Background/Purpose: Higher disease activity has been described in Hispanic patients with Juvenile Idiopathic Arthritis (JIA) living in the United States (US) vs non-Hispanics. There is no data available comparing JIA disease activity among Hispanics living in the US vs Latin America, or between Hispanic subgroups. We aim to describe the clinical characteristics of Hispanic children with JIA at several centers in the United States and in Latin America.

Methods: We analyzed preliminary data of 95 subjects from 4 centers (US: 2, Latin America:2) with a confirmed diagnosis of JIA based on the revised ILAR criteria with age of disease onset ≤16 years old. Subjects were grouped based on self-reported ethnicity and residency, with 52 Hispanics residing in Latin America (Colombia and Puerto Rico). In the US, 20 Hispanics and 23 non- Hispanic subjects were surveyed. Data collection is ongoing; we anticipate 240 subjects by completion of the study. We compared clinical characteristics, physician assessment of disease activity, parent/subject assessment of disease activity and pain, CHAQ score and presence/absence of imaging evidence of joint damage among the three groups.

Results: There was a significant difference in distribution of JIA subtypes between groups. Oligoarticular JIA was the most common among non-Hispanic US patients (27%) and polyarticular RF negative was the most common subtype in both Hispanic groups (35%). RF positive polyarticular JIA was more common in US Hispanics (25%) vs US non-Hispanics (13%), but lower in Hispanics residing in Latin America (12%). HLA B27 positivity was more frequent in US non-Hispanics (18% vs 5% in Hispanics in US and 15% in Hispanics in Latin America). Radiographic damage was significant more frequent among Latin American Hispanics (42%), compared to US Hispanics (35%) and US non-Hispanics (22%). Systemic steroid use was more frequent among Latin American Hispanics. Treatment with biologics was highest in US Hispanics (80%) vs US Non-Hispanics (70%); 54% of subjects in Latin America reported receiving biologics. Non-biologic DMARD use was similarly prevalent in the three groups: 90% in Latin American patients, 86% in US non-Hispanics, and 85% in US Hispanics. CHAQ scores were slightly higher in non-Hispanics; however physician global disease assessment was worse in Hispanics, particularly those residing in US.

Conclusion: Radiographic changes were significantly higher in all Hispanics which may reflect more aggressive disease as well as decreased use of biologic medications in Latin America. Systemic steroids are used more commonly among Latin American patients which likely reflects decreased availability of other medications, particularly biologics. In addition to treatment variation, genetics and environmental factors may contribute to the variable phenotypic expression of JIA found among Hispanic groups in this preliminary study. An improved understanding of the characteristics of JIA among Hispanic children is essential to guide disease management and better meet the needs of this population.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/demographic-and-clinical-characteristics-of-hispanic-children-with-juvenile-idiopathic-arthritis-an-international-multicenter-cross-sectional-study/