Rheumatology Medical News about JIA;juvenile psoriatic arthritis

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Juvenile psoriatic arthritis: Longterm outcome and differentiation from other subtypes of juvenile idiopathic arthritis
Journal of Rheumatology, 03/24/09

Flato B et al. - In addition to a history of psoriasis, dactylitis, ankle or toe arthritis, and DRB1*11/12 in children with juvenile idiopathic arthritis (JIA) indicate the likelihood of psoriatic arthritis (PsA), a subtype associated with unfavorable outcome.

Methods

Aim was to compare outcomes in pts with juvenile PsA with those in pts with other JIA subtypes
Characteristics and genetic markers that may differentiate PsA from other subtypes of JIA were also evaluated
JIA pts admitted between 1980-1985 were clinically examined after a median of 15 yrs
Health status reassessed by the SF-36 after a median of 23 yrs
Of 336 JIA pts, 9% had PsA

Results

Predictors of PsA were:
- psoriasis in the patient or first-degree relative
- dactylitis, and ankle/toe arthritis within the first 6 mo
HLA-DRB1*11/12 status and onset after age 6 yrs differentiated PsA from either oligoarthritis or polyarthritis
After 15 yrs, PsA pts had poorer physical health than healthy population controls
After 23 yrs, the SF-36 physical scores were poorer in PsA pts vs either oligoarthritis or polyarthritis
The need for DMARDs and/or anti-TNF agents was present in 33% of PsA vs 8% in oligoarthritis and 13% in either oligoarthritis or polyarthritis pts

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