Risk Markers of Juvenile Idiopathic Arthritis-associated Uveitis in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry

Objective. To characterize the epidemiology and clinical course of children with juvenile idiopathic arthritis-associated uveitis (MA-U) in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry and explore differences between African American (AA) and non-Hispanic white (NHW) children. Methods. There were 4983 children with JIA enrolled in the CARRA Registry. Of those, 3967 NHW and AA children were included in this study. Demographic and disease-related data were collected from diagnosis to enrollment. Children with JIA were compared to those with MA-U. Children with MA-U were also compared by race. Results. There were 459/3967 children (11.6%) with MA-U in our cohort with a mean age (SD) of 11.4 years (+/- 4.5) at enrollment. Compared to children with MA, they were younger at arthritis onset, more likely to be female, had < 5 joints involved, had oligoarticular MA, and were antinuclear antibody (ANA)-positive, rheumatoid factor (RF)-negative, and anticitrullinated protein antibody-negative. Predictors of uveitis development included female sex, early age of arthritis onset, and oligoarticular JIA. Polyarticular RF-positive MA subtype was protective. Nearly 3% of children with JIA-U were AA. However, of the 220 AA children with HA, 6% had uveitis; in contrast, 12% of the 3721 NHW children with MA had uveitis. Conclusion. In the CARRA registry, the prevalence of JIA-U in AA and NHW children is 11.6%. We confirmed known uveitis risk markers (ANA positivity, younger age at arthritis onset, and oligoarticular HA). We describe a decreased likelihood of uveitis in AA children and recommend further exploration of race as a risk factor in a larger population of AA children.