Objective This study aimed to identify key prognostic factors for a successful transition from pediatric to adult rheumatology care. Methods A retrospective analysis was conducted of patients enrolled in the transition program at the Hamburg Centre for Pediatric and Adolescent Rheumatology between December 2014 and December 2023. Only patients who received disease-modifying antirheumatic drugs (DMARDs) during their disease course, were offered to participate in the transition program. The first two visits (T1 and T2) were conducted in presence of both specialists at the same time in the pediatric rheumatology clinic, followed by a third visit (T3) at the adult rheumatology clinic. Successful transitions were defined as attendance at the T3. Patients who decided to leave the program were excluded. Variables analyzed included demographics, diagnosis, treatment, joint count and Childhood Health Assessment Questionnaire (CHAQ) scores. Results Out of 547 included patients, 359 (65.6%) completed the transition successfully. Completion was highest in patients with uveitis (96%, with the lowest risk to discontinue the transition process (RDTP) of 0.16), biologic DMARD therapy (83.3%, with an RDTP of 0.42), and combination DMARD treatment (91.2%, with an RDTP of 0.27). The success rate among patients not receiving medication at T1 was 56.6% (RDTP of 1.48). Higher joint counts, increased disease activity, and elevated CHAQ scores are associated with a successful transition to adult care. Conclusion Higher disease activity, ongoing DMARD treatment and specific diagnoses such as uveitis are associated with better transition outcomes. Patients with no active treatment may require additional support.
Narberhaus et al. (Sun,) studied this question.