Predicting disease outcomes in juvenile idiopathic arthritis: challenges, evidence, and new directions

The aims of treating juvenile idiopathic arthritis (JIA) are to elicit treatment response toward remission, whilst preventing future flare. Understanding patient and disease characteristics that predispose young people with JIA to these outcomes would allow the forecasting of disease process and the tailoring of therapies. Currently, the strongest predictor of remission is disease category, particularly oligoarthritis, although a few additional clinical predictors of treatment response have been identified. More novel evidence using biomarkers, such as S100 proteins and novel single nucleotide polymorphism data, may add value to clinical models. Future directions for personalised medicine in JIA will be aided with international collaborations, allowing for the analysis of larger datasets with novel biomarker data. In a complex disease such as JIA, it is likely that a combined clinical and biomarker panel will be required for predicting outcome.