Risk Factors and Biomarkers for the Occurrence of Uveitis in Juvenile Idiopathic Arthritis: Data From the Inception Cohort of Newly Diagnosed Patients With Juvenile Idiopathic Arthritis Study.
Risk Factors and Biomarkers for the Occurrence of Uveitis in Juvenile Idiopathic Arthritis: Data From the Inception Cohort of Newly Diagnosed Patients With Juvenile Idiopathic Arthritis Study.
复制标题
DOI：
10.1002/art.40544
复制
发表时间：
2018-10
期刊：
影响因子：
--
通讯作者：
Heiligenhaus A
中科院分区：
文献类型：
--
作者：
Tappeiner C;Klotsche J;Sengler C;Niewerth M;Liedmann I;Walscheid K;Lavric M;Foell D;Minden K;Heiligenhaus A
分析人口统计学、临床和治疗因素及实验室生物标志物的预后价值，并评估其在预测幼年特发性关节炎（JIA）患者葡萄膜炎发生中的作用。JIA患者在JIA诊断后一年内入组。记录了人口统计学和临床参数。在研究入组时收集血清样本，在第一年随访3个月，然后每6个月收集一次血清样本。采用多变量Cox回归分析来评估人口统计学、临床、实验室和治疗参数对葡萄膜炎发病的影响。我们纳入954例JIA患者（67.2%为女性，54.2%为抗核抗体[ANA]阳性，平均±SD发病年龄7.1±4.6岁）。葡萄膜炎133例（观察期44.5个月）。JIA发病年龄小、ANA阳性与葡萄膜炎发病显著相关（P < 0.001）。单用甲氨蝶呤（风险比[HR] 0.18[95%可信区间（95% CI） 0.12-0.29], P < 0.001）或联合依那西普（风险比[HR] 0.10 [95% CI 0.04-0.23], P < 0.001）或阿达木单抗（风险比[HR] 0.09 [95% CI 0.01-0.61], P = 0.014）治疗关节炎可降低葡萄膜炎发病和葡萄膜炎相关并发症的发生风险。葡萄膜炎发病的预测因子包括基线时红细胞沉降率升高（风险比2.36 [95% CI 1.38-4.02], P = 0.002）和随访期间持续的中度或高度疾病活动性（风险比4.30 [95% CI 2.51-7.37], P < 0.001）。此外，基线时S100A12水平≥250 ng/ml与葡萄膜炎的风险显著相关（HR 2.10 [95% CI 1.15-3.85], P = 0.016）。除了人口统计学危险因素和治疗方式外，JIA疾病活动度评分和实验室生物标志物可以更好地定义JIA患者发生葡萄膜炎的高危人群。
To analyze the prognostic value of demographic, clinical, and therapeutic factors and laboratory biomarkers and to assess their role in predicting uveitis occurrence in patients with juvenile idiopathic arthritis (JIA). Patients with JIA were enrolled within the first year after JIA diagnosis. Demographic and clinical parameters were documented. Serum samples were collected at study enrollment, at 3‐month follow‐up visits within the first year, and then every 6 months. A multivariable Cox regression analysis was performed to evaluate the impact of demographic, clinical, laboratory, and therapeutic parameters on uveitis onset. We included 954 JIA patients (67.2% female, 54.2% antinuclear antibody [ANA] positive, mean ± SD age at onset 7.1 ± 4.6 years). Uveitis occurred in 133 patients (observation period 44.5 months). Young age at JIA onset and ANA positivity were significantly associated with the onset of uveitis (both P < 0.001). Treatment of arthritis with methotrexate alone (hazard ratio [HR] 0.18 [95% confidence interval (95% CI) 0.12–0.29], P < 0.001) or combined with etanercept (HR 0.10 [95% CI 0.04–0.23], P < 0.001) or adalimumab (HR 0.09 [95% CI 0.01–0.61], P = 0.014) reduced the risk of uveitis onset and the occurrence of uveitis‐related complications. Predictors of uveitis onset included elevated erythrocyte sedimentation rate at baseline (HR 2.36 [95% CI 1.38–4.02], P = 0.002) and continuing moderate or high disease activity during follow‐up as measured by the 10‐joint clinical Juvenile Arthritis Disease Activity Score (HR 4.30 [95% CI 2.51–7.37], P < 0.001). Additionally, S100A12 levels ≥250 ng/ml at baseline were significantly associated with the risk of uveitis (HR 2.10 [95% CI 1.15–3.85], P = 0.016). Apart from demographic risk factors and treatment modalities, JIA disease activity scores and laboratory biomarkers could be used to better define the group of JIA patients at high risk of uveitis onset.
登录
查看更多内容
影响因子：
120.7
作者：
Foell, Dirk;Wulffraat, Nico;Roth, Johannes
通讯作者：
Roth, Johannes
DOI：
10.1186/s12969-017-0195-8
发表时间：
2017-08-18
期刊：
Pediatric rheumatology online journal
影响因子：
--
作者：
Nordal E;Rypdal V;Christoffersen T;Aalto K;Berntson L;Fasth A;Herlin T;Nielsen S;Peltoniemi S;Straume B;Zak M;Rygg M;Nordic Study Group of Pediatric Rheumatology (NoSPeR)
通讯作者：
Nordic Study Group of Pediatric Rheumatology (NoSPeR)
影响因子：
3.9
作者：
Angeles-Han, Sheila T.;Pelajo, Christina F.;Prahalad, Sampath
通讯作者：
Prahalad, Sampath
影响因子：
13.7
作者：
Kotaniemi, K;Kautiainen, H;Aho, K
通讯作者：
Aho, K
影响因子：
5.5
作者：
Heiligenhaus, A.;Niewerth, M.;Minden, K.
通讯作者：
Minden, K.