Modified Juvenile Spondyloarthritis Disease Activity Index in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry

Hemalatha Srinivasalu, Division of Rheumatology, Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA; Division of Rheumatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Division of Rheumatology, Children's Hospital of Philadelphia; Departments of Pediatrics and Epidemiology, University of Pennsylvania Perelman School of Medicine; Pediatric Translational Research Branch, National Institute of Arthritis, Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA. Funding: This work was supported by a CARRA data analysis grant and the NIAMS Intramural Research Program, grant Z01-AR041184. Conflict of interest: The authors have no financial conflicts of interest to disclose. Correspondence to: Hemalatha Srinivasalu, MD, 111 Michigan Avenue NW, Washington, DC 20010; hsriniva@childrensnational.org.
Erin Brennan Treemarcki, Division of Rheumatology, Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA; Division of Rheumatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Division of Rheumatology, Children's Hospital of Philadelphia; Departments of Pediatrics and Epidemiology, University of Pennsylvania Perelman School of Medicine; Pediatric Translational Research Branch, National Institute of Arthritis, Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA. Funding: This work was supported by a CARRA data analysis grant and the NIAMS Intramural Research Program, grant Z01-AR041184. Conflict of interest: The authors have no financial conflicts of interest to disclose. Correspondence to: Hemalatha Srinivasalu, MD, 111 Michigan Avenue NW, Washington, DC 20010; hsriniva@childrensnational.org.
Dax G. Rumsey, Division of Rheumatology, Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA; Division of Rheumatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Division of Rheumatology, Children's Hospital of Philadelphia; Departments of Pediatrics and Epidemiology, University of Pennsylvania Perelman School of Medicine; Pediatric Translational Research Branch, National Institute of Arthritis, Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA. Funding: This work was supported by a CARRA data analysis grant and the NIAMS Intramural Research Program, grant Z01-AR041184. Conflict of interest: The authors have no financial conflicts of interest to disclose. Correspondence to: Hemalatha Srinivasalu, MD, 111 Michigan Avenue NW, Washington, DC 20010; hsriniva@childrensnational.org.
Pamela F. Weiss, Division of Rheumatology, Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA; Division of Rheumatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Division of Rheumatology, Children's Hospital of Philadelphia; Departments of Pediatrics and Epidemiology, University of Pennsylvania Perelman School of Medicine; Pediatric Translational Research Branch, National Institute of Arthritis, Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA. Funding: This work was supported by a CARRA data analysis grant and the NIAMS Intramural Research Program, grant Z01-AR041184. Conflict of interest: The authors have no financial conflicts of interest to disclose. Correspondence to: Hemalatha Srinivasalu, MD, 111 Michigan Avenue NW, Washington, DC 20010; hsriniva@childrensnational.org.
Robert A. Colbert

Document Type

Journal Article

Publication Date

11-1-2022

Journal

The Journal of rheumatology

DOI

10.3899/jrheum.220509

Abstract

OBJECTIVE: To validate the Juvenile Spondyloarthritis Disease Activity (JSpADA) index, and modified versions thereof, in a North American cohort of patients with enthesitis-related arthritis (ERA). METHODS: We utilized the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry database ERA cohort to validate the JSpADA and its modifications (JSpADA6-no Schober, no CRP/ESR; JSpADA7- no Schober; and JSpADA7- no CRP/ESR) using OMERACT principles of face validity, discriminative validity, and responsiveness to change. RESULTS: There were 51 subjects (64 visits) with complete JSpADA data with a mean age of 13.7 years and disease duration of 30.9 months. Subjects were predominantly white (84.3%) with half of them, male (56.9%), and HLA-B27 positive (50%). The JSpADA showed high correlation with the cJADAS-10 (r=0.81), moderate-to-high correlation with physician global (r=0.69), and low-to-fair correlation with CHAQ (0.22). The modifications of JSpADA (JSpADA7- no Schober, JSpADA7-no CRP/ESR, and JSpADA6 - no Schober, no CRP/ESR) performed similarly with high correlation with cJADAS-10 (r=0.81, 0.79, and 0.80, respectively), moderateto- high correlation with physician global (r=0.65, 0.67, 0.64), and low-to-fair correlation with CHAQ (r= 0.35, 0.34, 0.39). All modified versions of JSpADA had good responsiveness to change. All versions of JSpADA had excellent discriminative validity. CONCLUSION: We propose the term "modified JSpADA" for the modification of JSpADA with 6 elements (JSpADA6 - no Schober, no CRP/ESR). This shorter disease activity index may improve implementation of JSpADA in both clinical practice and research trials.

Department

Pediatrics

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