1
|
Low JM, Hyrich KL, Ciurtin C, McErlane F, Wedderburn LR, Geifman N, Shoop-Worrall SJW. The impact of psoriasis on wellbeing and clinical outcomes in juvenile psoriatic arthritis. Rheumatology (Oxford) 2024; 63:1273-1280. [PMID: 37467079 PMCID: PMC11065439 DOI: 10.1093/rheumatology/kead370] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 06/05/2023] [Accepted: 07/10/2023] [Indexed: 07/21/2023] Open
Abstract
OBJECTIVES Juvenile PsA (JPsA) has varied clinical features that are distinctive from other JIA categories. This study investigates whether such features impact patient-reported and clinical outcomes. METHODS Children and young people (CYP) were selected if recruited to the Childhood Arthritis Prospective Study, a UK multicentre JIA inception cohort, between January 2001 and March 2018. At diagnosis, patient/parent-reported outcomes (as age-appropriate) included the parental global assessment (10 cm visual analogue scale), functional ability (Childhood Health Assessment Questionnaire (CHAQ)), pain (10 cm visual analogue scale), health-related quality of life (Child Health Questionnaire PF50 psychosocial score), mood/depressive symptoms (Moods and Feelings Questionnaire) and parent psychosocial health (General Health Questionnaire 30). Three-year outcome trajectories have previously been defined using active joint counts, physician and parent global assessments (PGA and PaGA, respectively). Patient-reported outcomes and outcome trajectories were compared in (i) CYP with JPsA vs other JIA categories and (ii) CYP within JPsA, with and without psoriasis via multivariable linear regression. RESULTS There were no significant differences in patient-reported outcomes at diagnosis between CYP with JPsA and non-JPsA. Within JPsA, those with psoriasis had more depressive symptoms (coefficient = 9.8; 95% CI: 0.5, 19.0) than those without psoriasis at diagnosis. CYP with JPsA had 2.3 times the odds of persistent high PaGA than other ILAR categories, despite improving joint counts and PGA (95% CI: 1.2, 4.6). CONCLUSION CYP with psoriasis at JPsA diagnosis report worse mood, supporting a greater disease impact in those with both skin and joint involvement. Multidisciplinary care with added focus to support wellbeing in children with JPsA plus psoriasis may help improve these outcomes.
Collapse
Affiliation(s)
- Jie Man Low
- Centre for Epidemiology Versus Arthritis, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
| | - Kimme L Hyrich
- Centre for Epidemiology Versus Arthritis, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
- National Institute for Health Research Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Coziana Ciurtin
- UCL Division of Medicine, University College London, London, UK
- Centre for Adolescent Rheumatology Versus Arthritis at UCL UCLH and GOSH, London, UK
| | - Flora McErlane
- Department of Paediatric Rheumatology, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Lucy R Wedderburn
- Centre for Adolescent Rheumatology Versus Arthritis at UCL UCLH and GOSH, London, UK
- UCL GOS Institute of Child Health, University College London, London, UK
- Department of Paediatric Rheumatology, Great Ormond Street Hospital, London, UK
- NIHR Biomedical Research Centre at Great Ormond Street Hospital, London, UK
| | - Nophar Geifman
- School of Health Sciences, Faculty of Health and Medical Sciences, The University of Surrey, Surrey, UK
| | - Stephanie J W Shoop-Worrall
- Centre for Epidemiology Versus Arthritis, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
- Centre for Health Informatics, The University of Manchester, Manchester, UK
| |
Collapse
|
2
|
Pascu LS, Sârbu N, Brădeanu AV, Jicman (Stan) D, Matei MN, Sârbu MI, Voinescu DC, Nechita A, Tatu AL. MRI Findings in Axial Psoriatic Spondylarthritis. Diagnostics (Basel) 2023; 13:diagnostics13071342. [PMID: 37046559 PMCID: PMC10093281 DOI: 10.3390/diagnostics13071342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/13/2023] [Accepted: 03/24/2023] [Indexed: 04/07/2023] Open
Abstract
Psoriatic arthritis is a significant medical condition with a high prevalence, a wide variety of non-specific symptoms, and a high degree of overlap with other spondylarthritis disorders, particularly ankylosing spondylitis. Hence, knowledge of the magnetic resonance imaging (MRI) manifestations and a multidisciplinary strategy are required for the better management of these patients. We searched publications from the last 10 years and focused on the most relevant ones which discussed the classification criteria, the MRI characteristics of axial psoriatic arthritis, the importance of MRI for follow up, and the reliability of skin and synovial biopsy. Axial spondylarthritis can be diagnosed and followed up on using the well-established MRI technique and, additionally, a biopsy. The analysis and concordance between them can provide new directions for future studies.
