Abstract 632: Predictors of Bone Mineral Density (BMD) in a Large Cohort of Children with Juvenile Idiopathic Arthritis
Sangeeta Sule, M.D.
Authors:
F Falcini, S Stagi , S. Capannini, L. Ricci, G. Simonini, T. Giani, R. Cimaz, M. de Martino. A.
Background:
Reduced bone mineral density (BMD) is a potential complication in pediatric patients with juvenile idiopathic arthritis (JIA). Postulated causes include the disease itself and/or drug treatments. The goal of this study was to identify predictors of reduced BMD in a cohort of children with JIA.
Methods:
Demographic characteristics, JIA onset, disease activity, medications, DXA results (lumbar spine) were recorded. Patients were compared to age and sex specific reference values in cross-sectional analysis.
Results:
144 patients with JIA (69 oligoarticular, 47 polyarticular, 11 systemic, 17 enthesitis related arthritis) with 107 females and 37 males were enrolled. Overall, patients with JIA had lower DXA BMD Z-scores (-0.5 ± 1.09 vs 0.02 ± 1.1, p<0.0001). BMD was more significantly reduced in systemic (-1.64 ± 1.35), polyarticular (-0.60 ± 0.99), and oligoarticular JIA (-0.39 ± 1.07) compared to controls. However, there was no difference between controls and enthesitis related arthritis (-0.01 ± 0.95). In multivariate analysis, reduced BMD was statistically significantly correlated with younger age at onset, increased disease activity, increased disease duration, and corticosteroid treatment.
Conclusions:
Disease activity, disease duration, and steroid dose are risk factors for reduced BMD in JIA patients.
Editorial Comment:
This abstract is important in identifying risk factors of reduced BMD in patients with JIA. Patients with all subtypes (except enthesitis-related) JIA were at increased risk of reduced BMD compared to normal controls, indicating that monitoring bone mineral density in JIA patients is important. A longitudinal study of BMD in this cohort is ongoing and will give important data on the impact of treatment and/or medication changes over time on BMD.
