Health-Related Quality of Life in Disease-Modifying Antirheumatic Drug–Treated Adults With Juvenile Idiopathic Arthritis Compared to Rheumatoid Arthritis and the General Population

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Abstract
Objective: To explore health-related quality of life (HRQOL) measured by the 36-item Short Form Health Survey (SF-36), SF-36 physical component summary (PCS), SF-36 mental component summary (MCS), and Short Form 6D (SF-6D) in adults with juvenile idiopathic arthritis (JIA) compared to patients with rheumatoid arthritis (RA) and the general population. Methods: We used 6-month follow-up data from the Norwegian Disease-Modifying Antirheumatic Drug Register (NOR-DMARD), including adult patients with JIA and RA starting or switching disease-modifying antirheumatic drug (DMARD) treatment. Age- and gender-adjusted regression analyses were used to compare outcomes among JIA, RA, and the general Norwegian population. Results: Register data were available for 232 patients with JIA and 2764 with RA at 6 months follow-up. Patients with JIA had poorer physical health compared to those with RA (adjusted difference [95% CI]: PCS −3.58 [−6.09 to −1.08]). Compared to the general population, PCS scores were lower in both JIA and RA (adjusted differences [95% CI]: JIA–general population −15.70 [−18.21 to −13.19], RA–general population −12.12 [−12.76 to −11.47]). Mental health measured by MCS was similar across the 3 groups. Average SF-6D utility levels were comparable in JIA and RA, but lower than in the general population. Similar proportions of patients with JIA and RA experienced improvements exceeding minimum clinically important difference (MCID) in SF-36 scale scores, PCS, MCS, and SF-6D after 6 months. Conclusion: Compared to patients with RA and the general population, patients with JIA had lower physical HRQOL 6 months after DMARD initiation. Mental health composite scores were similar among patients with JIA, those with RA, and the general population. Both disease groups showed similar levels of improvement with treatment.

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