Collapse
Affiliation(s)
| | - Nicolae Sârbu
- “Sf. Ioan” Clinical Emergency Children Hospital, 800487 Galati, Romania
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania
| | - Andrei Vlad Brădeanu
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania
- “Sf. Andrei” Emergency County Clinical Hospital, 177 Brailei st, 800578 Galati, Romania
| | - Daniela Jicman (Stan)
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania
| | - Madalina Nicoleta Matei
- “Sf. Ioan” Clinical Emergency Children Hospital, 800487 Galati, Romania
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania
| | - Mihaela Ionela Sârbu
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania
| | - Doina Carina Voinescu
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania
- “Sf. Andrei” Emergency County Clinical Hospital, 177 Brailei st, 800578 Galati, Romania
| | - Aurel Nechita
- “Sf. Ioan” Clinical Emergency Children Hospital, 800487 Galati, Romania
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania
| | - Alin Laurențiu Tatu
- Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania
- Infectious Diseases Dermatology Department, “Sf. Parascheva” Infectious Diseases Clinical Hospital, 800179 Galati, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR, 800008 Galati, Romania
| |
Collapse
|
3
|
Naddei R, Rebollo-Giménez A, Burrone M, Natoli V, Rosina S, Consolaro A, Ravelli A. Juvenile Psoriatic Arthritis: Myth or Reality? An Unending Debate. J Clin Med 2023; 12:jcm12010367. [PMID: 36615167 PMCID: PMC9821505 DOI: 10.3390/jcm12010367] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023] Open
Abstract
Juvenile psoriatic arthritis (JPsA) accounts for 1-7% of all cases of juvenile idiopathic arthritis (JIA) and its definition has been a matter of controversy among pediatric rheumatologists for many years. The traditional attribution of JPsA to the spondyloarthropathy group was challenged in the early 1990s, whereas the recent demonstrations of its heterogenous nature have led to questions about its identification as a distinct category in JIA classification. It has been shown that children with the phenotype of JPsA can be divided in two subgroups, one presenting with the features of early-onset ANA-positive JIA, and another that belongs to the spectrum of spondyloarthropathies. The few studies that have compared the clinical characteristics and genetic determinants of JPsA with those of the other JIA categories have obtained contrasting findings. The debate on the categorization of JPsA as a distinct entity within JIA classification is still ongoing and has prompted the revision of its current classification.
Collapse
Affiliation(s)
- Roberta Naddei
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-0817463269
| | - Ana Rebollo-Giménez
- Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Marco Burrone
- Dipartimento di Pediatria, Ospedale dei Bambini “Vittore Buzzi”, Università degli Studi di Milano, 20154 Milan, Italy
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, 16132 Genoa, Italy
| | - Valentina Natoli
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, 16132 Genoa, Italy
| | - Silvia Rosina
- Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Alessandro Consolaro
- Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, 16132 Genoa, Italy
| | - Angelo Ravelli
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, 16132 Genoa, Italy
- Direzione Scientifica, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| |
Collapse
|
4
|
van Straalen JW, de Roock S, Giancane G, Alexeeva E, Koskova E, Mesa-del-Castillo Bermejo P, Zulian F, Civino A, Montin D, Wulffraat NM, Ruperto N, Swart JF. Prevalence of familial autoimmune diseases in juvenile idiopathic arthritis: results from the international Pharmachild registry. Pediatr Rheumatol Online J 2022; 20:103. [PMID: 36401230 PMCID: PMC9673358 DOI: 10.1186/s12969-022-00762-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/29/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Little is known about the disposition to autoimmune diseases (ADs) among children diagnosed with JIA. In this study, we provide a comprehensive overview of the prevalence of and factors associated with ADs in parents of children with juvenile idiopathic arthritis (JIA). METHODS Prevalence rates of ADs and 95% Poisson confidence intervals were calculated for parents of JIA patients from the international Pharmachild registry and compared with general population prevalence rates as reported in the literature. Demographic, clinical and laboratory features were compared between JIA patients with and without a family history of AD using χ2 and Mann-Whitney U tests. RESULTS Eight thousand six hundred seventy three patients were included and the most common familial ADs were psoriasis, autoimmune thyroid disease, rheumatoid arthritis and ankylosing spondylitis. The prevalence of several ADs was higher in parents of the included JIA patients than in the general population. Clinical Juvenile Arthritis Disease Activity Scores at study entry and last follow-up were not significantly different between patients with (n = 1231) and without a family history of AD (n = 7442). Factors associated with familial AD were older age at JIA onset (P < 0.01), Scandinavian residence (P < 0.01), enthesitis-related arthritis, psoriatic arthritis and undifferentiated arthritis (P < 0.01), ANA positivity (P = 0.03) and HLA-B27 positivity (P < 0.01). CONCLUSIONS Familial AD proves to be a risk factor for JIA development and certain diseases should therefore not be overlooked during family health history at the diagnosis stage. A family history of AD is associated with the JIA category but does not influence the severity or disease course.
