{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:40:11Z","timestamp":1790894411922,"version":"4.1.0"},"reference-count":37,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["FKZ 01G19946"],"award-info":[{"award-number":["FKZ 01G19946"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2017,2,7]]},"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To describe the course and the 4-year outcome of juvenile spondyloarthritis (jSpA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with a diagnosis of jSpA and an age at onset \u226416\u2005years were included in the German Spondyloarthritis Inception cohort (GESPIC) and followed up prospectively for 4\u2005years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>118 patients (73% men, 66% HLA-B27 positive, mean age 13.5\u2005years, mean symptom duration 2.2\u2005years) were enrolled in 2 study centres: 52% of patients with jSpA were captured by the enthesitis-related arthritis subgroup of the International League of Associations for Rheumatology classification criteria. At inclusion, the majority of patients had active peripheral arthritis (75.4%), followed by inflammatory back pain (IBP) (19.5%) and enthesitis (16.1%). There was a significant improvement in clinical manifestations and in patient-reported outcomes over time. During the 4-year follow-up, 85% of the patients had at least 1 period of remission on drug \u22656\u2005months, and 46% of the patients achieved remission \u226512\u2005months without medication, of whom 68% kept this status and 32% worsened. At the end of 4\u2005years of observation, 23% of the patients were in remission without medication, but 57% still suffered from active disease. Patients with peripheral arthritis had a likelihood of 29% for having peripheral arthritis after 4\u2005years, whereas the likelihood of IBP persistence was 53% for those with IBP at enrolment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Although 1 quarter of patients with jSpA achieved remission off medication after 4\u2005years, the likelihood of having recurrent or persistent disease into adulthood is substantial, particularly for jSpA with IBP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>NCT 01277419.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2016-000366","type":"journal-article","created":{"date-parts":[[2017,3,21]],"date-time":"2017-03-21T20:55:14Z","timestamp":1490129714000},"page":"e000366","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Course of patients with juvenile spondyloarthritis during 4\u2005years of observation, juvenile part of GESPIC"],"prefix":"10.1136","volume":"3","author":[{"given":"Anja","family":"Wei\u00df","sequence":"first","affiliation":[{"name":"German Rheumatism Research Center, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Minden","sequence":"additional","affiliation":[{"name":"German Rheumatism Research Center, Berlin, Germany"},{"name":"Charit\u00e9 University Medicine Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Listing","sequence":"additional","affiliation":[{"name":"German Rheumatism Research Center, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Foeldvari","sequence":"additional","affiliation":[{"name":"Hamburg Center for Pediatric Rheumatology, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Sieper","sequence":"additional","affiliation":[{"name":"Charit\u00e9 University Medicine Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Rudwaleit","sequence":"additional","affiliation":[{"name":"Klinikum Bielefeld, Bielefeld, Germany"},{"name":"Charite University, Medicine, Berlin, Germany"},{"name":"Ghent University, Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,3,21]]},"reference":[{"key":"2025090313515131000_3.1.e000366.1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2012.37"},{"key":"2025090313515131000_3.1.e000366.2","doi-asserted-by":"publisher","DOI":"10.1186\/1546-0096-10-14"},{"key":"2025090313515131000_3.1.e000366.3","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.092304"},{"key":"2025090313515131000_3.1.e000366.4","first-page":"869","article-title":"The place of juvenile onset spondyloarthropathies in the Durban 1997 ILAR classification criteria of juvenile idiopathic arthritis. 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