Skip to main content

Advertisement

SpringerLink
Log in

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

  • Cohort Studies
  • Published:
Rheumatology International Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Manners PJ, Bower C (2002) Worldwide prevalence of juvenile arthritis why does it vary so much? J Rheumatol 29:1520–1530

    PubMed  Google Scholar 

  2. Rocha FA (2017) Latin-American challenges and opportunities in rheumatology. Arthritis Res Ther 19:29–30

    Article  PubMed  PubMed Central  Google Scholar 

  3. Terreri MT, Campos LM, Okuda EM, Silva CA, Sacchetti SB, Marini R et al (2013) Profile of paediatric rheumatology specialists and services in the state of São Paulo. Rev Bras Reumatol 53:346–351

    Article  PubMed  Google Scholar 

  4. Yamashita E, Terreri MT, Hilário MO, Len CA (2013) Prevalence of juvenile idiopathic arthritis in children aged 6 to 12 years in Embu das Artes, state of Sao Paulo, Brazil. Rev Bras Reumatol 53:542–545

    Article  PubMed  Google Scholar 

  5. Shenoi S, Shaffer ML, Wallace CA (2016) Environmental risk factors and early-life exposures in juvenile idiopathic arthritis: a case–control study. Arthritis Care Res (Hoboken) 68:1186–1194

    Article  CAS  Google Scholar 

  6. World Health Organization (2011) 10 facts on health inequities and their causes. World Health Organization, Geneva

    Google Scholar 

  7. Marmot M (2015) The health gap: the challenge of an unequal world. Lancet 386:2442–2444

    Article  PubMed  Google Scholar 

  8. Reveille JD, Muñoz R, Soriano E, Albanese M, Espada G, Lozada CJ, Montúfar RA, Neubarth F, Vasquez GM, Zummer M, Sheen R, Caballero-Uribe CV, Pineda C (2016) Review of current workforce for rheumatology in the countries of the Americas 2012–2015. J Clin Rheumatol 22:405–410

    Article  PubMed  Google Scholar 

  9. https://en.wikipedia.org/wiki/List_of_Brazilian_federative_units_by_gross_domestic_product. Accessed 14 Feb 2018

  10. Gutiérrez-Suárez R, Pistorio A, Cespedes Cruz A, Norambuena X, Flato B, Rumba I, Harjacek M, Nielsen S, Susic G, Mihaylova D, Huemer C, Melo-Gomes J, Andersson-Gare B, Balogh Z, De Cunto C, Vesely R, Pagava K, Romicka AM, Burgos-Vargas R, Martini A, Ruperto N; Pediatric Rheumatology International Trials Organisation (PRINTO) (2007) Health-related quality of life of patients with juvenile idiopathic arthritis coming from 3 different geographic areas. The PRINTO multinational quality of life cohort study. Rheumatology 46:314–320

    Article  PubMed  Google Scholar 

  11. de Sousa Studart SA, Leite AC, Marinho AL, Pinto AC, Rabelo Júnior CN, de Melo Nunes R, Rocha HA, Rocha FA (2015) Vitamin D levels in juvenile idiopathic arthritis from an equatorial region. Rheumatol Int 35:1717–1723

    Article  CAS  PubMed  Google Scholar 

  12. Alcântara AC, Leite CA, Leite AC, Sidrim JJ, Silva FS Jr, Rocha FA (2014) A longterm prospective real-life experience with leflunomide in juvenile idiopathic arthritis. J Rheumatol 41:338–344

    Article  PubMed  Google Scholar 

  13. GEO-RA Group (2016) Latitude gradient influences the age of onset of rheumatoid arthritis: a worldwide survey. Clin Rheumatol 36:485–497

    Article  Google Scholar 

  14. Consolaro A, Giancane G, Schiappapietra B, Davì S, Calandra S, Lanni S, Ravelli A (2016) Clinical outcome measures in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 14:23–30

    Article  PubMed  PubMed Central  Google Scholar 

  15. Consolaro A, Ruperto N, Bazso A, Pistorio A, Magni-Manzoni S, Filocamo G et al (2009) Development and validation of a composite disease activity score for juvenile idiopathic arthritis. Arthritis Rheum 61:658–666