Collapse
Affiliation(s)
- Joeri W. van Straalen
- grid.7692.a0000000090126352Department of Pediatric Immunology and Rheumatology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, P.O. box 85090, 3508 AB Utrecht, the Netherlands ,grid.5477.10000000120346234Faculty of Medicine, Utrecht University, Utrecht, the Netherlands
| | - Sytze de Roock
- grid.7692.a0000000090126352Department of Pediatric Immunology and Rheumatology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, P.O. box 85090, 3508 AB Utrecht, the Netherlands ,grid.5477.10000000120346234Faculty of Medicine, Utrecht University, Utrecht, the Netherlands
| | - Gabriella Giancane
- grid.419504.d0000 0004 1760 0109IRCCS Istituto Giannina Gaslini, Clinica Pediatrica e Reumatologia, Genoa, Italy ,grid.5606.50000 0001 2151 3065Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy
| | - Ekaterina Alexeeva
- grid.465370.30000 0004 4914 227XFederal State Autonomous Institution “National Medical Research Center of Children’s Health” of the Ministry of Health of the Russian Federation, Moscow, Russian Federation ,grid.448878.f0000 0001 2288 8774Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Elena Koskova
- grid.419284.20000 0000 9847 3762Department of Pediatric Rheumatology, National Institute of Rheumatic Diseases, Piestany, Slovakia
| | - Pablo Mesa-del-Castillo Bermejo
- grid.411372.20000 0001 0534 3000Rheumatology, Pediatrics, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Francesco Zulian
- grid.5608.b0000 0004 1757 3470Department of Woman and Child Health, University of Padua, Padua, Italy
| | - Adele Civino
- UO Pediatria - Sez. Reumatologia e Immunologia pediatrica, P.O. “Vito Fazzi”, Lecce, Italy
| | - Davide Montin
- Immunology and Rheumatology Unit, Regina Margherita Children Hospital, Turin, Italy
| | - Nico M. Wulffraat
- grid.7692.a0000000090126352Department of Pediatric Immunology and Rheumatology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, P.O. box 85090, 3508 AB Utrecht, the Netherlands ,grid.5477.10000000120346234Faculty of Medicine, Utrecht University, Utrecht, the Netherlands
| | - Nicolino Ruperto
- grid.419504.d0000 0004 1760 0109UOSID Centro trial, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Joost F. Swart
- grid.7692.a0000000090126352Department of Pediatric Immunology and Rheumatology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, P.O. box 85090, 3508 AB Utrecht, the Netherlands ,grid.5477.10000000120346234Faculty of Medicine, Utrecht University, Utrecht, the Netherlands
| | | |
Collapse
|
5
|
Validation of the psoriasis epidemiology screening tool (PEST) and the new early arthritis for psoriatic patients (EARP) in pediatric population: pilot study. Clin Rheumatol 2022; 41:1125-1130. [PMID: 35028742 DOI: 10.1007/s10067-021-06009-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/17/2021] [Accepted: 12/01/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Juvenile psoriatic arthritis (JPsA) is a severe inflammatory arthritis, which is associated with psoriasis in most cases. While there are few validated screening tools for diagnosis of arthritis for adult patients with psoriasis, those screening tools were never evaluated in children. The aims of this study were to evaluate two screening tools among pediatric patients with psoriasis. METHODS Thirty-nine patients with the diagnosis of psoriasis completed two screening questionnaires: The Psoriasis Epidemiology Screening Tool (PEST) questionnaire and the new Early Arthritis for Psoriatic Patients (EARP) questionnaire. All patients were evaluated by a rheumatologist for the diagnosis of JPsA, and the accuracy of the two questionnaires was compared. RESULTS The 4/39 (10.1%) patients diagnosed with JPsA had a PEST questionnaire score of ≥ 3, compared to a median PEST score of the patients without the diagnosis of JPsA of 0 (0-2). Thus, both the sensitivity and specificity of the PEST in diagnosing JPsA were 100%. For the EARP questionnaire, 8/39 patients had a screening questionnaire score of ≥ 3, suggestive of JPsA, four were true positive, and four false positive. Thus, the sensitivity and specificity of EARP in diagnosing JPsA were 100% and 89%, respectively. CONCLUSION Both the PEST and EARP questionnaires were easy to use and had high sensitivity for the diagnosis of JPsA in the pediatric population with psoriasis. The PEST questionnaire had a higher specificity than the EARP. KEY POINTS • EARP and PEST are good screening tools for diagnosis of arthritis in pediatric population with psoriasis.
