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Paediatric Rheumatology

 

Long-term comorbidity patterns in juvenile idiopathic arthritis

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30

 

  1. Paediatric Rheumatology Unit, Rheumatology and Paediatric Department, Unidade Local de Saúde Santa Maria, Lisbon School of Medicine, Lisbon University; and Rheumatology Department, Unidade Local de Saúde Santa Maria, Lisbon, Portugal. carolina.zinterl@ulssm.min-saude.pt
  2. Paediatric Rheumatology Unit, Rheumatology and Paediatric Department, Unidade Local de Saúde Santa Maria, Lisbon School of Medicine, Lisbon University; and Rheumatology Department, Unidade Local de Saúde Santa Maria, Lisbon, Portugal.
  3. Rheumatology Department, Unidade Local de Saúde Santa Maria, Lisbon, Portugal.
  4. Centro de Estatística e Aplicações, Faculdade de Ciências, Universidade de Lisboa (CEAUL), Lisbon, Portugal.
  5. Centro de Estatística e Aplicações, Faculdade de Ciências, Universidade de Lisboa (CEAUL), Lisbon, Portugal.
  6. Rheumatology Department, Hospital Beatriz Ângelo, Loures, Portugal.
  7. Centro Hospitalar Trás-os-Montes e Alto Douro, H. Vila Real, Portugal.
  8. Hospital Infante D. Pedro, Aveiro, Portugal.
  9. Department of Paediatrics, Hospital Fernando Fonseca, Amadora, Portugal.
  10. Department of Rheumatology, Hospital da Universidade de Coimbra, Portugal.
  11. Unidade de Reumatologia Pediátrica, Hospital Dona Estefânia, ULS São José, Lisbon, Portugal.
  12. Hospital Sousa Martins, ULS Guarda, Portugal.
  13. Department of Rheumatology, ULS São João, Oporto, Portugal.
  14. Unidade de Reumatologia Pediátrica, Centro Hospitalar e Universitário de Coimbra, Portugal.
  15. Hospital Central do Funchal, Madeira, Portugal.
  16. Department of Rheumatology, ULS Entre o Douro e Vouga, Portugal.
  17. Department of Rheumatology, ULS Almada-Seixal, Hospital Garcia de Orta, Almada, Portugal.
  18. Department of Rheumatology, Hospital do Divino Espírito Santo, Portugal.
  19. Department of Rheumatology, ULS Tâmega e Sousa, Portugal.
  20. Serviço de Reumatologia, ULS Médio Tejo, Torres Novas, Portugal.
  21. Unidade Local de Saúde Lisboa Ocidental, Lisbon; and Comprehensive Health Research Centre, Nova Medical School, Lisbon, Portugal.
  22. Hospital CUF Descobertas, Lisbon, Portugal.
  23. Department of Rheumatology, ULS Gaia e Espinho, Portugal.
  24. Unidade Local de Saúde do Alto Minho, Portugal.
  25. Centro Hospitalar do Algarve, Unidade Faro, Portugal.
  26. Unidade Local de Saúde Viseu Dão-Lafões, Portugal.
  27. Rheumatology Unit, Unidade Local de Saúde São José, Lisbon, Portugal.
  28. Instituto Português de Reumatologia, Lisbon, Portugal.
  29. Paediatric Rheumatology Unit, Rheumatology and Paediatric Department, Unidade Local de Saúde Santa Maria, Lisbon School of Medicine, Lisbon University; and Rheumatology Department, Unidade Local de Saúde Santa Maria, Lisbon, Portugal.
  30. Paediatric Rheumatology Unit, Rheumatology and Paediatric Department, Unidade Local de Saúde Santa Maria, Lisbon School of Medicine, Lisbon University; and Rheumatology Department, Unidade Local de Saúde Santa Maria, Lisbon, Portugal.

CER19552
Paediatric Rheumatology

purchase article

PMID: 41841673 [PubMed]

Received: 23/11/2025
Accepted : 30/01/2026
In Press: 12/03/2026

Abstract

OBJECTIVES:
Juvenile idiopathic arthritis (JIA) leads to significant long-term morbidity from articular and extra-articular complications, yet the burden of comorbidities in adults with long-standing disease is not well characterised. This study aimed to determine the prevalence and incidence of key comorbidities in adults with JIA and assess their association with demographic and clinical features.
METHODS:
We performed a national multicentre retrospective cohort study using data from adults with JIA, defined by the 2001 ILAR criteria, enrolled in the Portuguese Rheumatic Diseases Register (Reuma.pt). Demographic and clinical data, along with comorbidities, were collected. Comorbidities included cardiovascular disease, hypertension, dyslipidaemia, diabetes, thyroid disease, amyloidosis, inflammatory bowel disease, allergy and asthma, osteoporosis, psychiatric disease, and autoimmune disease. Rare conditions were grouped into broader categories. Extra-articular JIA manifestations were excluded. Incidence rates were calculated as the number of new events per 1,000 person-years (95% CI), and prevalence was assessed using frequencies.
RESULTS:
The cohort included 748 patients, 65.6% female, with a median age of 27.7 years and a median disease duration of 20.6 years. Oligoarticular JIA was the most common subtype (29.9%). Autoimmune diseases had the highest incidence rate (7.1/1,000 person-years), followed by hypertension (5.1/1,000 person-years) and psychiatric disease (4.0/1,000 person-years). Hypertension (9%), psychiatric disease (8%), and osteoporosis (5%) were the most prevalent comorbidities. Biologic DMARD use was associated with reduced risk of psychiatric disease (OR=0.38, p=0.03), and no significant association with malignancy or infection was found.
CONCLUSIONS:
JIA patients with long-standing disease frequently develop comorbidities, particularly hypertension. Biologic therapy seems to reduce the risk of comorbidities. Long-term monitoring of comorbidities in JIA patients is paramount.

DOI: https://doi.org/10.55563/clinexprheumatol/t7zeld

Rheumatology Article