manuscript.
Competing interests RD, LK-F, and EB received Arthritis Research UK grant; TS received medical education grant from Pfizer; HEF received Arthritis Research UK grant and Abbvie, Pfizer, Sobi, Roche and Chugai personal fees; KLH received Arthritis Research UK grant and Abbvie and Pfizer personal fees.
Ethics approval West Midlands Research Ethics Committee and North West 7 REC Greater Manchester Central Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.