Date: Monday, November 9, 2015
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Long-term studies have shown that many patients with juvenile idiopathic arthritis (JIA) still suffer from persistent inflammation and disability as adults. Because of the heterogeneity of JIA, there are not many clinical or laboratory parameters that could be used to clarify the prognosis of a single patient. The human leukocyte antigen HLA-B27 is known to be related to spondyloarthritides in adults. Some children with JIA have the antigen, but at least so far, it has a primary role in the classification. The aim of the study was to find out if there are major differences between HLA-B27 positive and negative children with JIA with respect to disease characteristics during 8-years’ follow-up.
Methods: This study is part of a multicentre population-based cohort study in the Nordic countries based on consecutive patients with a new diagnosis of JIA according to ILAR criteria. They were enrolled 1997-2000 from a defined area of Southern Finland. Information regarding clinical data, serology, and disease activity was registered at certain intervals for 8 years.
Results: 163 of 187 children fulfilled the criteria for 8-year study. HLA-B27 was analysed in 141 patients. 20% of the children were HLA-B27 positive and 67% negative. The most common ILAR categories were enthesitis-related arthritis (41%) among the HLA-B27 positive patients and oligoarthritis (51%) among the negative, when combining the persistent and extended oligoarthritis categories together. At 8-years’ time 41% of the antigen positive patients were not in remission vs. 33% of the antigen negative ones. Also the percentage of current users of biological agents was higher in the HLA-B27 positive group, 28 vs. 18%. The highest incidence of uveitis (30%) was among the HLA-B27 negative patients, who also had the maximum mean number (9) of cumulative joints. A larger proportion of HLA-B27 positive boys with older age at disease onset was found (p=0.004), which is consistent with the findings in other Nordic studies.
Conclusion: Some trends for differences were found regarding the presence of HLA-B27, including the main ILAR subgroups, rates of remission and use of biological agents. However, a statistically significant older age at disease onset was found in HLA-B27 positive boys.
To cite this abstract in AMA style:Peltoniemi S, Nordal EB, Lahdenne P, Aalto K. 8-Year Follow-up Study: Differences Between HLA-B27 Positive and Negative Children with Juvenile Idiopathic Arthritis in Finland [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/8-year-follow-up-study-differences-between-hla-b27-positive-and-negative-children-with-juvenile-idiopathic-arthritis-in-finland/. Accessed May 23, 2017.
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