The incidence and risk factors of uveitis in children with juvenile idiopathic arthritis (JIA): a meta -analysis and literature review

BACKGROUND: Uveitis is a serious complication of juvenile idiopathic arthritis (JIA). Despite its seriousness, a comprehensive understanding of its incidence and early risk factors remains elusive. This knowledge gap poses challenges for formulating tailored clinical early identification and prevention strategies. Therefore, our study aims to review the incidence and risk factors of uveitis in JIA patients, and provide evidence-based insights for developing specific clinical risk identification and prevention strategies. METHODS: We systematically searched databases including PubMed, Cochrane, Embase, and Web of Science until December 31, 2023. The quality of included studies was assessed through the Newcastle-Ottawa Scale (NOS). Incidence data were synthesized from cohort studies, and meta-analysis was conducted through R language. RESULTS: Our review encompassed 28 original studies involving 22,834 JIA patients, among whom 3,381 developed uveitis during the follow-up period. Meta-analysis revealed an overall prevalence of uveitis at 12.7% (95% CI: 10.5 - 15.1%), with rates of 14.3% (95% CI: 11.9 - 15.1%) in European populations, 6.5% (95% CI: 4.0 - 9.5%) in Asian populations, and 13.4% (95% CI: 9.5 - 17.8%) in North America. Identified risk factors for the development of uveitis included early age at JIA onset, ANA-positive, and increased ESR. CONCLUSION: The notable prevalence of uveitis in JIA demands clinical vigilance. Our study findings highlight that age, ANA status, and ESR correlate with risk of complicated uveitis. Future research endeavors could focus on constructing a concise risk assessment tool incorporating more potent independent factors. Such a tool would enhance screening efficacy within this demographic, facilitating tailored preventive strategies.