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

FAC Rocha, JIVD Landim, MG Aguiar… - Rheumatology …, 2019 - Springer
FAC Rocha, JIVD Landim, MG Aguiar, JPE Accioly, CN Lechiu, LHA Costa, CNR Júnior…
Rheumatology international, 2019Springer
Determine disease activity in a low income juvenile idiopathic arthritis (JIA) cohort. 164 JIA
patients from families with less than US 4500.00/
capitameanannualincomefollowedinFortaleza-CE,Brazil,werecross-
sectionallyevaluatedbetweenMay2015–April2016.Meanagewas14±5.1years(95female)
with10.31±3.7yearsdiseaseduration.Polyarticularcategorypredominated,with63(38.4%)
patients,followedby40(24%)enthesitis-related(ERA),and36(22%)oligoarticular …
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.
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