Evaluation of disease activity in a low-income juvenile idiopathic arthritis cohort

Rheumatol Int. 2019 Jan;39(1):67-71. doi: 10.1007/s00296-018-4128-8. Epub 2018 Aug 13.

Abstract

Determine disease activity in a low income juvenile idiopathic arthritis (JIA) cohort. 164 JIA patients from families with less than US$ 4500.00/capita mean annual income followed in Fortaleza-CE, Brazil, were cross-sectionally evaluated between May 2015-April 2016. Mean age was 14 ± 5.1 years (95 female) with 10.31 ± 3.7 years disease duration. Polyarticular category predominated, with 63 (38.4%) patients, followed by 40 (24%) enthesitis-related (ERA), and 36 (22%) oligoarticular. All but 1 out of 84 parents declared less than US$ 10,000.00 annual family income. Eighty-eight (60.7%) were receiving methotrexate and 19 (13%) leflunomide including 12 (63%) using both; 46 (28%) were on biologic DMARD including 20 (43.5%) adalimumab, 17 (41.5) etanercept, 5 (10.8%) tocilizumab, 2 (4.2%) abatacept, and 1 (2.1%) each on infliximab and canakinumab. Mean CHAQ and JADAS27 were 0.36 ± 0.55 and 5.31 ± 8.5, respectively. Thirty-two (20%) out of 159 patients had deformities. A bivariate analysis revealed that polyarticular had more deformities than oligoarticular patients (p = 0.002; OR = 2.389; 95% CI 1.37-4.14). Logistic regression showed no association between high JADAS and family income (p = 0.339; OR = 1.45; 95% CI 0.67-3.31). A general linear model showed significantly lower CHAQ score in patients from families earning more as compared to those earning less than 300.00 US$ monthly (p = 0.002). This study reports JIA disease activity in a low income population. Low income apparently did not influence prognosis given the low mean JADAS27 and CHAQ scores vis-à-vis data from other cohorts.

Keywords: Epidemiology; Juvenile idiopathic arthritis; Pediatric rheumatology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abatacept / therapeutic use
  • Adalimumab / therapeutic use
  • Adolescent
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Juvenile / diagnosis*
  • Arthritis, Juvenile / drug therapy
  • Brazil
  • Child
  • Cohort Studies
  • Etanercept / therapeutic use
  • Female
  • Humans
  • Male
  • Methotrexate / therapeutic use
  • Poverty
  • Prognosis
  • Severity of Illness Index
  • Young Adult

Substances

  • Antirheumatic Agents
  • Abatacept
  • Adalimumab
  • Etanercept
  • Methotrexate