Prospective Determination of the Incidence and Risk Factors of New-Onset Uveitis in Juvenile Idiopathic Arthritis: The Research in Arthritis in Canadian Children Emphasizing Outcomes Cohort

for the ReACCh-Out Investigators

doi:10.1002/acr.23783

Prospective Determination of the Incidence and Risk Factors of New-Onset Uveitis in Juvenile Idiopathic Arthritis: The Research in Arthritis in Canadian Children Emphasizing Outcomes Cohort

for the ReACCh-Out Investigators

Résultat de recherche: Article › examen par les pairs

35 Citations (Scopus)

Résumé

Objective: Identification of the incidence of juvenile idiopathic arthritis (JIA)–associated uveitis and its risk factors is essential to optimize early detection. Data from the Research in Arthritis in Canadian Children Emphasizing Outcomes inception cohort were used to estimate the annual incidence of new-onset uveitis following JIA diagnosis and to identify associated risk factors. Methods: Data were reported every 6 months for 2 years, then yearly to 5 years. Incidence was determined by Kaplan-Meier estimators with time of JIA diagnosis as the reference point. Univariate log-rank analysis identified risk factors and Cox regression determined independent predictors. Results: In total, 1,183 patients who enrolled within 6 months of JIA diagnosis met inclusion criteria, median age at diagnosis of 9.0 years (interquartile range [IQR] 3.8–12.9), median follow-up of 35.2 months (IQR 22.7–48.3). Of these patients, 87 developed uveitis after enrollment. The incidence of new-onset uveitis was 2.8% per year (95% confidence interval [95% CI] 2.0–3.5) in the first 5 years. The annual incidence decreased during follow-up but remained at 2.1% (95% CI 0–4.5) in the fifth year, although confidence intervals overlapped. Uveitis was associated with young age (<7 years) at JIA diagnosis (hazard ratio [HR] 8.29, P < 0.001), positive antinuclear antibody (ANA) test (HR 3.20, P < 0.001), oligoarthritis (HR 2.45, P = 0.002), polyarthritis rheumatoid factor negative (HR 1.65, P = 0.002), and female sex (HR 1.80, P = 0.02). In multivariable analysis, only young age at JIA diagnosis and ANA positivity were independent predictors of uveitis. Conclusion: Vigilant uveitis screening should continue for at least 5 years after JIA diagnosis, and priority for screening should be placed on young age (<7 years) at JIA diagnosis and a positive ANA test.

Langue d'origine	English
Pages (de-à)	1436-1443
Nombre de pages	8
Journal	Arthritis Care and Research
Volume	71
Numéro de publication	11
DOI	https://doi.org/10.1002/acr.23783
Statut de publication	Published - nov. 1 2019
Publié à l'externe	Oui

Note bibliographique

Funding Information:
The authors thank all of the families for their generous participation and the following Canadian colleagues who are ReACCh-Out study investigators: Roxana Bolaria, Katherine Gross, Kristin Houghton, Ross E. Petty, Stuart E. Turvey (British Columbia Children's Hospital and University of British Columbia, Vancouver); Janet Ellsworth (Stollery Children's Hospital and University of Alberta, Edmonton); Susanne Benseler, Nicole Johnson, Paivi Miettunen, Heinrike Schmeling (Alberta Children's Hospital and University of Calgary, Calgary); Roberta A. Berard (Children's Hospital, London Health Science Centre and Western University, London); Maggie Larché (McMaster University, Hamilton); Bonnie Cameron, Ronald M. Laxer, Deborah M. Levy, Rayfel Schneider, Earl Silverman, Shirley M. L. Tse (Hospital for Sick Children and University of Toronto, Toronto); Michele Gibbon (national ReACCh-Out study coordinator), Roman Jurencak, Johannes Roth (Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa); Anne-Laure Chetaille, Jean Dorval (Centre Hospitalier Universitaire de Laval and Université Laval, Quebec); Alessandra Bruns (Centre Hospitalier Universitaire de Sherbrooke and Université de Sherbrooke, Sherbrooke); Sarah Campillo, Gaëlle Chédeville, Claire LeBlanc, Rosie Scuccimarri (McGill University Health Centre and McGill University, Montreal); Debbie Feldman (Université de Montréal, Montréal); Elie Haddad, Claire St. Cyr (CHU Ste. Justine and Université de Montréal, Montréal); Suzanne E. Ramsey (IWK Health Centre and Dalhousie University, Halifax); and Paul Dancey (Janeway Children's Health and Rehabilitation Centre and Memorial University, Saint John's).

