Trends in Population‐Based Incidence and Prevalence of Juvenile Idiopathic Arthritis in Manitoba, Canada

Shiff, Natalie J.; Oen, Kiem; Kroeker, Kristine; Lix, Lisa M.

doi:10.1002/acr.23606

Cited by 27 publications

(17 citation statements)

References 11 publications

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“…These pooled rates were however based on studies using the three different disease classifications (ILAR, ACR, and EULAR). The incidence rates of juvenile arthritis differ between 15.0/100,000/year in the Nordic countries (ILAR) [6], 10.3/100,000 in Minnesota (USA) (ILAR and ACR) [7], 8.5/100,000 in Manitoba (Canada) (ILAR) [8], 6.9/100,000 in Catalonia (Spain) (ILAR) [9], and 3.1/100,000 in Alsace (France) (ILAR) [10].…”

Section: Introductionmentioning

confidence: 99%

Outcome in juvenile idiopathic arthritis: a population-based study from Sweden

2019

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BackgroundAs the treatment arsenal for children with juvenile idiopathic arthritis (JIA) has expanded during the last decades, follow-up studies are needed on children diagnosed in the era of biological treatment to evaluate if this has improved the outcome. Our aim was to study the epidemiology and outcome of JIA in southern Sweden using a population-based cohort of children with a validated diagnosis of JIA collected over 9 years.MethodsPotential cases of JIA between 2002 and 2010 were collected after a database search, using the ICD codes M08-M09. The study area was Skåne, the southernmost county of Sweden (population 1.24 million; 17.6% aged < 16 years). The JIA diagnosis was validated and subcategorized through medical record review based on the criteria defined by the International League of Associations for Rheumatism (ILAR). Parameters on disease activity and pharmacologic treatment were recorded annually until the end of the study period (December 31, 2015).ResultsIn total, 251 cases of JIA were confirmed. The mean annual incidence rate for JIA was estimated to be 12.8/100,000 children < 16 years, with the highest age-specific annual incidence at the age of 2 years (36/100,000). Oligoarthritis was the largest subgroup (44.7%), and systemic JIA was the smallest subgroup (2.8%). Methotrexate was the most common disease-modifying anti-rheumatic drug prescribed (60.6%). Tumor necrosis factor alpha inhibitors were used as treatment for 23.9% of the children. Only 40.0% of the follow-up years, with a median follow-up time of 8 years, were free of arthritis or uveitis. Uveitis occurred in 10.8% of the children (8.0% chronic uveitis), and the need for joint corrective orthopedic surgery was 9.2%.ConclusionsThe incidence of JIA in this well-defined, population-based cohort is slightly lower than in previously published studies from Scandinavia. The need for orthopedic surgery and the presence of uveitis are diminished compared to studies with patients diagnosed more than 20 years ago. Children with JIA however still experience disease activity more than 50% of the time. In conclusion, we still have long-term challenges in the care for children with JIA, in spite of state-of-the-art treatment.

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Section: Introductionmentioning

confidence: 99%

Outcome in juvenile idiopathic arthritis: a population-based study from Sweden

2019

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“…Panel B shows results for the random effects approach requires consideration of the longitudinal disease markers of interest, additional model covariates, and random effects. In this study, the disease markers and covariates were chosen based on prior research [31,34,35]. Fit statistics may also be used to provide empirical evidence about the choices to be made.…”

Section: Discussionmentioning

confidence: 99%

A population‐based study to develop juvenile arthritis case definitions for administrative health data using model‐based dynamic classification

