A comprehensive report of disease complications of juvenile idiopathic arthritis using a prospective cohort study

Given the chronic inflammatory nature of juvenile idiopathic arthritis (JIA), disease complications may occur including chronic joint damage, ocular complications, and growth restrictions. Few studies have provided a comprehensive assessment of disease complication rates in a contemporary population of patients with JIA. The primary objective of this study was to provide a comprehensive report of disease complications in our JIA population. Secondary objectives included characterizing patients who developed complications and identifying associated risk factors. We conducted a prospective cohort study. A standardized list of JIA disease complications was created by consensus among rheumatologists and included in the electronic medical record. A total of 432 patients diagnosed with JIA for more than one year were evaluated at our rheumatology clinic between January 2023 and February 2024 and were assessed for the development of disease complications. Univariate analysis was used to test for associations between the presence of complications and potential risk factors such as sex, age of disease onset, diagnosis duration, serology positivity, and treatment history. Of the 432 patients, 146 (33.8%) were identified to have at least one disease complication. Joint complications occurred in 73 patients (16.9%), and uveitis was identified in 57 patients (13.2%), with 14 (25%) of those experiencing secondary ocular complications. Growth failure was observed in 4% of patients, with short stature resulting in 1%. Younger age at disease onset and longer time to initiation of biologic therapy were associated with an increased risk of developing complications. Additionally, delayed initial rheumatology evaluation and delayed initiation of biologic therapy were both associated with a progressively increasing risk of joint complications. Despite therapeutic advances in the treatment of JIA, a substantial proportion of patients continue to develop disease complications. Approximately one-third of patients in our cohort experienced at least one disease complication. Delayed initiation of biologic therapy was associated with higher complication rates, highlighting the importance of early therapeutic intervention to reduce the burden of disease complications.