Publisher Copyright:
© 2018, American College of Rheumatology

ASJC Scopus Subject Areas

Rheumatology

PubMed: MeSH publication types

Journal Article
Research Support, Non-U.S. Gov't

Accès au document

10.1002/acr.23783

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@article{6cd02116209d40c18e1b8ea47f418c11,

title = "Prospective Determination of the Incidence and Risk Factors of New-Onset Uveitis in Juvenile Idiopathic Arthritis: The Research in Arthritis in Canadian Children Emphasizing Outcomes Cohort",

abstract = "Objective: Identification of the incidence of juvenile idiopathic arthritis (JIA)–associated uveitis and its risk factors is essential to optimize early detection. Data from the Research in Arthritis in Canadian Children Emphasizing Outcomes inception cohort were used to estimate the annual incidence of new-onset uveitis following JIA diagnosis and to identify associated risk factors. Methods: Data were reported every 6 months for 2 years, then yearly to 5 years. Incidence was determined by Kaplan-Meier estimators with time of JIA diagnosis as the reference point. Univariate log-rank analysis identified risk factors and Cox regression determined independent predictors. Results: In total, 1,183 patients who enrolled within 6 months of JIA diagnosis met inclusion criteria, median age at diagnosis of 9.0 years (interquartile range [IQR] 3.8–12.9), median follow-up of 35.2 months (IQR 22.7–48.3). Of these patients, 87 developed uveitis after enrollment. The incidence of new-onset uveitis was 2.8% per year (95% confidence interval [95% CI] 2.0–3.5) in the first 5 years. The annual incidence decreased during follow-up but remained at 2.1% (95% CI 0–4.5) in the fifth year, although confidence intervals overlapped. Uveitis was associated with young age (<7 years) at JIA diagnosis (hazard ratio [HR] 8.29, P < 0.001), positive antinuclear antibody (ANA) test (HR 3.20, P < 0.001), oligoarthritis (HR 2.45, P = 0.002), polyarthritis rheumatoid factor negative (HR 1.65, P = 0.002), and female sex (HR 1.80, P = 0.02). In multivariable analysis, only young age at JIA diagnosis and ANA positivity were independent predictors of uveitis. Conclusion: Vigilant uveitis screening should continue for at least 5 years after JIA diagnosis, and priority for screening should be placed on young age (<7 years) at JIA diagnosis and a positive ANA test.",

author = "{for the ReACCh-Out Investigators} and Lee, {Jennifer J.Y.} and Duffy, {Ciar{\'a}n M.} and Jaime Guzman and Kiem Oen and Nick Barrowman and Rosenberg, {Alan M.} and Shiff, {Natalie J.} and Gilles Boire and Elizabeth Stringer and Lynn Spiegel and Morishita, {Kimberly A.} and Bianca Lang and Deepti Reddy and Huber, {Adam M.} and Cabral, {David A.} and Feldman, {Brian M.} and Yeung, {Rae S.M.} and Tucker, {Lori B.} and {Watanabe Duffy}, Karen",

