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. 2023 Jul 10;21(1):68.
doi: 10.1186/s12969-023-00852-5.

Disability and disease-related damage in Thai children and adolescents with juvenile idiopathic arthritis

Sirikarn Tangcheewinsirikul  1 , Maynart Sukharomana  1 , Sirirat Charuvanij  2
Affiliations

Disability and disease-related damage in Thai children and adolescents with juvenile idiopathic arthritis

Sirikarn Tangcheewinsirikul et al. Pediatr Rheumatol Online J. .

Abstract

Background: Children and adolescents with juvenile idiopathic arthritis (JIA) may suffer from disability and disease-related damage. This study aimed to investigate the prevalence of disability and damage, and identify the factors associated with articular and extra-articular damage in children and adolescents with JIA in a resource-restricted setting in Thailand.

Methods: This cross-sectional study enrolled JIA patients during June 2019-June 2021. Disability was assessed using the Child Health Assessment Questionnaire (CHAQ) and Steinbrocker classification criteria. Damage was evaluated using the Juvenile Arthritis Damage Index (JADI) and the modified-JADI (mJADI) tools.

Results: There were 101 patients (50.5% female) with median age of 11.8 years. Median disease duration was 32.7 months. Enthesitis-related arthritis (ERA) was the most common subtype (33.7%), followed by systemic JIA (25.7%). Thirty-three (32.7%) patients had delayed diagnosis ≥ 6 months. Moderate to severe disability was found in 20 (19.8%) patients. Patients with Steinbrocker functional classification > class I were seen in 17.9%. Thirty-seven (36.6%) patients had articular damage. Extra-articular complications were observed in 24.8%. Growth failure and striae were the most common complications in 7.8%. Leg-length discrepancy was documented in 5.0%. Ocular damage was found in 1 patient with ERA. Multivariable logistic regression analysis revealed Steinbrocker functional classification > class I (aOR: 18.1, 95% CI: 3.9-84.6; p < 0.001), delayed diagnosis ≥ 6 months (aOR: 8.5, 95%CI: 2.7-27.0; p < 0.001), and ERA (aOR: 5.7, 95%CI: 1.8-18.3; p = 0.004) as independent predictors of articular damage. Systemic corticosteroids use was the independent predictor of extra-articular damage (aOR: 3.8, 95%CI: 1.3-11.1; p = 0.013).

Conclusions: Disability and disease-related damage was identified in one-fifth and one-third of JIA patients. Early detection and treatment are essential for preventing permanent damage.

Keywords: Articular damage; Children; Damage; Disability; Juvenile idiopathic arthritis.

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Conflict of interest statement

All authors declare no personal or professional conflicts of interest relating to any aspect of this study.

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References

    1. Petty RE, Southwood TR, Manners P, et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004;31:390–2. - PubMed
    1. Ravelli A, Consolaro A, Horneff G, et al. Treating juvenile idiopathic arthritis to target: recommendations of an international task force. Ann Rheum Dis. 2018;77:819–28. - PubMed
    1. Ringold S, Angeles-Han ST, Beukelman T, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the treatment of juvenile idiopathic arthritis: therapeutic approaches for non-systemic Polyarthritis, Sacroiliitis, and Enthesitis. Arthritis Rheumatol. 2019;71:846–63. doi: 10.1002/art.40884. - DOI - PMC - PubMed
    1. Onel KB, Horton DB, Lovell DJ, et al. 2021 American College of Rheumatology Guideline for the treatment of juvenile idiopathic arthritis: therapeutic approaches for Oligoarthritis, Temporomandibular Joint Arthritis, and systemic juvenile idiopathic arthritis. Arthritis Rheumatol. 2022;74:553–69. doi: 10.1002/art.42037. - DOI - PMC - PubMed
    1. Scott C, Chan M, Slamang W, et al. Juvenile arthritis management in less resourced countries (JAMLess): consensus recommendations from the cradle of Humankind. Clin Rheumatol. 2019;38:563–75. doi: 10.1007/s10067-018-4304-y. - DOI - PubMed