Cross sectional, qualitative thematic analysis of patient perspectives of disease impact in juvenile idiopathic arthritis-associated uveitis

Sen, Ethan S; Morgan, Michelle; MacLeod, Rachael; Strike, Helen; Hinchcliffe, Ann; Dick, Andrew D.; Muthusamy, Brinda; Ramanan, Athimalaipet V

doi:10.1186/s12969-017-0189-6

Cited by 34 publications

(23 citation statements)

References 25 publications

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“…Nevertheless, previous studies mostly focused on children with JIA, which is the most frequent cause for uveitis and the most important rheumatic disease with extra-articular signs. Epidemiologically, owing to differences in the type of studies, the geographical area as well as the different criteria for determining uveitis between 11.6 and 30.0% [53,54], the prevalence of uveitis associated with JIA was varied. However, our meta-analyses yielded a pooled prevalence of 11.8% (95%CI: 11.2 to 12.4%) for uveitis following JIA, which is close to the lower limit of the prevalence published in the literature.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological and advanced therapeutic approaches to treatment of uveitis in pediatric rheumatic diseases: a systematic review and meta-analysis

Jari

Shiari

Salehpour

et al. 2020

Orphanet J Rare Dis

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Background: Despite the low prevalence of uveitis in pediatric rheumatic diseases, potential problems as well as high disease burden can complicate its management. In this review, we systematically assessed the epidemiological, etiological, and managerial aspects of uveitis in pediatric rheumatic diseases. Methods: This current study was conducted in accordance with the established methods and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). We searched the manuscript databases, including Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane for all eligible studies in line with the considered keywords. We also conducted the statistical analysis using the Stata software. Results: Considering studies focusing on uveitis in Juvenile Idiopathic Arthritis (JIA) yielded a pooled prevalence of 11.8% (95%CI: 11.2 to 12.4%) for uveitis following JIA. In this regard, the prevalence rate of uveitis related to Behçet , s disease and Systemic Lupus Erythematosus (SLE(was estimated to be 15.0 and 0.8%, respectively. The pooled response rate to Adalimumab and Infliximab was estimated to be 68.0% (95%CI: 65.4 to 70.6%), 64.7% (95%CI: 59.8 to 69.3%), respectively. The documents for the systematical assessment of other biological medications (e.g. Tocilizumab, Daclizumab and Rituximab) were inadequate; however, the mean response rate for these drugs was 59, 75 and 80%, respectively. Our meta-analysis showed a pooled response rate of 40.0% (95%CI, 36.0% to 44.2) to Methotrexate. Significant heterogeneity and significant diffusion bias were demonstrated by reviewing studies. Conclusions: The pooled prevalence of uveitis in pediatric rheumatic diseases widely varied based on the underlying disease requiring more investigations in different subtypes of rheumatic diseases. The biologic medications, especially Adalimumab are the most effective treatments for uveitis in pediatric rheumatic diseases; however, a combination of the safe, available alternatives is preferred to achieve the most desirable treatment response.

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Section: Discussionmentioning

confidence: 99%

Epidemiological and advanced therapeutic approaches to treatment of uveitis in pediatric rheumatic diseases: a systematic review and meta-analysis

Jari

Shiari

Salehpour

et al. 2020

Orphanet J Rare Dis

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“…We also recognise the burden to children and their families managing frequent hospital appointments, eye drops and immunosuppression regimes. Even in the absence of long term complications, uveitis can have emotional and psychological consequences for the child and family encompassing anxiety, anger and fear of the future [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of non-infectious Paediatric uveitis in the era of biologic therapy