Feely

Lim

Jiang

et al. 2021

BMC Med Res Methodol

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Background Previous research has shown that chronic disease case definitions constructed using population-based administrative health data may have low accuracy for ascertaining cases of episodic diseases such as rheumatoid arthritis, which are characterized by periods of good health followed by periods of illness. No studies have considered a dynamic approach that uses statistical (i.e., probability) models for repeated measures data to classify individuals into disease, non-disease, and indeterminate categories as an alternative to deterministic (i.e., non-probability) methods that use summary data for case ascertainment. The research objectives were to validate a model-based dynamic classification approach for ascertaining cases of juvenile arthritis (JA) from administrative data, and compare its performance with a deterministic approach for case ascertainment. Methods The study cohort was comprised of JA cases and non-JA controls 16 years or younger identified from a pediatric clinical registry in the Canadian province of Manitoba and born between 1980 and 2002. Registry data were linked to hospital records and physician billing claims up to 2018. Longitudinal discriminant analysis (LoDA) models and dynamic classification were applied to annual healthcare utilization measures. The deterministic case definition was based on JA diagnoses in healthcare use data anytime between birth and age 16 years; it required one hospitalization ever or two physician visits. Case definitions based on model-based dynamic classification and deterministic approaches were assessed on sensitivity, specificity, and positive and negative predictive values (PPV, NPV). Mean time to classification was also measured for the former. Results The cohort included 797 individuals; 386 (48.4 %) were JA cases. A model-based dynamic classification approach using an annual measure of any JA-related healthcare contact had sensitivity = 0.70 and PPV = 0.82. Mean classification time was 9.21 years. The deterministic case definition had sensitivity = 0.91 and PPV = 0.92. Conclusions A model-based dynamic classification approach had lower accuracy for ascertaining JA cases than a deterministic approach. However, the dynamic approach required a shorter duration of time to produce a case definition with acceptable PPV. The choice of methods to construct case definitions and their performance may depend on the characteristics of the chronic disease under investigation.

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“…Juvenile idiopathic arthritis (JIA) has been considered as the most common rheumatic disease characterized by complex chronic inflammation of unknown cause in children, representing a heterogeneous group of disorders all sharing the clinical manifestation of arthritis [ 1 ]. The worldwide incidence rates per 100,000 range from 0.8 to 22.6 and the prevalence rates are from 7 to 401 per 100,000 [ 2 , 3 ]. The International League of Associations for Rheumatology (ILAR) proposed a classification that divided JIA into 7 subgroups to standardize nomenclature in 1995, which has been widely adopted at present [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Association between high mobility group box 1 protein and juvenile idiopathic arthritis: a prospective longitudinal study

Zhang

et al. 2021

Pediatr Rheumatol

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Objective To analyze the levels of high mobility group box 1 (HMGB1) protein on different courses of juvenile idiopathic arthritis (JIA). Methods In our prospective longitudinal study, children with JIA were included with their blood samples collected at the first visit, 1-month, 3-month, and 6-month follow-up, respectively. Samples were also collected from healthy controls and children with reactive arthritis at the first visit. Levels of HMGB1 were determined using enzyme-linked immunosorbent assays. Clinical disease characteristics and routine laboratory findings were analyzed as well. Results A total of 64 children were enrolled, of whom 31 (48.4%) were female. The median age at the first visit for participants with JIA was 9.25 years (range, 1.42–15.42) and the median duration of disease was 2.38 months (range, 1.53–49.31). Serum HMGB1 levels at the first visit were significantly elevated in children with systemic JIA compared with other groups, and so were in enthesitis-related arthritis versus healthy controls. Significant correlations were established at the first visit between HMGB1 levels and duration of disease, C-reactive protein, percentage of neutrophils, and ferritin. Data from all samples revealed that serum HMGB1 levels in JIA were significantly associated with erythrocyte sedimentation rates, C-reactive protein, percentage of neutrophils, and disease activity scores. Conclusions Serum HMGB1 may be associated with clinical disease activity of JIA and specifically increased at the first visit in children with systemic JIA, suggesting its function as a sensitive inflammatory marker. Further large-scale studies are warranted to explore its spectrum in JIA.

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Trends in Population‐Based Incidence and Prevalence of Juvenile Idiopathic Arthritis in Manitoba, Canada

Cited by 27 publications

References 11 publications

Outcome in juvenile idiopathic arthritis: a population-based study from Sweden

Outcome in juvenile idiopathic arthritis: a population-based study from Sweden

A population‐based study to develop juvenile arthritis case definitions for administrative health data using model‐based dynamic classification

Association between high mobility group box 1 protein and juvenile idiopathic arthritis: a prospective longitudinal study

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