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rheumatology paediatrics

JADAS-27 — Juvenile Arthritis Disease Activity Score

Composite disease-activity score for juvenile idiopathic arthritis (Consolaro 2009). JADAS-27 = physician global (0–10) + parent/patient global (0–10) + active joint count in 27 joints (0–27) + normalised ESR ((ESR − 20)/10, limited to 0–10). Range 0–57. Cut-offs differ for oligoarticular and polyarticular JIA.

Score interpretation

Inactive Disease (≤ 1) 0–1

JADAS-27 ≤ 1: inactive disease in oligoarticular and polyarticular JIA (Consolaro 2012).

→ Continue current therapy; consider tapering only after sustained inactive disease, with paediatric rheumatology.

Minimal Disease Activity 1.01–2

Oligoarticular (≤ 2) and polyarticular (≤ 3.8): minimal disease activity.

→ Treat-to-target; optimise the current DMARD and reassess in 1–3 months.

Oligoarticular: Moderate · Polyarticular: Minimal 2.01–3.8

Oligoarticular JIA: moderate activity (2.1–4.2). Polyarticular JIA: minimal disease activity (≤ 3.8).

→ Oligoarticular: Step up therapy with paediatric rheumatology: methotrexate review, add or switch biologic per NICE TAs. Polyarticular: Treat-to-target; optimise the current DMARD and reassess in 1–3 months.

Moderate Disease Activity 3.81–4.2

Oligoarticular (2.1–4.2) and polyarticular (3.9–8.5): moderate disease activity.

→ Step up therapy with paediatric rheumatology: methotrexate review, add or switch biologic per NICE TAs.

Oligoarticular: High · Polyarticular: Moderate 4.21–8.5

Oligoarticular JIA: high activity (> 4.2). Polyarticular JIA: moderate activity (3.9–8.5).

→ Oligoarticular: Urgent paediatric rheumatology review: escalate therapy (biologic switch, intra-articular or systemic corticosteroids); imaging for joint damage. Polyarticular: Step up therapy with paediatric rheumatology: methotrexate review, add or switch biologic per NICE TAs.

High Disease Activity 8.51–57

Oligoarticular (> 4.2) and polyarticular (> 8.5): high disease activity (Consolaro 2014).

→ Urgent paediatric rheumatology review: escalate therapy (biologic switch, intra-articular or systemic corticosteroids); imaging for joint damage.

Interpretation bands for the JADAS-27. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Drugs
Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.