    Article  PubMed  Google Scholar 

  16. Machado CS, Ruperto N, Silva CH, Ferriani VP, Roscoe I, Campos LM, Oliveira SK, Kiss MH, Bica BE, Sztajnbok F, Len CA, Melo-Gomes JA (2001) The Brazilian version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ). Paediatric Rheumatology International Trials Organisation. Clin Exp Rheumatol 19(4 Suppl 23):S25–S29

    CAS  PubMed  Google Scholar 

  17. Consolaro A, Negro G, Gallo MC et al (2014) Defining criteria for disease activity states in nonsystemic juvenile idiopathic arthritis based on a three-variable juvenile arthritis disease activity score. Art Care Res 66:1703–1709

    Article  Google Scholar 

  18. Beukelman T, Kimura Y, Ilowite NT, Mieszkalski K, Natter MD, Burrell G, Best B, Jones J, Schanberg LE, CARRA Registry Investigators (2017) The new Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry: design, rationale, and characteristics of patients enrolled in the first 12 months. Pediatr Rheumatol Online J 15:30–39

    Article  PubMed  PubMed Central  Google Scholar 

  19. França CMP, Sallum AME, Braga ALF et al (2018) Risk factors associated with juvenile idiopathic arthritis: exposure to cigarette smoking and air pollution from pregnancy to disease diagnosis. J Rheumatol 45:248–256

    Article  CAS  PubMed  Google Scholar 

  20. Dempster H, Porepa M, Young N, Feldman BM (2001) The clinical meaning of functional outcome scores in children with juvenile arthritis. Arthritis Rheum 44:1768–1774

    Article  CAS  PubMed  Google Scholar 

  21. Philippi K, Hoetzel M, Robinson AB, Kim S, for the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry Investigators (2017) Race, income, and disease outcomes in juvenile dermatomyositis. J Pediatr 184:38–44

    Article  Google Scholar 

  22. Consolaro A, Negro G, Lanni S, Solari N, Martini A, Ravelli A (2012) Toward a treat-to-target approach in the management of juvenile idiopathic arthritis. Clin Exp Rheumatol 30:S157–S162

    PubMed  Google Scholar 

Download references

Funding

This work was financially supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ), Brasil—Grant 459334/2014-0.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Liga de Reumatologia e Doenças Autoimunes, Faculdade de Medicina, Federal University of Ceará, Fortaleza, Brazil

    Francisco Airton Castro Rocha, Joaquim Ivo Vasques Dantas Landim, Marcela Gondim Aguiar, João Pedro Emrich Accioly, Carolina Noronha Lechiu, Luiza Helena Acácio Costa & Leila Nascimento da Rocha

  2. Rheumatology Service, Pediatric Rheumatology Division, Hospital Geral de Fortaleza, Fortaleza, CE, Brazil

    Carlos Nobre Rabelo Júnior

  3. Department of Public Health, Federal University of Ceará, Fortaleza, Brazil

    Hermano Alexandre Lima Rocha

  4. Instituto de Biomedicina, Laboratório de Investigação em Osteoartropatias, Rua Cel. Nunes de Melo, 1315-1°, Andar, Rodolfo Teófilo, Fortaleza, CE, 60430-270, Brazil

    Francisco Airton Castro Rocha

Authors
  1. Francisco Airton Castro Rocha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joaquim Ivo Vasques Dantas Landim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marcela Gondim Aguiar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. João Pedro Emrich Accioly
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Carolina Noronha Lechiu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Luiza Helena Acácio Costa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Carlos Nobre Rabelo Júnior
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Leila Nascimento da Rocha
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hermano Alexandre Lima Rocha
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

FACR and CNRJ conceived the article. FACR, JIVDL, LNR and HALR performed tabulation of data and statistics. JIVDL, MGA, JPEA, CNL, LHAC, LNR performed data collection, revision of clinical files, interviewed and applied questionnaires to patients/parents. All authors participated in the preparation and revision of the manuscript, read and approved the final version to be submitted.

Corresponding author

Correspondence to Francisco Airton Castro Rocha.

Ethics declarations

Conflict of interest

All authors declare that they have no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rocha, F.A.C., Landim, J.I.V.D., Aguiar, M.G. et al. Evaluation of disease activity in a low-income juvenile idiopathic arthritis cohort. Rheumatol Int 39, 67–71 (2019). https://doi.org/10.1007/s00296-018-4128-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-018-4128-8

Keywords

Search

Navigation