note = "Funding Information: The authors thank all of the families for their generous participation and the following Canadian colleagues who are ReACCh-Out study investigators: Roxana Bolaria, Katherine Gross, Kristin Houghton, Ross E. Petty, Stuart E. Turvey (British Columbia Children's Hospital and University of British Columbia, Vancouver); Janet Ellsworth (Stollery Children's Hospital and University of Alberta, Edmonton); Susanne Benseler, Nicole Johnson, Paivi Miettunen, Heinrike Schmeling (Alberta Children's Hospital and University of Calgary, Calgary); Roberta A. Berard (Children's Hospital, London Health Science Centre and Western University, London); Maggie Larch{\'e} (McMaster University, Hamilton); Bonnie Cameron, Ronald M. Laxer, Deborah M. Levy, Rayfel Schneider, Earl Silverman, Shirley M. L. Tse (Hospital for Sick Children and University of Toronto, Toronto); Michele Gibbon (national ReACCh-Out study coordinator), Roman Jurencak, Johannes Roth (Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa); Anne-Laure Chetaille, Jean Dorval (Centre Hospitalier Universitaire de Laval and Universit{\'e} Laval, Quebec); Alessandra Bruns (Centre Hospitalier Universitaire de Sherbrooke and Universit{\'e} de Sherbrooke, Sherbrooke); Sarah Campillo, Ga{\"e}lle Ch{\'e}deville, Claire LeBlanc, Rosie Scuccimarri (McGill University Health Centre and McGill University, Montreal); Debbie Feldman (Universit{\'e} de Montr{\'e}al, Montr{\'e}al); Elie Haddad, Claire St. Cyr (CHU Ste. Justine and Universit{\'e} de Montr{\'e}al, Montr{\'e}al); Suzanne E. Ramsey (IWK Health Centre and Dalhousie University, Halifax); and Paul Dancey (Janeway Children's Health and Rehabilitation Centre and Memorial University, Saint John's). Publisher Copyright: {\textcopyright} 2018, American College of Rheumatology",

year = "2019",

month = nov,

day = "1",

doi = "10.1002/acr.23783",

language = "English",

volume = "71",

pages = "1436--1443",

journal = "Arthritis Care and Research",

issn = "2151-464X",

publisher = "John Wiley & Sons Inc.",

number = "11",

}

TY - JOUR

T1 - Prospective Determination of the Incidence and Risk Factors of New-Onset Uveitis in Juvenile Idiopathic Arthritis

T2 - The Research in Arthritis in Canadian Children Emphasizing Outcomes Cohort

AU - for the ReACCh-Out Investigators

AU - Lee, Jennifer J.Y.

AU - Duffy, Ciarán M.

AU - Guzman, Jaime

AU - Oen, Kiem

AU - Barrowman, Nick

AU - Rosenberg, Alan M.

AU - Shiff, Natalie J.

AU - Boire, Gilles

AU - Stringer, Elizabeth

AU - Spiegel, Lynn

AU - Morishita, Kimberly A.

AU - Lang, Bianca

AU - Reddy, Deepti

AU - Huber, Adam M.

AU - Cabral, David A.

AU - Feldman, Brian M.

AU - Yeung, Rae S.M.

AU - Tucker, Lori B.

AU - Watanabe Duffy, Karen

N1 - Funding Information: The authors thank all of the families for their generous participation and the following Canadian colleagues who are ReACCh-Out study investigators: Roxana Bolaria, Katherine Gross, Kristin Houghton, Ross E. Petty, Stuart E. Turvey (British Columbia Children's Hospital and University of British Columbia, Vancouver); Janet Ellsworth (Stollery Children's Hospital and University of Alberta, Edmonton); Susanne Benseler, Nicole Johnson, Paivi Miettunen, Heinrike Schmeling (Alberta Children's Hospital and University of Calgary, Calgary); Roberta A. Berard (Children's Hospital, London Health Science Centre and Western University, London); Maggie Larché (McMaster University, Hamilton); Bonnie Cameron, Ronald M. Laxer, Deborah M. Levy, Rayfel Schneider, Earl Silverman, Shirley M. L. Tse (Hospital for Sick Children and University of Toronto, Toronto); Michele Gibbon (national ReACCh-Out study coordinator), Roman Jurencak, Johannes Roth (Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa); Anne-Laure Chetaille, Jean Dorval (Centre Hospitalier Universitaire de Laval and Université Laval, Quebec); Alessandra Bruns (Centre Hospitalier Universitaire de Sherbrooke and Université de Sherbrooke, Sherbrooke); Sarah Campillo, Gaëlle Chédeville, Claire LeBlanc, Rosie Scuccimarri (McGill University Health Centre and McGill University, Montreal); Debbie Feldman (Université de Montréal, Montréal); Elie Haddad, Claire St. Cyr (CHU Ste. Justine and Université de Montréal, Montréal); Suzanne E. Ramsey (IWK Health Centre and Dalhousie University, Halifax); and Paul Dancey (Janeway Children's Health and Rehabilitation Centre and Memorial University, Saint John's). Publisher Copyright: © 2018, American College of Rheumatology

