Background
Methods
Study site and participants
Inclusion criteria | Exclusion criteria |
---|---|
Arthritis and enthesitis | ▪ Psoriasis or a history of psoriasis in the patient or a first degree relative |
or
| ▪ Presence of IgM RF on at least two occasions at least 3 months apart |
Arthritis or enthesitis with at least two of the following: | ▪ Systemic JIA in the patient |
▪ Sacroiliac joint tenderness and/or inflammatory spinal pain ▪ Presence of HLA-B27 ▪ Onset of arthritis in a male over 6 years of age ▪ Family history in at least one first degree relative of ankylosing spondylitis, ERA, sacroiliitis with IBD, reactive arthritis or acute anterior uveitis ▪ Acute anterior uveitis |
Clinical characteristics
Analysis
Results
Clinical characteristics
All subjects (n = 234) | |
---|---|
Demographics, median (IQR) or n (%) | |
Age in years | 11.6 (9.8–13.7) |
Sex, male | 169 (72.2) |
Race, Caucasian | 194 (82.9) |
Family history of HLA-B27-associated disease | 36 (15.4) |
Clinical characteristics, median (IQR) or n (%) | |
HLA-B27 positivity | 135 (59.2) |
Active joint count | 2 (1–4) |
Tender entheses count | 2 (1–4) |
MRI-defined sacroiliitis (n = 45 with imaging) | 25 (55.6) |
Polyarticular onset | 52 (22.2) |
ANA-positive | 49 (23.4) |
CRP, abnormal/elevated | 39 (26.9) |
ESR, abnormal/elevated | 93 (45.8) |
Patient-/physician-reported outcomes, median (IQR) | |
Physician global disease activity assessment (0–10) | 2.5 (2–4) |
Juvenile Spondyloarthritis Disease Activity Index (JSpADA) (0–8) | 3 (2.5–4) |
Juvenile Arthritis Disease Activity Score (cJADAS), excluding ESR (0–30) | 9 (5–14) |
Patient/parent global disease activity assessment (0–10) | 4 (2–6) |
Function (CHAQ) (0–3) | 0.563 (0–1) |
Patient/parent pain assessment (0–10) | 4 (2–7) |
Medication use
HLA-B27 status and clinical phenotype
Alla (n = 156) | HLA-B27 positive (n = 69) | HLA-B27 negative (n = 87) |
p Value | |
---|---|---|---|---|
Demographics and clinical findings, n (%) or median (IQR) | ||||
Age in years | 11.5 (9.6, 13.6) | 12.3 (10.3, 14.1) | 11.0 (8.8,13.2) |
<0.01
|
Sex, male | 100 (64.1) | 50 (72.5) | 50 (57.5) | 0.05 |
Race, Caucasian | 129 (82.7) | 59 (85.5) | 70 (80.5) | 0.66 |
Active joint count | 2 (1–4) | 3 (2–5) | 2 (1–4) |
<0.01
|
Tender entheses count | 2 (2–4) | 2 (1–3) | 2 (2–5) |
0.01
|
MRI-defined sacroiliitis | 22 (57.9) | 15 (83.3) | 7 (35.0) |
<0.01
|
Polyarticular onset | 36 (23.1) | 20 (29.0) | 16 (18.4) | 0.15 |
ANA-positive | 31 (21.4) | 10 (15.6) | 21 (25.9) | 0.13 |
CRP, abnormal/elevated | 31 (28.4) | 13 (31.0) | 18 (26.9) | 0.65 |
ESR, abnormal/elevated | 57 (41.9) | 34 (54.8) | 23 (31.1) |
<0.01
|
Outcome measures, median (IQR) | ||||
Physician disease activity (0–10) | 2.4 (2–3) | 2 (2–3) | 2.6 (2–4) | 0.07 |
Juvenile Spondyloarthritis Disease Activity Index (JSpADA) (0–8) | 3 (2.5–4) | 3.5 (2.5–4) | 3 (2.5–3.5) |
0.04
|
Patient/parent disease activity (0–10) | 4 (2–6) | 4 (2–5) | 4 (2–6) | 0.63 |
Function (CHAQ) (0–3) | 0.625 (0–1) | 0.375 (0–1) | 0.625 (0–1) | 0.85 |
Patient/parent pain (0–10) | 4 (2–7) | 4 (3–7) | 4 (2–7) | 0.71 |
Juvenile Arthritis Disease Activity Score, excluding ESR (cJADAS) (0–30) | 9 (5–13) | 9 (5–13) | 9 (5–14) | 0.98 |
ILAR criteria, n (%) | ||||
Acute, symptomatic uveitis | 7 (4.5) | 4 (5.8) | 3 (3.5) | 0.48 |
Arthritis in a male over 6 years of age | 93 (59.6) | 50 (72.5) | 43 (49.4) |
<0.01
|
Family history of HLA-B27-associated disease | 18 (11.5) | 7 (10.1) | 11 (12.6) | 0.63 |
Sacroiliac tenderness or lumbosacral pain | 46 (29.5) | 20 (29.0) | 26 (29.9) | 0.9 |