Juvenile Arthritis Patients Distinct From Those With RA

Recent research published in the Journal of Clinical Rheumatology found that two populations that are commonly grouped together, adults with polyarticular juvenile idiopathic arthritis (JIA) and rheumatoid arthritis (RA), have different medical needs and should be treated differently.

Attempting to identify clinical features and therapies involved with polyarticular JIA patients and RA patients, researchers conducted a cross-sectional study including 45 adults with polyarticular JIA and 94 with RA. All patients were recruited through Penn State Hershey Medical Center system, from 2013 to 2017 and were at least 18 years of age.  Comparing criteria via chi-squared analyses and McNemar testing, researchers identified polyarticular arthritis as five or more joints being affected after 6 months of the disease. TNF-inhibitor survival was used to evaluate therapies and medications. Researchers also made an accelerated failure-time model for time to methotrexate initiation.

The team found that polyarticular JIA patients were less likely to cyclic citrullinated peptide antibody or rheumatoid factor positive than those with RA, with less than half of them meeting classification criteria for RA. Both groups showed a correlation between time between diagnosis and methotrexate therapy and longer disease duration. While 49% of polyarticular JIA patients received TNF-inhibitor treatment, only 18% of the RA patients did. TNF-inhibitor treatment continued for longer durations in polyarticular JIA patients, yielding a median survival of 4.41 years in these patients and 0.71 years in patients with RA.

The authors conclude that, “Although often considered together in adult rheumatology practice, adults with pJIA are distinct from patients with RA. Medication use markedly differed between the 2 populations with greater prevalence and duration of TNFi use in pJIA patients. Further study is needed to improve outcomes in this unique population.”

Sources: Journal of Clinical Rheumatology, Healio