Chiara TrinciantiEvert Hendrik Pieter Van DijkhuizenAlessandra AlongiMarta MazzoniJoost F. SwartIrina NikishinaPekka LahdenneLidia Rutkowska-SakTadej AvcinPierre QuartierVioleta PanavieneYosef UzielChris PruunsildVeronika VargovaSoamarat VilaiyukPavla DolezalovaSarah RingoldMarco GarroneNicolino RupertoAngelo RavelliAlessandro ConsolaroRamathibodi HospitalSeattle Children's HospitalUniversité Paris CitéV.A. Nasonova Research Institute of RheumatologyUniversity Children's Hospital, LjubljanaWilhelmina KinderziekenhuisTartu Ülikooli KliinikumVilniaus UniversitetasVšeobecná Fakultní Nemocnice v PrazePavol Jozef Safarik University in KosiceUniversità degli Studi di GenovaHelsinki University HospitalIstituto Giannina GasliniTel Aviv UniversityNational Institute of Geriatrics2022-08-042022-08-042021-11-01Arthritis and Rheumatology. Vol.73, No.11 (2021), 1966-197523265205232651912-s2.0-85116323480https://repository.li.mahidol.ac.th/handle/20.500.14594/77202Objective: To develop and validate new Juvenile Arthritis Disease Activity Score 10 (JADAS10) and clinical JADAS10 (cJADAS10) cutoffs to separate the states of inactive disease (ID), minimal disease activity (MiDA), moderate disease activity (MoDA), and high disease activity (HDA) in children with oligoarthritis and with rheumatoid factor–negative polyarthritis, based on subjective disease assessment by the treating pediatric rheumatologist. Methods: The cutoffs definition cohort was composed of 1,936 patients included in the multinational Epidemiology, Treatment and Outcome of Childhood Arthritis (EPOCA) study. Using the subjective physician rating as an external criterion, 4 methods were applied to identify the cutoffs: mapping, Youden index, 90% specificity, and maximum agreement. The validation cohort included 4,014 EPOCA patients, patients from 2 randomized trials, and 88 patients from the PharmaChild registry. Cutoff validation was conducted by assessing discriminative and predictive ability. Results: The JADAS10 cutoffs were 1.4, 4, and 13, respectively, for oligoarthritis and 2.7, 6, and 17, respectively, for polyarthritis. The cJADAS10 cutoffs were 1.1, 4, and 12, respectively, for oligoarthritis and 2.5, 5, and 16, respectively, for polyarthritis. The cutoffs discriminated strongly among different levels of pain and morning stiffness, between patients who were and those who were not prescribed a new medication, and between different levels of improvement in clinical trials. Achievement of ID and MiDA according to the new JADAS cutoffs at least twice in the first year of disease predicted better outcome at 2 years. Conclusion: The 2021 JADAS and cJADAS cutoffs revealed good metrologic properties in both definition and validation samples, and are therefore suitable for use in clinical trials and routine practice.Mahidol UniversityImmunology and MicrobiologyMedicineArticleSCOPUS10.1002/art.41879