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Evaluation of the association between Hispanic ethnicity and disease activity and severity in a large cohort of patients with juvenile idiopathic arthritis

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Abstract

To examine the association between ethnicity and disease activity in patients with juvenile idiopathic arthritis (JIA), and to determine the association of ethnicity with disease severity and disability in this population. CARRAnet, a US database containing information (collected between May 2010 and June 2011) on almost 3,000 subjects with JIA, was used. Demographic variables were compared between Hispanic patients and non-Hispanic patients. Mann–Whitney and chi-square tests were used to compare indicators of disease activity, as well as imaging evidence of joint damage, and Childhood Health Assessment Questionnaire (CHAQ) scores between ethnicities. Two linear regression models were used to determine the association of ethnicity with number of active joints in JIA, and the association between ethnicity and disability (CHAQ scores). A total of 2,704 patients with JIA (277 Hispanic; 2,427 non-Hispanic) were included. Income and health insurance coverage were higher in non-Hispanics. RF-positive polyarticular JIA, positive RF and anti-CCP, as well as use of systemic steroids were more frequent in Hispanics. Imaging evidence of joint damage was present in 32 % of the Hispanic patients compared to 24 % of the non-Hispanic patients (p = 0.008). In multivariate linear regression analyses, the number of active joints was significantly higher in Hispanics than in non-Hispanics (p = 0.03), as well as CHAQ scores (p = 0.003), after adjusting for confounders. Hispanic patients with JIA had higher disease activity than non-Hispanic patients, as well as higher disease severity and disability. Since ethnicity influences disease activity, severity, and disability, different management and treatment plans should be planned accordingly.

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Acknowledgments

We would like to acknowledge all the PI’s of the CARRA Registry sites (James Birmingham, Peter Blier, Norman Ilowite, Thomas Graham, Fatma Dedeoglu, David Sherry, Kathryn Torok, Rita Jerath, Marisa Klein-Gitelman, Andrew Lasky, Lawrence Jung, Steven Spalding, Lawrence Zemel, Consuelo Rabinovich, Sampath Prahalad, Jorge Lopez-Benitez, Ali Yalcindag, Suzanne Bowyer, Jennifer Weiss, Daniel Kingsbury, Ann Reed, Judyann Olson, Natasha Ruth, Lisa Imundo, Gloria Higgins, Philip Kahn, Karin Peterson, Nora Singer, Nandini Moorthy, Elizabeth Chalom, Reema Syed, Ana Quintero, Beth Gottlieb, Sarah Ringold, Deborah Rothman, Donald Goldsmith, Christy Sandborg, Barry Myones, Andrew White, Timothy Beukelman, Emily von Scheven, Karen Onel, J. Roger Hollister, Polly Ferguson, Carol Lindsley, Kenneth Schikler, Richard Vehe, Kathleen O’Neil, Marilynn Punaro, Christi Inman, Anna Huttenlocher, Leslie Abramson, Barbara Adams, Kabita Nanda, Deborah McCurdy, Thomas Lehman), as well as all CARRA Registry investigators and study coordinators. Grant supporters: NIAMS (Grant Number 1RC2AR058934-01 and R01-AR060893 to SP), Arthritis Foundation, Friends of CARRA, and supported in part by The National Eye Institute (K23-EY021760 to SAH).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Pediatric Rheumatology, Hospital Pequeno Príncipe, R. Desembargador Motta, Curitiba, PR, 1070, Brazil

    Christina F. Pelajo

  2. Pediatric Rheumatology, Emory-Children’s Center, 2015 Uppergate Drive NE, Atlanta, GA, 30322-1015, USA

    Sheila T. Angeles-Han & Sampath Prahalad

  3. Pediatric Rheumatology, Golisano Children’s Hospital, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA

    Caitlin M. Sgarlat

  4. Pediatric Rheumatology, Floating Hospital for Children at Tufts Medical Center, 800 Washington St, Box #190, Boston, MA, 02111, USA

    Trevor E. Davis, Laurie C. Miller & Jorge M. Lopez-Benitez

Authors
  1. Christina F. Pelajo
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  2. Sheila T. Angeles-Han
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  3. Sampath Prahalad
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  4. Caitlin M. Sgarlat
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  5. Trevor E. Davis
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  6. Laurie C. Miller
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  7. Jorge M. Lopez-Benitez
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Corresponding author

Correspondence to Christina F. Pelajo .

Additional information

The study was conducted for the CARRA Registry Investigators.

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Pelajo , C.F., Angeles-Han, S.T., Prahalad, S. et al. Evaluation of the association between Hispanic ethnicity and disease activity and severity in a large cohort of patients with juvenile idiopathic arthritis. Rheumatol Int 33, 2549–2554 (2013). https://doi.org/10.1007/s00296-013-2773-5

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  • DOI: https://doi.org/10.1007/s00296-013-2773-5

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