Prognosis
Reports suggest that approximately two-thirds of patients achieve remission or inactive disease.[119] However, outcome is variable depending on disease subtype, and long-term outcome is best predicted by disease characteristics at 5 years follow-up than at onset.[120] Generally speaking, there have been vast improvements in the past decade as a result of novel and highly effective therapeutic modalities.
Shorter disease duration prior to treatment, good initial response to therapy, and aggressive therapy result in a higher likelihood and longer duration of clinically inactive disease in patients with polyarticular JIA.[121] Unfortunately, some patients do not respond to treatment and experience moderate to severe disabilities.
Oligoarticular disease appears to have the best prognosis, with better functional outcomes, and a greater proportion of patients achieve remission.[122] A greater proportion of patients with rheumatoid factor-positive and systemic-onset subtypes continue to have active disease after several years.
Juvenile idiopathic onset-associated uveitis is the most common extra-articular manifestation and can lead to visual impairment if disease is poorly controlled. Although most patients have good outcomes when properly monitored and treated, 25% to 50% of children with uveitis develop cataracts, glaucoma, or synechiae, and 10% to 20% develop visual loss.[123]
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