Autoimmune disease more prevalent in patients with juvenile arthritis vs. ADHD
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Patients with juvenile idiopathic arthritis are more likely to develop concurrent autoimmune disease than those with attention deficit hyperactivity disorder, according to data published in Pediatric Rheumatology.
“JIA is not confined to childhood, with more than a third of patients continuing to have episodes of active inflammation during their adult years,” Teresa A. Simon, MPH, of Bristol-Myers Squibb, in Princeton, New Jersey, and colleagues wrote. “Several studies have reported the prevalence of JIA; however, there is limited knowledge about the frequency of the co-occurrence of other autoimmune diseases in patients with JIA, with the exception of uveitis, which is known to occur in 12% to 31% of patients with JIA.”
To quantify the existence of concurrent autoimmune disease among patients with JIA, Simon and colleagues conducted a cross-sectional study of two U.S.-based administrative claims databases — the Truven Health MarketScan Commercial Database and IMS PharMetrics. The researchers used these sources to screen for multiple autoimmune conditions among a total of 29,215 patients with JIA, and 134,625 control patients with ADHD.
All included patients had been diagnosed with either JIA or ADHD between Jan. 1, 2006, and Sept. 30, 2017. Researchers separated them into two cohorts — adults and juveniles — and matched them based on age, sex, number of medical encounters and calendar year of diagnosis. They then compared the prevalence rates of 30 pre-specified autoimmune diseases among them during the 12-month period before and after their diagnosis.
In the Truven database, 28 of the 30 pre-specified autoimmune diseases were more prevalent among juvenile patients with JIA — with 29 of them more prevalent in adult patients with JIA — compared with the matched cohort with ADHD, according to the researchers. In the PharMetrics database, 29 out of 30 autoimmune diseases were more prevalent in patients with juveniles with JIA — and all 30 more likely in adult patients — compared with the matched cohort with ADHD.
Among juvenile patients with JIA, the greatest odds ratios were seen for Sjögren’s syndrome, sicca syndrome and uveitis. Among adults in the MarketScan database, the greatest odds ratios were reported for uveitis. Meanwhile, the PharMetrics database suggested that the greatest odds ratios were for uveitis and chronic glomerulonephritis.
“We observed that patients with JIA had a greater prevalence of co-existing autoimmune diseases compared to patients with ADHD,” Simon and colleagues wrote. “In addition, the large ORs suggest that patients with JIA may be predisposed to the earlier development of autoimmune diseases than the general pediatric population.
“Management and treatment options for patients with JIA should be considered in the context of any other autoimmune diseases present,” they said. “The design and analyses of future studies assessing the impact of treatment in patients with JIA need to incorporate the risk of other autoimmune diseases in this population.”
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