Clinical predictors of remission in systemic juvenile idiopathic arthritis/Still's disease: insight from real-life data and the potential relevance of the 'window of opportunity'
Authors' conclusion
A diagnostic and therapeutic delay predicts a longer time to reach remission in sJIA patients, and seems to affect the response to IL1 inhibition, according to the 'window of opportunity' hypothesis in sJIA treatment. A failure to IL1 inhibitors predicts a longer time to reach remission both on and off medications and is associated with an early polyarticular onset and non-monophasic disease course.
Study context
- Population
- Patients diagnosed with systemic juvenile idiopathic arthritis (sJIA) between 2017 and 2022 in two tertiary paediatric hospitals
- Participants
- 64 patients
- Outcome
- Predictors of remission and relapse in sJIA
Methodological detailsobservational, bicentric, real-life clinical setting
- Observational
- Bicentric
- Real-life clinical setting
Main finding
As reported in the abstract
- Time from first symptom to diagnosis: predictor of longer time to remission on therapy (HR)
- 0.991
- IL1 inhibitor treatment failure: predictor of longer time to remission on therapy (HR)
- 0.236
- Clinical inactive disease at month 3: predictor of shorter time to remission off medication (HR)
- 3.506
- Anti-IL1 failure: predictor of longer time to remission off medication (HR)
- 0.153
- Rash 3 months after onset: associated with shorter time to relapse (HR)
- 5.763
- Male gender: protective factor for relapse (HR)
- 0.247
Observational data: associations, not effects.
Further findings
Characteristics of IL1 inhibitor non-responders (15/42, 35.7%)
- Lower age
- P = 0.040
- Higher frequency of polyarthritis at onset
- P = 0.029
- Non-monophasic disease course
- P < 0.001
- Higher number of relapses
- P = 0.010
- Longer time to remission on therapy
- P < 0.001
Original publication
Clinical predictors of remission in systemic juvenile idiopathic arthritis/Still's disease: insight from real-life data and the potential relevance of the 'window of opportunity'. Clin Exp Rheumatol. Published 23 October 2025. doi:10.
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