Disclosure: T32 grant: the National Institutes of Health under Ruth L. Kirschstein National Research Service Award T32 AR007505 from the NIH NIAMS. The CARRA Registry is supported by grants from National Institute of Arthritis and Musculoskeletal and Skin Diseases (RC2AR058934), Friends of CARRA, and the Arthritis Foundation, as well as by the Duke Clinical Research Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Arthritis and Musculoskeletal and Skin Diseases or the National Institutes of Health.

Background/Purpose: A significant number of patients with juvenile dermatomyositis (JDM) develop long term morbidity, such as calcinosis or lipodystrophy, however, the factors contributing to the development of such morbidities are not well understood. 

Methods: Data from 426 patients with JDM enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry were analyzed to evaluate potential risk factors for morbidity, including age at diagnosis, sex, race, ethnic status, insurance status, family income, time to treatment, disease duration, functional status measures (CHAQ, ACR functional status, CMAS, physician and patient global assessments), and a history of calcinosis or lipodystrophy. 

Results: By univariate analysis, black or minority race, annual family income less than $25,000 per year, negative ANA, and delay in diagnosis greater than 12 months were associated with the development of calcinosis or lipodystrophy.  Multivariate analysis demonstrated that disease duration and delay to diagnosis are independent predictors of either calcinosis or lipodystrophy. Black race (OR 2.42, 1.11-5.27), disease duration (OR 1.22, 1.12-1.33), and delayed diagnosis (OR 1.02, 1.00-1.04) were independent risk factors for the development of calcinosis alone.  Minority subjects with JDM in the CARRA Registry are more likely than Caucasian subjects to have low family income and no health insurance, and this subgroup had lower scores on measures of function and disease outcome. 

 Conclusion: Race and socioeconomic status are associated with worse morbidity and outcomes in patients with JDM.  Future studies are needed to further clarify these associations so that efforts may be developed to address health disparities in patients with JDM and improve their disease outcomes.

« Back to 2015 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/associations-between-race-and-income-disparity-on-morbidity-in-juvenile-dermatomyositis/