Older Age, Disability, Longer Disease Duration Are Risk Factors for Greater Pain in JIA Patients

Older Age, Disability, Longer Disease Duration Are Risk Factors for Greater Pain in JIA Patients

Juvenile idiopathic arthritis (JIA) patients who are older at disease onset, have poor functioning or disability, and have a longer disease duration consistently experience greater levels of pain, new research shows.

The study, “Patterns of pain over time among children with juvenile idiopathic arthritis,” was published in the journal Archives of Disease in Childhood.

Pain is commonly reported in people with JIA. In fact, a study showed that JIA patients experience pain almost daily, with 31% reporting severe pain. This level of pain can hugely interfere with patients’ quality of life. In some cases, the pain continues into adulthood.

Studies conducted to correlate the level of active disease with pain have shown that while the disease itself partially accounts for pain levels, there is still considerable variance in pain that cannot be explained.

Little was known about which factors influence or predict pain in people with JIA. Therefore, British researchers set out to identify and group children with similar patterns of pain over time, to determine potential risk factors that could account for the various pain levels.

Researchers used data from patients ages 1 to 16 with new-onset JIA from the Childhood Arthritis Prospective Study (CAPS). Patients were evaluated at baseline and up to five years afterward.

The study was conducted in a two-step manner. First, the team evaluated pain trajectories in patients using statistical modeling and analysis. Next, researchers assessed the possible correlation between variables and pain levels.

Results from 851 patients were included in the analysis. The patients tended to fall into three categories: those with consistently low pain (453 patients), improved pain (254), and consistently high pain (144).

This allowed researchers to identify potential factors that were contributing to the different pain levels.

The team showed that patients with certain features, such as older age at the onset of disease, poor functioning or a higher disability, and a longer disease duration at baseline tended to experience consistently high pain compared to patients with consistently low pain.

This information is beneficial as the risk factors identified are routinely assessed in clinical practice, and therefore can help indicate which children are at a higher risk for poor pain outcomes.

“Identifying those at highest risk of poor pain outcomes at disease onset may enable targeted pain management strategies to be implemented early in disease, thus reducing the risk of poor pain outcomes,” the team concluded.

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