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Objective: Identification of the incidence of juvenile idiopathic arthritis (JIA)–associated uveitis and its risk factors is essential to optimize early detection. Data from the Research in Arthritis in Canadian Children Emphasizing Outcomes inception cohort were used to estimate the annual incidence of new-onset uveitis following JIA diagnosis and to identify associated risk factors. Methods: Data were reported every 6 months for 2 years, then yearly to 5 years. Incidence was determined by Kaplan-Meier estimators with time of JIA diagnosis as the reference point. Univariate log-rank analysis identified risk factors and Cox regression determined independent predictors. Results: In total, 1,183 patients who enrolled within 6 months of JIA diagnosis met inclusion criteria, median age at diagnosis of 9.0 years (interquartile range [IQR] 3.8–12.9), median follow-up of 35.2 months (IQR 22.7–48.3). Of these patients, 87 developed uveitis after enrollment. The incidence of new-onset uveitis was 2.8% per year (95% confidence interval [95% CI] 2.0–3.5) in the first 5 years. The annual incidence decreased during follow-up but remained at 2.1% (95% CI 0–4.5) in the fifth year, although confidence intervals overlapped. Uveitis was associated with young age (<7 years) at JIA diagnosis (hazard ratio [HR] 8.29, P < 0.001), positive antinuclear antibody (ANA) test (HR 3.20, P < 0.001), oligoarthritis (HR 2.45, P = 0.002), polyarthritis rheumatoid factor negative (HR 1.65, P = 0.002), and female sex (HR 1.80, P = 0.02). In multivariable analysis, only young age at JIA diagnosis and ANA positivity were independent predictors of uveitis. Conclusion: Vigilant uveitis screening should continue for at least 5 years after JIA diagnosis, and priority for screening should be placed on young age (<7 years) at JIA diagnosis and a positive ANA test.

AB - Objective: Identification of the incidence of juvenile idiopathic arthritis (JIA)–associated uveitis and its risk factors is essential to optimize early detection. Data from the Research in Arthritis in Canadian Children Emphasizing Outcomes inception cohort were used to estimate the annual incidence of new-onset uveitis following JIA diagnosis and to identify associated risk factors. Methods: Data were reported every 6 months for 2 years, then yearly to 5 years. Incidence was determined by Kaplan-Meier estimators with time of JIA diagnosis as the reference point. Univariate log-rank analysis identified risk factors and Cox regression determined independent predictors. Results: In total, 1,183 patients who enrolled within 6 months of JIA diagnosis met inclusion criteria, median age at diagnosis of 9.0 years (interquartile range [IQR] 3.8–12.9), median follow-up of 35.2 months (IQR 22.7–48.3). Of these patients, 87 developed uveitis after enrollment. The incidence of new-onset uveitis was 2.8% per year (95% confidence interval [95% CI] 2.0–3.5) in the first 5 years. The annual incidence decreased during follow-up but remained at 2.1% (95% CI 0–4.5) in the fifth year, although confidence intervals overlapped. Uveitis was associated with young age (<7 years) at JIA diagnosis (hazard ratio [HR] 8.29, P < 0.001), positive antinuclear antibody (ANA) test (HR 3.20, P < 0.001), oligoarthritis (HR 2.45, P = 0.002), polyarthritis rheumatoid factor negative (HR 1.65, P = 0.002), and female sex (HR 1.80, P = 0.02). In multivariable analysis, only young age at JIA diagnosis and ANA positivity were independent predictors of uveitis. Conclusion: Vigilant uveitis screening should continue for at least 5 years after JIA diagnosis, and priority for screening should be placed on young age (<7 years) at JIA diagnosis and a positive ANA test.

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