Ethnic heterogeneity of juvenile arthritis in the Republic of Sakha (Yakutia) related to a high human leukocyte antigen B27 frequency.

Abstract

Background: Prevalence of the main rheumatic diseases in the Republic of Sakha (Yakutia) [RS(Y)], one of the regions of the Russian Federation, differs from the other regions of the Russian Federation due to its ethnic and geographic features. Knowledge regarding the prevalence and structure of juvenile idiopathic arthritis (JIA) allows us to shape the work of the pediatric rheumatology service in the region correctly, and optimize the healthcare system and the need for medications.

Aim: To describe the epidemiological, demographic, clinical, and laboratory characteristics of children with JIA in the RS(Y) and evaluate the main outcomes.

Methods: This retrospective cohort study assessed all the data from the medical histories of the patients (n = 225) diagnosed with JIA (2016-2023) in the Cardiorheumatology Department of the M.E. Nikolaev National Center of Medicine. Pearson's χ² test, Fisher's exact test, Mann-Whitney and Kruskal-Wallis tests were used for statistical analyses.

Results: The ethnic prevalence of JIA is higher in Sakha than in Russian children at 110.1 per 100000 children and 69.4 per 100000 children, respectively. The prevalence of JIA among boys and girls in Sakha was similar, unlike in Russians, where the number of girls predominated. The JIA categories were as follows: (1) Systemic arthritis: 3.5%; (2) Oligoarthritis (persistent and extended): 33.8%; (3) Rheumatoid factor (RF) (+) polyarthritis: 0.9%; (4) RF (-) polyarthritis: 14.7%; (5) Enthesitis-related arthritis (ERA): 44%; and (6) Psoriatic arthritis: 3.1%. Prevalence of the ERA category was 4.4 times higher in Sakha children, but the prevalence of systemic arthritis was 2.9 times lower compared to Russians (P = 0.0005). The frequency of uveitis was 10.2%, and the frequency of human leukocyte antigen (HLA) B27 was 39.6% in JIA children. Biologic treatment was received by 40.4% of JIA children and 45.3% achieved remission.

Conclusion: Higher JIA prevalence, male and ERA predominance, related to a higher frequency of HLA B27 are typical in RS(Y). These data might improve the pediatric rheumatology health service.