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Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients
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Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients

Published on: March 1, 2024

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The Juvenile Psoriatic Arthritis Cohort in the CARRA Registry: Clinical Characteristics, Classification, and Outcomes

Devy Zisman, Dafna D Gladman, Matthew L Stoll

    The Journal of Rheumatology
    |February 3, 2017
    PubMed

    Insights

    Juvenile psoriatic arthritis (JPsA) patients may be divided into two groups based on age at onset. While objective symptoms improved, patient-reported outcomes did not, suggesting a need to unify JPsA and adult psoriatic arthritis classification criteria.

    Area of Science:

    • Rheumatology
    • Pediatric Rheumatology
    • Clinical Immunology

    Background:

    • Juvenile psoriatic arthritis (JPsA) is a complex condition requiring precise classification.
    • Current classification criteria, including the International League of Associations for Rheumatology (ILAR) and Classification criteria for Psoriatic Arthritis (CASPAR), may not fully capture all pediatric cases.

    Purpose of the Study:

    • To analyze demographic and clinical features of children with JPsA.
    • To compare JPsA patients classified by ILAR and CASPAR criteria.
    • To investigate the relationship between age at disease onset and clinical presentation in JPsA.

    Main Methods:

    • Cross-sectional analysis of 361 children in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry.
    • Stratification of patients by age at disease onset (≤ or > 4 years).
    • Comparison of baseline and 1-year follow-up data using statistical tests.

    Main Results:

    • 72.02% of patients had symptom onset after 4 years of age, with male predominance and high enthesitis prevalence.
    • Statistically significant improvements were observed in arthritis, dactylitis, enthesitis, psoriasis, sacroiliitis, and nail pitting at follow-up.
    • Patients meeting CASPAR criteria but not ILAR criteria showed more enthesitis, sacroiliitis, inflammatory bowel disease, and uveitis, with less psoriasis.

    Conclusions:

    • JPsA patients can be divided into two clinical subgroups based on age at disease onset.
    • Objective symptom improvement did not correlate with health questionnaire scores.
    • Unifying adult and pediatric psoriatic arthritis classification criteria should be considered, as current pediatric criteria may not identify all children meeting adult criteria.
    Abstract

    Keywords:
    EPIDEMIOLOGYJUVENILE IDIOPATHIC ARTHRITISMANIFESTATIONSPSORIATIC ARTHRITISSPONDYLOARTHROPATHY

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