Background Comorbidities can have a significant influence on presentation, course and prognosis of JIA.
Objectives The aim of this study is to analyse the occurrence of comorbidities in a large JIA cohort.
Methods JIA patients starting treatment with biologics or methotrexate were followed by the BIKER registry. This database was screened for comorbid conditions reported at baseline. Differences were analyzed by χ2 test.
Results 3427 pts (67.6% female) were admitted. The median [IQR] age at onset was 7.1 y. [3.1; 11.3], at inclusion was 11.8 y. [7.3-14.9] and the median disease duration was 2.1 y. [0,7-5.2]. 1517 (44.3%) pts started MTX. 1916 (55.7%) pts started a biologic. A total of 1327 comorbidities were reported in 959 pts (up to 4 per pts). Uveitis (327) was the most common followed by asthma (53), short stature (47), atopic dermatitis (44), Hashimoto thyreoiditis (29), obesity (28), heart defects (20), arterial hypertension (20), Psoriasis (25), pain amplification syndrome (19), attention-deficit hyperactivity disorder (19), diabetes mellitus type 1 (18), epilepsies (14) and cushingoid syndrome (14). Thus with the exception of uveitis, comorbidities are rarely reported. On interest, the rate of obesity reported is the same as the rate calculated (BMI SDS>3 according to WHO), the rate of short stature reported is much lower than calculated (n=234, length SDS <-2). Significant differences in gender distribution were noted for a number of comorbidities (table). Pts with hip dysplasia, Raynaud's, and those suffering from macrophage activation syndrome were all female. For patients with systemic JIA especially short stature, hypertension, cushingoids, cataract, osteoporosis, celiac disease and MAS, in RF+ polyJIA osteoporosis and anaemia, in ext/pers. oligo JIA uveitis, in ERA attention deficit disorder and CRMO and in PsA asthma, Hashimoto's and psoriasis were reported at least 2 fold more frequently than average.
Conclusions Apart from uveitis comorbidities are rare, but there were marked gender related differences. Gender specific aspects should be taken into account considering the diagnostics and treatment of JIA. The limitation of these analyses is the voluntary reporting of comorbidities in BIKER.
Disclosure of Interest None declared
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