Occurrence and Risk Factors of Uveitis in Juvenile Psoriatic Arthritis: Data From a Population-based Nationwide Study in Germany

• Published in: Journal of rheumatology 2022-07, Vol.49 (7), p.719-724
• Main Authors: Baquet-Walscheid, Karoline, Rothaus, Kai, Niewerth, Martina, Klotsche, Jens, Minden, Kirsten, Heiligenhaus, Arnd
• Format: Article
• Language: English
• ISSN: 0315-162X; 1499-2752
• DOI: 10.3899/jrheum.210755

Data on uveitis in juvenile psoriatic arthritis ( JPsA), a category of juvenile idiopathic arthritis ( JIA), are scarce. We describe prevalence and risk factors for JPsA-associated uveitis ( JPsA-U). Cross-sectional data from the German National Pediatric Rheumatological Database (2002-2014) were used to characterize JPsA-U and assess risk factors for the development of uveitis. Uveitis developed in 6.6% of 1862 patients with JPsA. Patients with JPsA-U were more frequently female (73.0 vs 62.9%, = 0.03), antinuclear antibody (ANA) positive (60.3 vs 37.0%, < 0.001), younger at JPsA onset (5.3 ± 4.1 vs 9.3 ± 4.4 yrs, < 0.001), and treated with disease-modifying antirheumatic drugs (DMARDs) significantly more frequently compared with JPsA patients without uveitis. On a multivariable analysis of a subgroup of 655 patients enrolled in the study ≤ 1 year after arthritis onset, mean clinical Juvenile Arthritis Disease Activity Score for 10 joints during study documentation was significantly associated with uveitis development. Children with early onset of JPsA (aged < 5 yrs vs ≥ 5 yrs) were significantly more frequently ANA positive (48.4% vs 35.7%, < 0.001), affected by uveitis (17.3% vs 3.8%, < 0.001), and treated with DMARDs (52.9% vs 43.8%, < 0.001), but less often affected by skin disease (55.3% vs 61.0%, = 0.03). The characteristics of patients with JPsA developing uveitis are similar to those of patients with uveitis in other JIA categories, such as oligoarticular JIA. Children with early-onset JPsA are at a higher risk for ocular involvement. Our data support the notion of a major clinical difference between those patients with early vs late onset of JPsA.