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

  • Francisco Airton Castro Rocha
  • Joaquim Ivo Vasques Dantas Landim
  • Marcela Gondim Aguiar
  • João Pedro Emrich Accioly
  • Carolina Noronha Lechiu
  • Luiza Helena Acácio Costa
  • Carlos Nobre Rabelo Júnior
  • Leila Nascimento da Rocha
  • Hermano Alexandre Lima Rocha
Cohort Studies

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.

Keywords

Juvenile idiopathic arthritis Epidemiology Pediatric rheumatology 

Notes

Author 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.

Funding

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

Compliance with ethical standards

Conflict of interest

All authors declare that they have no competing interests.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Internal Medicine, Liga de Reumatologia e Doenças Autoimunes, Faculdade de MedicinaFederal University of CearáFortalezaBrazil
  2. 2.Rheumatology Service, Pediatric Rheumatology DivisionHospital Geral de FortalezaFortalezaBrazil
  3. 3.Department of Public HealthFederal University of CearáFortalezaBrazil
  4. 4.Instituto de Biomedicina, Laboratório de Investigação em OsteoartropatiasFortalezaBrazil

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