et al. 2018

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BackgroundThere is a paucity of data on the ocular outcomes in paediatric non-infectious uveitis since the introduction of the biologic agents. The purpose of this study was to outline the clinical characteristics of children with non-infectious uveitis and determine the visual outcomes and ocular complication rates in the modern era.MethodsChildren with non-infectious uveitis from January 2011 to December 2015 were identified. Data was collected at baseline, 1, 3, 5, and 10 years post diagnosis. The incidence rates of visual impairment, structural ocular complications and surgical intervention were calculated. Using logistic regression the association between various baseline characteristics and later visual impairment was investigated.ResultsOf the 166 children, 60.2% (n = 100) had a systemic disease association. 72.9% (n = 121) children received methotrexate, 58 children progressed to a biologic. The incidence rates of visual acuity loss to > 0.3 LogMAR (6/12) and to ≥1.0 LogMAR (6/60) were 0.05/Eye Year (EY) and 0.01/EY, respectively. Visual outcomes in the Juvenile Idiopathic Arthritis associated Uveitis (JIA-U) and Idiopathic Uveitis cohorts were not statistically significant. Of the 293 affected eyes, posterior synechiae was the predominant complication on presentation, while cataract had the highest incidence rate (0.05/EY). On direct comparison, children with JIA-U were statistically significantly more likely to develop glaucoma while children with Idiopathic Uveitis were statistically significantly more likely to develop macular oedema.ConclusionOne third of children received a biological therapy, reflecting increasing utilisation and importance of biological agents in the management of inflammatory conditions. Rates of visual impairment and ocular complications are an improvement on previously published data.

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“…Indeed, JIA patients usually present a lower physical well-being dimension associated with increased difficulties in performing regular physical activity as compared with healthy subjects [49,50], and this was highly correlated with a lower HRQoL among JIA adolescents [51]. Moreover, these patients are constantly treated for their chronic pathology and they also undergo regular medical consultations due to pain, physical disability and eye-related problems (uveitis) that negatively affect their emotions, their possibility to attend school and their daily activities [52]. Finally, since the progression of the pathology is characterized by frequent relapses, these patients require constant follow-up over the years, which is associated with a high number of hospitalizations, stressful treatment experiences (e.g., repeated intravenous infusions, frequent injections), and regular multi-professional treatment approaches [53].…”

Section: Discussionmentioning

confidence: 99%

The Psychological Impact of Dental Aesthetics in Patients with Juvenile Idiopathic Arthritis Compared with Healthy Peers: A Cross-Sectional Study

et al. 2019

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This study aimed to assess whether dental aesthetics had a different impact on the psychosocial domains of adolescents with juvenile idiopathic arthritis (JIA) as compared with healthy peers. Fifty JIA patients and eighty controls aged between 13 and 17 years were enrolled. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was administered along with tools for the self-assessment of malocclusion and self-esteem. An objective evaluation of malocclusion severity was performed through a clinical evaluation with the Dental Aesthetic Index (DAI). The sample was divided according to the DAI stages of malocclusion severity; a two-way analysis of variance (ANOVA) was performed to assess whether there was a difference in the studied variables according to the malocclusion and the presence of JIA. The results showed no interaction between the malocclusion severity and the presence of JIA in all analyzed variables (all p > 0.05). According to the DAI stages, the Dental Self-Confidence domain of the PIDAQ and the Perception of Occlusion Scale showed statistically significant differences only within the controls (p = 0.027 and p = 0.014, respectively). Therefore, JIA adolescents seem to be less concerned about their dental aesthetics compared with healthy peers, and clinicians should take particular care when proposing orthodontic treatments aiming only to improve dental aesthetics.

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Cross sectional, qualitative thematic analysis of patient perspectives of disease impact in juvenile idiopathic arthritis-associated uveitis

Cited by 34 publications

References 25 publications

Epidemiological and advanced therapeutic approaches to treatment of uveitis in pediatric rheumatic diseases: a systematic review and meta-analysis

Epidemiological and advanced therapeutic approaches to treatment of uveitis in pediatric rheumatic diseases: a systematic review and meta-analysis

Outcomes of non-infectious Paediatric uveitis in the era of biologic therapy

The Psychological Impact of Dental Aesthetics in Patients with Juvenile Idiopathic Arthritis Compared with Healthy Peers: A Cross-Sectional Study

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