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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Dec 9, 2025; 14(4): 108878
Published online Dec 9, 2025. doi: 10.5409/wjcp.v14.i4.108878
Published online Dec 9, 2025. doi: 10.5409/wjcp.v14.i4.108878
Juvenile arthritis damage index predicts poor response to biological treatment: A prospective cohort study
Zarina A Kolkhidova, Irina P Nikishina, Svetlana I Glukhova, Department of Pediatric Rheuma
Oleg G Melikhov, Department of Clinical, Institute of Clinical Research, Moscow 119590, Moskva, Russia
Mikhail M Kostik, Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Sankt-Peterburg, Russia
Co-first authors: Zarina A Kolkhidova and Irina P Nikishina.
Author contributions: Kolkhidova ZA, Nikishina IP, and Kostik MM conceptualized the manuscript, provided resources, and wrote the manuscript; Kolkhidova ZA and Nikishina IP contributed equally to this article, they are the co-first authors of this manuscript; Nikishina IP, Kostik MM, Kolkhidova ZA, and Melikhov OG designed the manuscript; Nikishina IP contributed supervision; Nikishina IP and Kolkhidova ZA provided materials for the manuscript and conducted a literature search; Kolkhidova ZA performed data collection and/or processing; Nikishina IP, Kolkhidova ZA, and Glukhova SI performed analysis and/or data interpretation; Nikishina IP, Glukhova SI, Melikhov OG, and Kostik MM conducted critical review; and all authors were involved in drafting or revising the article for important intellectual content, and all authors approved the final version to be published.
Supported by an Independent Grant from Pfizer.
Institutional review board statement: This study was approved by the Medical Ethics Committee of V.A. Nasonova Institute of Rheumatology, approval No. 22.
Clinical trial registration statement: This study is registered at URL: https://rheumatolog.su/specialists/ds/dissertations/de8b017c-33b0-4145-b208-fda219cf5be2/. The registration identification No. 22, dated November 23, 2021.
Informed consent statement: According to the Declaration of Helsinki, written consent from the parents and patients older than 14 years has been obtained.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mikhail M Kostik, MD, PhD, Professor, Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Lytovskaya 2, Saint Petersburg 194100, Sankt-Peterburg, Russia. kost-mikhail@yandex.ru
Received: April 24, 2025
Revised: May 11, 2025
Accepted: August 12, 2025
Published online: December 9, 2025
Processing time: 190 Days and 2.7 Hours
Revised: May 11, 2025
Accepted: August 12, 2025
Published online: December 9, 2025
Processing time: 190 Days and 2.7 Hours
Core Tip
Core Tip: This prospective study of biological-naïve juvenile idiopathic arthritis patients demonstrates that baseline articular/extraarticular damage (assessed via the juvenile arthritis damage index) predicts reduced response to biological disease-modifying antirheumatic drugs. Patients with baseline damage demonstrated higher disease activity (polyarticular course, elevated juvenile arthritis disease activity score 71, magnetic resonance imaging erosions) than those without damage. The observed juvenile arthritis damage index reduction in juvenile idiopathic arthritis patients showed significant associations with baseline joint damage status, treatment stability, and absence of uveitis/osteonecrosis. This index en