June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Risk for uveitis occurrence in juvenile idiopathic arthritis (JIA) and predictive factors for the 2-years outcome: Data from the Inception Cohort of Newly diagnosed patients with JIA (ICON-JIA) study
Author Affiliations & Notes
  • Karoline Walscheid
    Department of Ophthalmology at St. Franziskus-Hospital, Muenster, Germany
    Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany
  • Christoph Tappeiner
    Department of Ophthalmology at St. Franziskus-Hospital, Muenster, Germany
    Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
  • Jens Klotsche
    German Rheumatism Research Center (DRFZ), Leibnitz Institute, Berlin, Germany
  • Sandra Schenck
    German Rheumatism Research Center (DRFZ), Leibnitz Institute, Berlin, Germany
  • Martina Niewerth
    German Rheumatism Research Center (DRFZ), Leibnitz Institute, Berlin, Germany
  • Ina Liedmann
    German Rheumatism Research Center (DRFZ), Leibnitz Institute, Berlin, Germany
  • Miha Lavric
    Clinic for Pediatric Rheumatology and Immunology, University of Muenster, Muenster, Germany
  • Dirk Foell
    Clinic for Pediatric Rheumatology and Immunology, University of Muenster, Muenster, Germany
  • Arnd Heiligenhaus
    Department of Ophthalmology at St. Franziskus-Hospital, Muenster, Germany
    Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany
  • Kirsten Minden
    German Rheumatism Research Center (DRFZ), Leibnitz Institute, Berlin, Germany
  • Footnotes
    Commercial Relationships   Karoline Walscheid, None; Christoph Tappeiner, None; Jens Klotsche, None; Sandra Schenck, None; Martina Niewerth, None; Ina Liedmann, None; Miha Lavric, None; Dirk Foell, Novartis (R), Novartis (F), Pfizer (R), Pfizer (F); Arnd Heiligenhaus, AbbVie (R), Alimera Sciences (R), Allergan (R), MSD Sharp and Dohme (R), Novartis (F), Pfizer (R), Pfizer (F), Santen (R), Xoma (R); Kirsten Minden, Abbvie (F), Pfizer (R), Pfizer (F), Pharm-Allergan (R), Roche (F), Roche/Chugai (R)
  • Footnotes
    Support  The study presented was supported by grants from the German Federal Ministry of Education and Research (BMBF, FKZ 01 ER 1504A, 01 ER 1504B, 01 ER 1504C)
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2157. doi:
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      Karoline Walscheid, Christoph Tappeiner, Jens Klotsche, Sandra Schenck, Martina Niewerth, Ina Liedmann, Miha Lavric, Dirk Foell, Arnd Heiligenhaus, Kirsten Minden; Risk for uveitis occurrence in juvenile idiopathic arthritis (JIA) and predictive factors for the 2-years outcome: Data from the Inception Cohort of Newly diagnosed patients with JIA (ICON-JIA) study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2157.

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Abstract

Purpose : To prospectively analyze predictors for occurrence and clinical course of uveitis in newly diagnosed juvenile idiopathic arthritis (JIA).

Methods : Patients with JIA (n=957) were enrolled in the Inception Cohort of Newly diagnosed patients with JIA (ICON-JIA) study within the first year after JIA diagnosis. Demographic and clinical parameters were documented at baseline, 3-monthly during the first year and 6-monthly afterwards. Serum samples were collected at each visit, and serum S100A12 levels were measured by ELISA. Multivariate Cox-regression analysis was performed to evaluate the impact of demographic, clinical, laboratory and therapeutic parameters on onset and two-years uveitis outcome.

Results : Mean age at JIA onset was 7.1 ± 4.6 years, 67.1% of patients were female and 56.6% ANA positive. In 61 patients, uveitis was present before JIA diagnosis, and occurred in another 60 patients during follow up (FU; mean 39 months). Risk factors for uveitis onset were young age at JIA onset (HR 1.19, p<0.0001), oligoarthritis (HR 1.22, p<0.0001) and ANA positivity (HR 2.34, p=0.004). Predictors for uveitis onset during FU were high cJADAS10 scores (HR 1.05, p=0.031), S100A12 levels >250ng/ml (HR 2.74, p=0.001) and ESR >20 mm/h (HR 2.32, p=0.005) at baseline. Uveitis inactivity was achieved in 78.9% and 89.5% of patients at 1- and 2-years FU, respectively. Predictors for uveitis quiescence (≥6 months) were uveitis onset after age of 5 years (OR 3.00; p=0.02), lower cJADAS10 (OR 0.78; p<0.0001), low anterior chamber (AC) cell-grade (OR 2.50; p=0.001), and adalimumab treatment (OR 5.10; p=0.001) at visit before attaining uveitis inactivity. Age <5 years at uveitis onset (OR 12.5, p=0.03) and cJADAS10 >4.5 (OR 5.54; p<0.03) were predictors for subsequent uveitis reactivation (n=13, 23%). Ocular complications were present in 27.8% at baseline, and in 28.2% and 34.0% at 1- and 2-year FU, respectively. AC cell grades ≥1+ (HR 4.00; p=0.086) and AC tyndall ≥1+ (HR 6.73; p=0.041) correlated with presence of uveitis-related complications.

Conclusions : Beside demographic risk factors, JIA disease activity scores and biomarkers can help to identify patients at risk for uveitis onset. Clinical characteristics and treatment are additional predictors for the 2-years outcome of uveitis.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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