{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T08:18:39Z","timestamp":1793089119294,"version":"4.5.0"},"reference-count":40,"publisher":"BMJ","issue":"5","funder":[{"name":"NIHR Clinical Research Network Portfolio"},{"name":"NIHR Biomedical Research Centre Funding Scheme"},{"DOI":"10.13039\/501100000341","name":"Arthritis Research UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000341","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR Manchester Musculoskeletal Biomedical Research Unit"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Pain is a very common symptom of juvenile idiopathic arthritis (JIA). Disease activity alone cannot explain symptoms of pain in all children, suggesting other factors may be relevant. The objectives of this study were to describe the different patterns of pain experienced over time in children with JIA and to identify predictors of which children are likely to experience ongoing pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study used longitudinal-data from patients (aged 1\u201316 years) with new-onset JIA. Baseline and up to 5-year follow-up pain data from the Childhood Arthritis Prospective Study (CAPS) were used. A two-step approach was adopted. First, pain trajectories were modelled using a discrete mixture model. Second, multinomial logistic regression was used to determine the association between variables and trajectories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data from 851 individuals were included (4\u2009years, median follow-up). A three-group trajectory model was identified: consistently low pain (n=453), improved pain (n=254) and consistently high pain (n=144). Children with improved pain or consistently high pain differed on average at baseline from consistently low pain. Older age at onset, poor function\/disability and longer disease duration at baseline were associated with consistently high pain compared with consistently low pain. Early increases in pain and poor function\/disability were also associated with consistently high pain compared with consistently low pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study has identified routinely collected clinical factors, which may indicate those individuals with JIA at risk of poor pain outcomes earlier in disease. Identifying those at highest risk of poor pain outcomes at disease onset may enable targeted pain management strategies to be implemented early in disease thus reducing the risk of poor pain outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1136\/archdischild-2017-313337","type":"journal-article","created":{"date-parts":[[2017,11,25]],"date-time":"2017-11-25T17:15:27Z","timestamp":1511630127000},"page":"437-443","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":55,"title":["Patterns of pain over time among children with juvenile idiopathic arthritis"],"prefix":"10.1136","volume":"103","author":[{"given":"Amir","family":"Rashid","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lis","family":"Cordingley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Carrasco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen E","family":"Foster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen M","family":"Baildam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Chieng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce E","family":"Davidson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy R","family":"Wedderburn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiannis","family":"Ioannou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora","family":"McErlane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne M M","family":"Verstappen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8242-9262","authenticated-orcid":false,"given":"Kimme L","family":"Hyrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Thomson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,11,25]]},"reference":[{"key":"2020050712442191000_103.5.437.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2013.09.003"},{"key":"2020050712442191000_103.5.437.2","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.paed.2013.07.008","article-title":"Outcomes for juvenile idiopathic arthritis","volume":"24","author":"Armon","year":"2014","journal-title":"Paediatr Child Health"},{"key":"2020050712442191000_103.5.437.3","first-page":"579","article-title":"Remission in juvenile chronic arthritis: a cohort study of 683 consecutive cases with a mean 10 year followup","volume":"30","author":"Fantini","year":"2003","journal-title":"J Rheumatol"},{"key":"2020050712442191000_103.5.437.4","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/41.12.1436"},{"key":"2020050712442191000_103.5.437.5","doi-asserted-by":"publisher","DOI":"10.1002\/art.24539"},{"key":"2020050712442191000_103.5.437.6","doi-asserted-by":"publisher","DOI":"10.1097\/00002281-200403000-00005"},{"key":"2020050712442191000_103.5.437.7","first-page":"1","article-title":"Neural mechanisms underlying the pain of juvenile idiopathic arthritis","volume":"10","author":"La Hausse de Lalouvi\u00e8re","year":"2014","journal-title":"Nat Rev Rheumatol"},{"key":"2020050712442191000_103.5.437.8","first-page":"832","article-title":"Radiologic outcome and its relationship to functional disability in juvenile rheumatoid arthritis","volume":"30","author":"Oen","year":"2003","journal-title":"J Rheumatol"},{"key":"2020050712442191000_103.5.437.9","unstructured":"Ghio D , Thomson W , Calam R , et al . Development and preliminary validation of the pain perceptions questionnaire for young people with juvenile arthritis, 2016."