The long-term impact of juvenile idiopathic arthritis into adulthood: a systematic review

Abstract Objectives Juvenile idiopathic arthritis (JIA), a childhood-onset chronic condition, often persists into adulthood. However, most studies investigating outcomes of JIA are limited to childhood, missing the long-term impact of the condition. This systematic literature review aimed to: identify the frequency of children with JIA that (i) continue to have active disease in adulthood, (ii) have limited functional ability in adulthood, (iii) are impacted by mental health problems in adulthood, and (iv) describe the impact of JIA on quality of life in adulthood compared with non-JIA peers. Methods The literature was searched for published reports of observational studies that measured outcomes in adults aged 18 years or over with an existing diagnosis of JIA. Outcomes of interest included disease activity, functional ability, mental health, and quality of life. Results Forty-four studies were included. When limited to studies that identified participants during childhood, 33-66% of adults with JIA had active disease, and 28-58% had limited functional ability. Mental health diagnoses were found in up to 19% of adults with JIA, and physical health-related quality of life measures were consistently lower in adults with JIA compared with non-JIA comparators. Conclusion Despite being a childhood-onset condition, a substantial proportion of adults with JIA experience active disease, limited functional ability, and mental health problems beyond 18 years old, as well as report poorer physical health-related quality of life. This is valuable information to support future research into the impact of JIA in adulthood, and how best to support individuals throughout the life-course of their condition.