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Worse Quality of Life, Function, and Pain in Children With Enthesitis, Irrespective of Their Juvenile Arthritis Category
Author(s) -
Rumsey Dax G.,
Guzman Jaime,
Rosenberg Alan M.,
Huber Adam M.,
Scuccimarri Rosie,
Shiff Natalie J.,
Bruns Alessandra,
Feldman Brian M.,
Eurich Dean T.
Publication year - 2020
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23844
Subject(s) - medicine , enthesitis , interquartile range , quality of life (healthcare) , arthritis , physical therapy , confidence interval , juvenile , psoriatic arthritis , nursing , biology , genetics
Objective To estimate the impact of enthesitis on patient‐reported outcomes in children with juvenile idiopathic arthritis ( JIA ), irrespective of JIA category. Methods Children enrolled in the Research in Arthritis in Canadian Children Emphasizing Outcomes cohort were studied. Entheseal tenderness by physician examination in 33 defined locations, Juvenile Arthritis Quality of Life Questionnaire ( JAQQ ), Quality of My Life (Qo ML ) Questionnaire, Childhood Health Assessment Questionnaire (C‐ HAQ ), and a pain visual analog scale were completed at enrollment, every 6 months for 2 years, and then yearly up to 5 years. Analyses consisted of descriptive statistics, linear mixed models for longitudinal data, and analysis of covariance. Results Among 1,371 patients followed for a median of 35.3 months (interquartile range 22.1, 49.2), 214 (16%) had enthesitis, of whom 137 (64%) were classified as having enthesitis‐related arthritis. After adjusting for JIA category and covariates, children with enthesitis reported higher JAQQ (mean raw score 2.71 versus 2.16, adjusted difference 0.41 points; 95% confidence interval [95% CI ] 0.22, 0.59), higher C‐ HAQ (0.47 versus 0.31, adjusted difference 0.14 points; 95% CI 0.07, 0.22), higher pain (3.01 versus 1.68, adjusted difference 0.94 points; 95% CI 0.64, 1.25), and lower Qo ML (7.02 versus 8.23, adjusted difference –0.80 points; 95% CI –1.09, –0.51) scores than children without enthesitis. These differences persisted up to 5 years. Conclusion Children with enthesitis, regardless of JIA category, report worse patient‐reported outcomes than those without enthesitis. Thus, enthesitis should be assessed in all children with JIA .