Outcomes for juvenile idiopathic arthritis

There is a shift towards early aggressive treatment with the intention to switch off inflammation since there may be a 'window of opportunity' before the disease becomes chronic. There is clear evidence for improved outcome in adult patients treated with this approach ('treat to target') but limited paediatric evidence to date. The explosion in anticytokine agents for treatment of disease resistant to conventional therapy has expanded our armamentarium, improving short term clinical outcomes, but it is still unclear whether we have achieved significant improvements in outcome longer term. This review describes the disease and current and longer-term data on outcomes for this common chronic childhood condition.