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Risk markers of juvenile idiopathic arthritis-associated uveitis in the Childhood Arthritis and Rheumatology Research
Sheila T Angeles-Han1, Christina F Pelajo, Larry B Vogler
1From the Department of Pediatrics, and Rollins School of Public Health, Emory University, Atlanta, Georgia; Department of Pediatric Rheumatology, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts; and Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
Insights
Juvenile idiopathic arthritis-associated uveitis (JIA-U) affects 11.6% of children in the CARRA Registry, with known risk factors confirmed. African American children showed a decreased likelihood of developing JIA-U.
Area of Science:
- Pediatric Rheumatology
- Ophthalmology
- Immunology
Background:
- Juvenile idiopathic arthritis-associated uveitis (JIA-U) is a significant complication of JIA.
- Understanding the epidemiology and clinical course of JIA-U is crucial for early diagnosis and management.
- Racial disparities in JIA-U prevalence and presentation warrant further investigation.
Purpose of the Study:
- To characterize the epidemiology and clinical course of JIA-U within the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry.
- To explore potential differences in JIA-U between African American (AA) and non-Hispanic white (NHW) children.
- To identify risk factors associated with the development of JIA-U.
Main Methods:
- Analysis of data from 3967 NHW and AA children with JIA enrolled in the CARRA Registry.
- Comparison of demographic and disease-related data between children with JIA and those with JIA-U.
- Stratification of JIA-U cases by race to identify disparities.
Main Results:
- The prevalence of JIA-U was 11.6% in the study cohort.
- Children with JIA-U were younger at onset, more likely female, and had oligoarticular JIA with ANA positivity.
- African American children represented nearly 3% of JIA-U cases, with a lower prevalence (6%) compared to NHW children (12%).
Conclusions:
- The study confirmed known risk factors for JIA-U, including ANA positivity, early onset of arthritis, and oligoarticular JIA.
- A decreased likelihood of JIA-U was observed in African American children compared to NHW children.
- Further research with larger populations of AA children is recommended to explore race as a risk factor for JIA-U.
Objective:
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 4983 children with JIA enrolled in the CARRA Registry. Of those, 3967 NHW and AA children were included in this study. Demographic and disease-related data were collected from diagnosis to enrollment. Children with JIA were compared to those with JIA-U. Children with JIA-U were also compared by race.
Results:
There were 459/3967 children (11.6%) with JIA-U in our cohort with a mean age (SD) of 11.4 years (± 4.5) at enrollment. Compared to children with JIA, they were younger at arthritis onset, more likely to be female, had < 5 joints involved, had oligoarticular JIA, and were antinuclear antibody (ANA)-positive, rheumatoid factor (RF)-negative, and anticitrullinated protein antibody-negative. Predictors of uveitis development included female sex, early age of arthritis onset, and oligoarticular JIA. Polyarticular RF-positive JIA subtype was protective. Nearly 3% of children with JIA-U were AA. However, of the 220 AA children with JIA, 6% had uveitis; in contrast, 12% of the 3721 NHW children with JIA had uveitis.
Conclusion:
In the CARRA registry, the prevalence of JIA-U in AA and NHW children is 11.6%. We confirmed known uveitis risk markers (ANA positivity, younger age at arthritis onset, and oligoarticular JIA). We describe a decreased likelihood of uveitis in AA children and recommend further exploration of race as a risk factor in a larger population of AA children.
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