Faculty Collaboration Database

Association of Short-Term Ultraviolet Radiation Exposure and Disease Severity in Juvenile Dermatomyositis: Results From the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry. Arthritis Care Res (Hoboken) 2019 Dec;71(12):1600-1605

Date

02/05/2019

Pubmed ID

30714338

DOI

10.1002/acr.23840

Scopus ID

2-s2.0-85070473507 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

OBJECTIVE: Ultraviolet (UV) radiation is considered to be an important environmental factor in the clinical course of children with juvenile dermatomyositis (DM). We aimed to evaluate the association between UV radiation and severe disease outcomes in juvenile DM.

METHODS: This is a cross-sectional study of patients with juvenile DM enrolled in the US multicenter Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry from 2010 to 2015. The mean UV index (UVI) in the calendar month prior to symptom onset in each subject's zip code was calculated from daily satellite solar noon measurements. Multivariable logistic regression was used to model the relationship between the mean UVI and calcinosis as well as other outcomes of severe disease. Covariates included sex, race, age, time to diagnosis, disease duration, and latitude.

RESULTS: In a multivariable model, there was no association between the mean UVI and calcinosis. African American race was associated with a 3-fold greater odds of calcinosis. However, there was a significant statistical interaction between race and mean UVI. Accounting for this interaction, the odds of calcinosis markedly decreased in African American subjects and steadily increased in non-African American subjects over a range of increasing the mean UVI. Higher mean UVI was associated with decreased odds of using biologics or nonmethotrexate disease-modifying antirheumatic drugs and skin ulceration.

CONCLUSION: We described a novel association between UV radiation, calcinosis, and race in a large cohort of patients with juvenile DM. This study furthers our knowledge of the role of UV radiation in the clinical course of juvenile DM and highlights the complex interplay between genes and environment in the clinical phenotypes and development of calcinosis in children with juvenile DM.

Author List

Neely J, Long CS, Sturrock H, Kim S, Childhood Arthritis and Rheumatology Research Alliance Registry Investigators

MESH terms used to index this publication - Major topics in bold

Calcinosis
Child
Child, Preschool
Cross-Sectional Studies
Dermatomyositis
Disease Progression
Environmental Exposure
Female
Follow-Up Studies
Humans
Incidence
Male
Prognosis
Registries
Retrospective Studies
Rheumatology
Risk Factors
Severity of Illness Index
Skin
Ultraviolet Rays
United States