Collapse
|
6
|
Brunello F, Tirelli F, Pegoraro L, Dell'Apa F, Alfisi A, Calzamatta G, Folisi C, Zulian F. New Insights on Juvenile Psoriatic Arthritis. Front Pediatr 2022; 10:884727. [PMID: 35722498 PMCID: PMC9199423 DOI: 10.3389/fped.2022.884727] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 04/25/2022] [Indexed: 01/31/2023] Open
Abstract
Juvenile psoriatic arthritis (JPsA) is a relatively rare condition in childhood as it represents approximately 5% of the whole Juvenile Idiopathic Arthritis (JIA) population. According to International League of Associations of Rheumatology (ILAR) classification, JPsA is defined by the association of arthritis and psoriasis or, in the absence of typical psoriatic lesions, with at least two of the following: dactylitis, nail pitting, onycholysis or family history of psoriasis in a first-degree relative. However, recent studies have shown that this classification system could conceal more homogeneous subgroups of patients differing by age of onset, clinical characteristics and prognosis. Little is known about genetic factors and pathogenetic mechanisms which distinguish JPsA from other JIA subtypes or from isolated psoriasis without joint involvement, especially in the pediatric population. Specific clinical trials testing the efficacy of biological agents are lacking for JPsA, while in recent years novel therapeutic agents are emerging in adults. In this review, we summarize the clinical features and the current evidence on pathogenesis and therapeutic options for JPsA in order to provide a comprehensive overview on the clinical management of this complex and overlapping entity in childhood.
Collapse
Affiliation(s)
- Francesco Brunello
- Department of Woman's and Child's Health, University of Padova, Padova, Italy
| | - Francesca Tirelli
- Department of Woman's and Child's Health, University of Padova, Padova, Italy
| | - Luca Pegoraro
- Department of Woman's and Child's Health, University of Padova, Padova, Italy
| | - Filippo Dell'Apa
- Department of Woman's and Child's Health, University of Padova, Padova, Italy
| | - Alessandra Alfisi
- Department of Woman's and Child's Health, University of Padova, Padova, Italy
| | - Giulia Calzamatta
- Department of Woman's and Child's Health, University of Padova, Padova, Italy
| | - Camilla Folisi
- Department of Woman's and Child's Health, University of Padova, Padova, Italy
| | - Francesco Zulian
- Department of Woman's and Child's Health, University of Padova, Padova, Italy
| |
Collapse
|
7
|
Abstract
Joint pain is a common symptom in children and adolescents. While there are many causes of joint pain in children, most of these are acute or not related to underlying joint inflammation. Chronic arthritis, however, can be one of the reasons behind the joint pain. The most common causes of chronic arthritis in children are categorized under juvenile idiopathic arthritis (JIA). The purpose of this review is to highlight the most important clinical features, work-up, and medical management of the different subtypes of JIA.
Collapse
|
8
|
Bewegungsstörungen bei chronischen Erkrankungen. Monatsschr Kinderheilkd 2020. [DOI: 10.1007/s00112-020-00931-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
9
|
Leong JY, Guan YJ, Albani S, Arkachaisri T. Recent advances in our understanding of the pathogenesis of juvenile idiopathic arthritis and their potential clinical implications. Expert Rev Clin Immunol 2018; 14:933-944. [PMID: 30269617 DOI: 10.1080/1744666x.2018.1529757] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Juvenile idiopathic arthritis (JIA) comprises systemic and non-systemic forms of chronic childhood arthritis diagnosed prior to age 16. Significant improvement in treatment outcomes has been witnessed since the introduction of biologics. In particular, advances in research in the area of multidimensional interrogation and network analysis have facilitated understanding of the complex cacophony of components orchestrating disease immunopathogenesis. Areas covered: In this review, we will examine the scientific advances that have augmented our understanding of JIA pathogenesis, focusing on the progress made in systemic, poly, and oligo JIA in four major aspects: (a) unraveling the pathogenic mechanisms, (b) disease classification, (c) therapeutic selection, and (d) decision for withdrawal of medications after achieving remission. Expert commentary: Dysregulation of innate immune cell physiology and function in sJIA will be highlighted. MicroRNAs contribute to monocyte/macrophage polarization with resulting consequences on macrophage activation syndrome development. The involvement of neutrophils, a major source of S100A8/9/12, in the active inflammatory phase of sJIA is compelling. In non-sJIA, circulating CD4 subsets in T effector and regulatory compartments possessing a strong synovial T-cell receptor coverage and disease activity correlation, acted as an accessible reservoir of pathogenic cells exploitable for clinical management.
