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Quality of life in children suffering from juvenile idiopathic arthritis-associated uveitis

Abstract

Uveitis (JIA-U), the most common extra-articular manifestation in juvenile idiopathic arthritis (JIA), may cause severe impairment of vision in children and affect their quality of life (QoL). Considering the lack of uveitis-related QoL assessment questionnaire, and multidimensional nature of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR), commonly used for monitoring and assessing the health status of children with JIA, we performed a cross-sectional study to investigate the potential of the JAMAR in estimation of QoL in children suffering from JIA-U. The study included 42 children with JIA, 21 of whom had JIA-U. Both children and their parents completed the JAMAR. We compared two groups of children (JIA-U and JIA without uveitis) and their parents against five extracted questionnaires items (QoL, functional ability, pain level, disease activity estimation, and current emotional state of the child) using the independent-samples t test to verify the differences and the Pearson correlation coefficient to measure the strength of a linear association between variables. No significant statistical difference in any of the examined variables was found between the two groups of children. In the groups of parents, current emotional state of children with JIA-U was assessed to be significantly worse (t = 2.05, p < 0.05) and the overall level of functioning significantly lower (t = 2.03, p < 0.05) than children without uveitis. Our results suggest the need for adding the uveitis-specific questionnaires items to JAMAR to improve its sensitivity and specificity in the assessment of QoL in children suffering from JIA-U, as well as designing a second assessment tool such as uveitis-specific questionnaires.

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Funding

No specific grant from any public or commercial agency was received for this study.

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Authors

Contributions

MS, MF, NK, SP, NV and KP contributed to the acquisition and interpretation of data for the work: they examined the patients, performed rheumatologic and ophthalmologic assessments and contributed to interpretation of the study data and writing the manuscript. DG, MS and MG contributed to the analysis and interpretation of data for the work: they performed the statistics, developed the figures, analyzed and interpreted the study data and contributed to writing the manuscript. MJ contributed to the conception and design of the work, organized the study, reviewed and revised the manuscript and supervised the project. All authors read and approved the final manuscript to be published. All co-authors are fully responsible for all aspects of the study and the final manuscript. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Marija Jelusic.

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Conflict of interest

The authors M. Sestan, D. Grguric, M. Sedmak, M. Frkovic, N. Kifer, M. Grubic, S. Peric, N. Vukojevic, K. Potocki and M. Jelusic declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of the University Hospital Centre Zagreb, Zagreb, Croatia (date: June 7, 2016; Protocol Number–Class: 8.1-16/94-2, Number: 02/21 AG).

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Informed consent was obtained from all individual participants included in the study.

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The results of this research are briefly presented in congress abstract publication: Sestan M, Grguric D, Sedmak M, Kifer N, Frkovic M, Peric S, Potocki K, Vukojevic N, Jelusic M (2019) Quality of life in juvenile idiopathic arthritis-associated uveitis: do we need a new assessment questionnaire? Ann Rheum Dis 78:1330. https://doi.org/10.1136/annrheumdis-2019-eular.5013

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Sestan, M., Grguric, D., Sedmak, M. et al. Quality of life in children suffering from juvenile idiopathic arthritis-associated uveitis. Rheumatol Int 40, 1117–1121 (2020). https://doi.org/10.1007/s00296-020-04536-1

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Keywords

  • Juvenile idiopathic arthritis
  • Uveitis
  • Health-related quality of life
  • Patient health questionnaire