},{"key":"2020050712442191000_103.5.437.10","doi-asserted-by":"publisher","DOI":"10.1002\/art.10986"},{"key":"2020050712442191000_103.5.437.11","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1038\/nrrheum.2013.108","article-title":"Paediatric rheumatology: Juvenile idiopathic arthritis\u2013are biologic agents effective for pain?","volume":"9","author":"Consolaro","year":"2013","journal-title":"Nat Rev Rheumatol"},{"key":"2020050712442191000_103.5.437.12","doi-asserted-by":"publisher","DOI":"10.1186\/1546-0096-11-21"},{"key":"2020050712442191000_103.5.437.13","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-206034"},{"key":"2020050712442191000_103.5.437.14","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.120642"},{"key":"2020050712442191000_103.5.437.15","doi-asserted-by":"publisher","DOI":"10.1136\/ard.51.3.343"},{"key":"2020050712442191000_103.5.437.16","doi-asserted-by":"publisher","DOI":"10.1002\/art.20238"},{"key":"2020050712442191000_103.5.437.17","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(87)91056-6"},{"key":"2020050712442191000_103.5.437.18","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(97)00110-3"},{"key":"2020050712442191000_103.5.437.19","doi-asserted-by":"publisher","DOI":"10.1037\/a0025075"},{"key":"2020050712442191000_103.5.437.20","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.091375"},{"key":"2020050712442191000_103.5.437.21","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.clinpsy.121208.131413"},{"key":"2020050712442191000_103.5.437.22","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken085"},{"key":"2020050712442191000_103.5.437.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.02.001"},{"key":"2020050712442191000_103.5.437.24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-9125.2005.00026.x"},{"key":"2020050712442191000_103.5.437.25","doi-asserted-by":"crossref","unstructured":"Nagin DS . Group-based trajectory modeling an overview. In: Piquero AR , Weisburd D , eds. Handbook of quantitative criminology. New York, 2010:53\u201367. doi.","DOI":"10.1007\/978-0-387-77650-7_4"},{"key":"2020050712442191000_103.5.437.26","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4067"},{"key":"2020050712442191000_103.5.437.27","doi-asserted-by":"publisher","DOI":"10.1177\/0049124113503141"},{"key":"2020050712442191000_103.5.437.28","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/41.12.1444"},{"key":"2020050712442191000_103.5.437.29","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1002\/art.38223","article-title":"Self-reported pain and disease symptoms persist in juvenile idiopathic arthritis despite treatment advances: an electronic diary study","volume":"66","author":"Bromberg","year":"2014","journal-title":"Arthritis Rheumatol"},{"key":"2020050712442191000_103.5.437.30","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes004"},{"key":"2020050712442191000_103.5.437.31","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.131536"},{"key":"2020050712442191000_103.5.437.32","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kep352"},{"key":"2020050712442191000_103.5.437.33","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2214.2012.01386.x"},{"key":"2020050712442191000_103.5.437.34","first-page":"61","article-title":"The child\u2019s perception of the disease and the experience of pain in juvenile chronic arthritis","volume":"10","author":"Beales","year":"1983","journal-title":"J Rheumatol"},{"key":"2020050712442191000_103.5.437.35","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jss099"},{"key":"2020050712442191000_103.5.437.36","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1002\/acr.22466","article-title":"The association between low socio-economic status with high physical limitations and low illness self-perception in patients with juvenile idiopathic arthritis: Results from the childhood arthritis prospective study","volume":"67","author":"Verstappen","year":"2015","journal-title":"Arthritis Care Res"},{"key":"2020050712442191000_103.5.437.37","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/1546-0096-12-39","article-title":"Pain hypersensitivity in juvenile idiopathic arthritis: a quantitative sensory testing study","volume":"12","author":"Cornelissen","year":"2014","journal-title":"Pediatr Rheumatol Online J"},{"key":"2020050712442191000_103.5.437.38","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsr088"},{"key":"2020050712442191000_103.5.437.39","doi-asserted-by":"publisher","DOI":"10.1186\/1546-0096-11-48"},{"key":"2020050712442191000_103.5.437.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2010.08.003"}],"container-title":["Archives of Disease in Childhood"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/archdischild-2017-313337","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T22:10:00Z","timestamp":1601071800000},"score":1,"resource":{"primary":{"URL":"https:\/\/adc.bmj.com\/lookup\/doi\/10.1136\/archdischild-2017-313337"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,25]]},"references-count":40,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2018,4,19]]},"published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1136\/archdischild-2017-313337"],"URL":"https:\/\/doi.org\/10.1136\/archdischild-2017-313337","relation":{},"ISSN":["0003-9888","1468-2044"],"issn-type":[{"value":"0003-9888","type":"print"},{"value":"1468-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,25]]}}}