PERFORMANCE OF THE PRELIMINARY DEFINITION OF IMPROVEMENT (PDI) IN JIA PATIENTS TREATED WITH MTX: EXPERIENCE FROM BANGLADESH
Mohammad I Islam*, Mahmuda Hossain**, Shahana Akhter Rahman***
Zitkha sub-center, Harirampur Upazilla Health Complex, Manikganj *, Zitkha sub-center, Harirampur Upazilla Health Complex, Manikganj. **, Zitkha sub-center, Harirampur Upazilla Health Complex, Manikganj. ***
Abstract
Objective
To investigate the performance of PDI in JIA patients treated with MTX.

Method
It was a prospective observational study. All the patients fulfilling the ILAR classification criteria had the core set of variables assessed at base line and followed up 4th, 12th and 24th week of treatment. Variables in the core set are:
  1. Physician global assessment of disease activity
  2. Patients and parents global assessment of disease activity
  3. Functional ability
  4. Number of joints with active arthritis
  5. Erythrocyte sedimentation rate

Patients are classified as improved or not improved according to PDI. Definition of improvement was selected as: 30% improvement from baseline in three of any six variables in the core set with no more than one of the remaining variables worsening by > 30%.

Results
A total of forty children with JIA 29 and 11 girls completed the six month treatment regimen. At the end, most of the patients (92.5%) had been declared as improved according to PDI. Among the core set variables active arthritis physicians and patients global assessment of disease activity detected the highest percentage of patients improved (92.5%) and functional assessment the lowest (37%).

Conclusion
The PDI identified that maximum JIA patients treated with MTX were improved.
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Islam I M, Hossain M, Rahman A S.. Available From : http://www.pediatriconcall.com/fordoctor/ Conference_abstracts/report.aspx?reportid=68
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