Risk Markers of Juvenile Idiopathic Arthritis-associated Uveitis in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry

Abstract

OBJECTIVES To characterize the epidemiology and clinical course of children with juvenile idiopathic arthritis-associated uveitis (JIA-U) in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry and explore differences between African American (AA) and Non-Hispanic White (NHW) children. METHODS There were 3,967 NHW and AA children with JIA enrolled in the CARRA Registry. Demographic and disease-related data were collected from time of diagnosis to enrollment. Children with JIA alone were compared to those with JIA-U. Children with JIA-U were then compared by race. RESULTS Mean age of children with JIA-U was 11.4 years (±4.5), 76.9% were female and 2.8% were AA. Children with JIA-U were younger at arthritis onset, female, required more medications, had <5 joints involved, had oligoarticular JIA, and ANA (+), RF (−) and anti-CCP (−). AA children with JIA-U had decreased uveitis frequency, were older at arthritis onset and more frequently diagnosed with enthesitis-related JIA. Predictors of uveitis development include female gender, early age of arthritis onset, and oligoarticular persistent and extended JIA classification, whereas polyarticular RF-positive JIA was protective. CONCLUSIONS The prevalence of JIA-U in AA and NHW children is 11.6% in the CARRA registry. Known risk markers (ANA, age at arthritis onset, and oligoarticular JIA) were more frequent in our JIA-U cohort. AA children had a lower frequency of JIA-U. There were significant differences in age of arthritis onset and JIA subtype between NHW and AA children, although the ANA, RF and HLA-B27 were similar. Exploration of race as a risk factor should be considered.

Phenotypic Characterization of Juvenile Idiopathic Arthritis in African American Children

“…Racial differences have also been described by Angeles-Han et al in children with JIA-associated uveitis enrolled in the CARRA registry. (13) Non-Hispanic AA children with JIA had a decreased uveitis prevalence compared to NHW and were older at JIA diagnosis. We could not confirm this finding using a larger cohort after correction for multiple testing.…”

“…(7, 10, 13) Race and ethnicity were found to be variably associated with joint damage, pain, and functional ability by Ringold et al who compared 234 AA and 78 Asian children with 4039 White children. (7) Onset age was higher among AA and Asian children compared to White children.…”

Can the Methotrexate Therapy Prevent the Development of Uveitis in Patients with Juvenile Idiopathic Arthritis: Results of a Retrospective Study

“…Примечательно, что в сравнении с исследованием, выполненном в Италии [22], увеличение в 2 раза пропорции пациентов, получающих метотрексат, привело к снижению риска развития увеита более чем в 4 раза. Нами определены основные предикторы развития увеита, хорошо извест-ные по результатам ряда предыдущих исследований [6,9,12]. Патофизиологические основы эффективного предотвращения риска увеита показаны в эксперимен-тальных исследованиях, отражающих способность мето-трексата проникать в ткани глаза и создавать там более высокие концентрации, чем в плазме крови [26,27].…”

“…Более короткий интервал меж-ду началом артрита и развитием увеита служит прог-ностическим признаком тяжелого течения увеита [8]. В предшествующих исследованиях было показано, что основными факторами риска развития увеита явля-ются олигоартикулярный субтип артрита, ранний воз-раст дебюта и серопозитивность по антинуклеарному фактору (АНФ) [9].…”

The Efficiency of Adalimumab in Cases of Chronic Methotrexate-Resistant Juvenile Idiopathic Arthritis-Associated Anterior Uveitis: Retrospective Case Series Study

“…Более короткий интервал между началом артрита и развитием увеита служит прогностическим признаком тяжелого течения увеита [4]. В ранее про-веденных исследованиях установлены основные фак-торы риска развития увеита: олигоартикулярный субтип артрита, ранний возраст манифестации, серопозитив-ность по антинуклеарному фактору, высокое содержа-ние С-реактивного белка в дебюте болезни [5].…”