Development and External Validation of a Model Predicting New-Onset Chronic Uveitis at Different Disease Durations in Juvenile Idiopathic Arthritis.

Autor: van Straalen JW; Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Faculty of Medicine, Utrecht University, Utrecht, The Netherlands., Kearsley-Fleet L; Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester, UK., Klotsche J; Epidemiology Unit, German Rheumatism Research Centre Berlin, Berlin, Germany., de Roock S; Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Faculty of Medicine, Utrecht University, Utrecht, The Netherlands., Minden K; Epidemiology Unit, German Rheumatism Research Centre Berlin, and Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany., Heiligenhaus A; Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany, and University of Duisburg-Essen, Essen, Germany., Hyrich KL; Centre for Epidemiology Versus Arthritis, The University of Manchester, and NIHR Manchester BRC, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK., de Boer JH; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands., Lamot L; Sestre Milosrdnice University Hospital Center Zagreb, Zagreb, Croatia, and University of Zagreb School of Medicine, Zagreb, Croatia., Olivieri AN; Dipartimento della Donna del Bambino e di Chirurgia Generale e Specialistica, Università degli Studi della Campania L.Vanvitelli, Naples, Italy., Gallizzi R; Department of Medical of Health Sciences, Magna Graecia University, Catanzaro, Italy., Smolewska E; Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, Lodz, Poland., Faugier E; Dipartimento della Donna del Bambino e di Chirurgia Generale e Specialistica, Università degli Studi della Campania L.Vanvitelli, Naples, Italy., Pastore S; Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy., Hashkes PJ; Pediatric Rheumatology Unit, Shaare Zedek Medical Center, and Hebrew University Hadassah School of Medicine, Jerusalem, Israel., Herrera CN; Servicio de Reumatología, Hospital de Niños Roberto Gilbert Elizalde, Guayaquil, Ecuador., Emminger W; Department of Pediatrics, University Children's Hospital, Medical University of Vienna, Vienna, Austria., Consolini R; Division of Pediatrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy., Wulffraat NM; Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Faculty of Medicine, Utrecht University, Utrecht, The Netherlands., Ruperto N; Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy., Swart JF; Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, and Faculty of Medicine, Utrecht University, Utrecht, The Netherlands.
Jazyk: angličtina
Zdroj: Arthritis & rheumatology (Hoboken, N.J.) [Arthritis Rheumatol] 2023 Feb; Vol. 75 (2), pp. 318-327. Date of Electronic Publication: 2022 Dec 13.
DOI: 10.1002/art.42329
Abstrakt: Objective: To develop and externally validate a prediction model for new-onset chronic uveitis in children with juvenile idiopathic arthritis (JIA) for clinical application.
Methods: Data from the international Pharmachild registry were used to develop a multivariable Cox proportional hazards model. Predictors were selected by backward selection, and missing values were handled by multiple imputation. The model was subsequently validated and recalibrated in 2 inception cohorts: the UK Childhood Arthritis Prospective Study (CAPS) study and the German Inception Cohort of Newly diagnosed patients with juvenile idiopathic arthritis (ICON) study. Model performance was evaluated by calibration plots and C statistics for the 2-, 4-, and 7-year risk of uveitis. A diagram and digital risk calculator were created for use in clinical practice.
Results: A total of 5,393 patients were included for model development, and predictor variables were age at JIA onset (hazard ratio [HR] 0.83 [95% confidence interval (95% CI) 0.77-0.89]), ANA positivity (HR 1.59 [95% CI 1.06-2.38]), and International League of Associations for Rheumatology category of JIA (HR for oligoarthritis, psoriatic arthritis, and undifferentiated arthritis versus rheumatoid factor-negative polyarthritis 1.40 [95% CI 0.91-2.16]). Performance of the recalibrated prediction model in the validation cohorts was acceptable; calibration plots indicated good calibration and C statistics for the 7-year risk of uveitis (0.75 [95% CI 0.72-0.79] for the ICON cohort and 0.70 [95% CI 0.64-0.76] for the CAPS cohort).
Conclusion: We present for the first time a validated prognostic tool for easily predicting chronic uveitis risk for individual JIA patients using common clinical parameters. This model could be used by clinicians to inform patients/parents and provide guidance in choice of uveitis screening frequency and arthritis drug therapy.
(© 2022 The Authors. Arthritis & Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.)
Databáze: MEDLINE
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