Collapse
Affiliation(s)
- Jing Yao Leong
- a Translational Immunology Institute, SingHealth Duke-NUS Academic Medical Centre , Singapore
| | - Yeo Joo Guan
- a Translational Immunology Institute, SingHealth Duke-NUS Academic Medical Centre , Singapore.,b Rheumatology and Immunology Service, Department of Pediatric Subspecialties , KK Women's and Children's Hospital , Singapore.,c Duke-NUS Medical School , Singapore
| | - Salvatore Albani
- a Translational Immunology Institute, SingHealth Duke-NUS Academic Medical Centre , Singapore.,b Rheumatology and Immunology Service, Department of Pediatric Subspecialties , KK Women's and Children's Hospital , Singapore.,c Duke-NUS Medical School , Singapore
| | - Thaschawee Arkachaisri
- b Rheumatology and Immunology Service, Department of Pediatric Subspecialties , KK Women's and Children's Hospital , Singapore.,c Duke-NUS Medical School , Singapore
| |
Collapse
|
10
|
Brandon TG, Manos CK, Xiao R, Ogdie A, Weiss PF. Pediatric psoriatic arthritis: a population-based cohort study of risk factors for onset and subsequent risk of inflammatory comorbidities. ACTA ACUST UNITED AC 2018; 3:131-136. [PMID: 31355354 DOI: 10.1177/2475530318799072] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Relatively little is known about the epidemiology of juvenile psoriatic arthritis (PsA), including clinical features associated with the development of arthritis among children with psoriasis and subsequent risk of inflammatory comorbidities. Objective To identify the overall risk of arthritis among children with psoriasis and subsequent risk of inflammatory comorbidities. Methods Using Clinformatics™ DataMart (OptumInsight, Eden Prairie, MN) de-identified US administrative claims data from 2000-2013, we identified children 0-16 years with an incident diagnosis of psoriasis or PsA using ICD-9-CM diagnostic, procedure and pharmacy billing codes. Cox proportional hazard regression was performed to assess clinical features associated with development of arthritis in children with psoriasis. Incidence rate ratios were used to compare the relative frequency of co-morbid diagnoses. Results We identified 212 children with PsA, 4,312 with psoriasis-only, and 45,240 controls. Approximately 33% of children with PsA received a diagnostic code for psoriasis before arthritis. Median time to index code for arthritis after index code for psoriasis was 17.6 months (IQR 4.1-38.1). Older age and uveitis were associated with a significantly increased risk of developing arthritis in children with psoriasis. Children with PsA had a significantly increased risk of uveitis, diabetes, and depressive disorder when compared to patients with psoriasis and inflammatory bowel disease, uveitis, diabetes, and depressive disorder when compared to controls. Conclusion Most children with PsA developed arthritis first. Older age and uveitis were risk factors for arthritis among children with psoriasis. PsA was associated with increased risk of several clinically relevant inflammatory comorbidities.
Collapse
Affiliation(s)
- Timothy G Brandon
- Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Center for Pediatric Clinical Effectiveness (CPCE), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Center for Pharmacoepidemiology Research and Training (CPeRT), University of Pennsylvania, Philadelphia, Pennsylvania
| | - Cynthia K Manos
- Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rui Xiao
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alexis Ogdie
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania.,Division of Rheumatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Pamela F Weiss
- Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Pediatric Clinical Effectiveness (CPCE), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Center for Pharmacoepidemiology Research and Training (CPeRT), University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
11
|
|
12
|
Guillaume-Czitrom S, Sibilia J, Nordal E. Growing up with chronic arthritis: the confusing matter of classification. RMD Open 2017; 3:e000417. [PMID: 28725456 PMCID: PMC5508402 DOI: 10.1136/rmdopen-2016-000417] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/13/2017] [Accepted: 03/01/2017] [Indexed: 11/05/2022] Open
Affiliation(s)
| | - Jean Sibilia
- Department of Rheumatology, Hautepierre University Hospital, Strasbourg, France
| | - Ellen Nordal
- Department of Pediatrics, UIT The Arctic University of Norway and University Hospital of North Norway, Tromsø, Norway
| |
Collapse
|