PEDIATRIC AND HERITABLE DISORDERS: Edited by Polly J. FergusonPredicting disease severity and remission in juvenile idiopathic arthritis: are we getting closer?Guzman, Jaimea; Oen, Kiemb; Loughin, Thomasc Author Information aDepartment of Pediatrics, University of British Columbia, Vancouver bDepartment of Pediatrics and Child Health, University of Manitoba, Winnipeg cDepartment of Statistics and Actuarial Sciences, Simon Fraser University, Burnaby, Canada Correspondence to Dr Jaime Guzman, MD, MSc, Division of Pediatric Rheumatology, BC Children's Hospital, 4500 Oak Street, Suite K4-122, Vancouver BC, Canada V6H 3N1. E-mail: [email protected] Current Opinion in Rheumatology: September 2019 - Volume 31 - Issue 5 - p 436-449 doi: 10.1097/BOR.0000000000000620 Buy Metrics Abstract Purpose of review To summarize current research on the prediction of severe disease or remission in children with juvenile arthritis, and define further steps needed towards developing prediction tools with sufficient accuracy for clinical use. Recent findings High disease activity, poor patient-reported outcomes, ankle or wrist involvement, and a longer time from onset to the start of treatment herald a severe disease course and a low chance of remission. Other studies confirmed that age less than 7 years and positive ANA are the strongest predictors of uveitis development. Preliminary evidence suggests ultrasound findings may predict flare in patients with clinically inactive disease, and several new biomarkers show promise. A few prediction tools that combine predictors to estimate the chance of remission or a severe disease course in the medium-term to long-term have shown good accuracy when internally validated in the population in which they were developed. Summary Promising candidate tools for predicting disease severity and long-term remission in juvenile arthritis are now available. These tools need external validation in other populations, and ideally formal trials to assess whether their use in practice improves patient outcomes. We are definitively getting closer, but we are not there yet. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.