Impact of Uveitis on Quality of Life in Adult Patients With Juvenile Idiopathic Arthritis

Arthritis Care Res (Hoboken). 2017 Dec;69(12):1895-1902. doi: 10.1002/acr.23224. Epub 2017 Nov 2.

Abstract

Objective: To establish the impact of uveitis on the quality of life (QoL) in adult patients with juvenile idiopathic arthritis (JIA).

Methods: Adult patients with a history of JIA, both with (n = 31) or without (n = 51) chronic anterior uveitis, were included. Their scores on 3 validated QoL questionnaires (National Eye Institute Visual Functioning Questionnaire [NEI VFQ-25], Medical Outcomes Study 36-Item Short Form health survey [SF-36], and EuroQol 5-domain questionnaire [EQ-5D]) were analyzed to find factors that could influence QoL.

Results: The median overall composite score (OCS) of the NEI VFQ-25 was significantly worse in the uveitis group compared to the non-uveitis group (respectively, 83.4 [range 15.2-94.7] and 94.9 [range 46.3-100]; P < 0.001). Nearly all subscale scores were lower in patients with uveitis than in patients without uveitis (P < 0.001 for all). After adjusting for duration of arthritis, JIA subtype, arthritis onset before or after 1990, and the use of systemic immunomodulatory medication, the QoL was still worse in patients with uveitis (NEI VFQ-25 OCS regression coefficient = -11.7; P = 0.002). No significant differences were found between the groups for the SF-36 and the EQ-5D. In the total JIA group, the use of systemic medication appeared to negatively influence some general QoL scores.

Conclusion: Having a history of uveitis has a substantial negative effect on the vision-related QoL in JIA in adulthood, despite good visual acuity. General QoL scores did not differ between uveitis and non-uveitis patients, but the use of systemic immunomodulatory treatment, independent of uveitis, did negatively influence general QoL scores in adult JIA patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Aged
  • Arthritis, Juvenile / complications
  • Arthritis, Juvenile / diagnosis
  • Arthritis, Juvenile / drug therapy
  • Arthritis, Juvenile / psychology*
  • Chronic Disease
  • Female
  • Health Status
  • Humans
  • Immunologic Factors / therapeutic use
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Quality of Life*
  • Risk Factors
  • Surveys and Questionnaires
  • Time Factors
  • Uveitis, Anterior / diagnosis
  • Uveitis, Anterior / drug therapy
  • Uveitis, Anterior / etiology
  • Uveitis, Anterior / psychology*
  • Young Adult

Substances

  • Immunologic Factors