Centre for Epidemiology Versus Arthritis, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany.
Rheumatology (Oxford). 2022 May 30;61(6):2524-2534. doi: 10.1093/rheumatology/keab641.
Burden of comorbidities are largely unknown in JIA. From 2000, national and international patient registries were established to monitor biologic treatment, disease activity and adverse events in patients with JIA. The aim of this analysis was to investigate in parallel, for the first time, three of the largest JIA registries in Europe/internationally-UK JIA Biologic Registers (BCRD/BSPAR-ETN), German biologic registers (BiKeR/JuMBO), multinational Pharmachild-to quantify the occurrence of selected comorbidities in patients with JIA.
Information on which data the registers collect were compared. Patient characteristics and levels of comorbidity were presented, focussing on four key conditions: uveitis, MAS, varicella, and history of tuberculosis. Incidence rates of these on MTX/biologic therapy were determined.
8066 patients were registered into the three JIA registers with similar history of the four comorbidities across the studies; however, varicella vaccination coverage was higher in Germany (56%) vs UK/Pharmachild (16%/13%). At final follow-up, prevalence of varicella infection was lower in Germany (15%) vs UK/Pharmachild (37%/50%). Prevalence of TB (0.1-1.8%) and uveitis (15-19%) was similar across all registers. The proportion of systemic-JIA patients who ever had MAS was lower in Germany (6%) vs UK (15%) and Pharmachild (17%).
This analysis is the first and largest to investigate the occurrence of four important comorbidities in three JIA registries in Europe and the role of anti-rheumatic drugs. Combined, these three registries represent one of the biggest collection of cases of JIA worldwide and offer a unique setting for future JIA outcome studies.
幼年特发性关节炎（JIA）患者的合并症负担尚不清楚。自 2000 年以来，建立了国家和国际患者登记处，以监测 JIA 患者的生物治疗、疾病活动度和不良事件。本分析的目的是首次同时调查欧洲/国际上三个最大的 JIA 登记处——英国 JIA 生物登记处（BCRD/BSPAR-ETN）、德国生物登记处（BiKeR/JuMBO）和多国 Pharmachild，以量化 JIA 患者中选定合并症的发生情况。
比较了登记处收集的数据信息。介绍了患者特征和合并症水平，重点关注四种关键疾病：葡萄膜炎、MAS、水痘和结核病病史。确定了这些疾病在 MTX/生物治疗中的发病率。
三个 JIA 登记处共登记了 8066 例患者，这些患者在四项合并症的历史方面具有相似特征；然而，德国的水痘疫苗接种覆盖率较高（56%），而英国/Pharmachild 较低（16%/13%）。在最终随访时，德国的水痘感染患病率较低（15%），而英国/Pharmachild 较高（37%/50%）。所有登记处的结核病（0.1-1.8%）和葡萄膜炎（15-19%）患病率相似。德国（6%）的全身型 JIA 患者中曾有 MAS 的比例低于英国（15%）和 Pharmachild（17%）。
这项分析是首次也是最大规模的一次研究，调查了欧洲三个 JIA 登记处的四种重要合并症的发生情况以及抗风湿药物的作用。这三个登记处联合起来，代表了全球最大的 JIA 病例之一，为未来的 JIA 结局研究提供了独特的环境。
