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Our study aimed to evaluate the clinical and laboratory features of juvenile idiopathic arthritis (JIA) children with temporomandibular joint (TMJ) arthritis. In the retrospective cohort study, we analyzed data of 753 patients with JIA aged 2–17 years, depending on TMJ arthritis or not. TMJ arthritis can to be diagnosed in the presence of at least two of the following clinical signs of inflammation: pain in TMJ, jaw opening limitation, jaw opening deviation, and micrognathia. We compared clinical, laboratory, and treatment features in JIA patients depending on the involvement of TMJ. TMJ arthritis was detected in 43 (5.7%) of our patients and associated with a longer course of the disease, polyarticular JIA category, treatment with systemic corticosteroids, and longer achievement of the remission and involvement of cervical spine, hip, and shoulder. Active joints >8 (OR = 14.9, p = 0.0000001), delayed remission >7 years (OR = 3.1; p = 0.0004), delayed hip involvement (OR = 4.6; p = 0.041), hip osteoarthritis (OR = 4.0; p = 0.014), cervical spine arthritis (OR = 10.3, p = 0.000001), and corticosteroid treatment (OR = 2.3, p = 0.0007) were associated with TMJ involvement. Patients with TMJ arthritis require more biologics (OR = 3.2, p = 0.0006, HR = 2.4, p = 0.005) and have decreased probability of remission achievement (p = 0.014). Consequently, TMJ arthritis was associated with a severe disease course. Early biologic treatment and corticosteroid avoidance might decrease TMJ involvement. [ABSTRACT FROM AUTHOR]

Introduction Recent recommendations suppose temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA) is a risk factor of poor outcomes and severe disease course. Objectives To compare the clinical characteristics of patients with juvenile idiopathic arthritis with and without TMJ involvement. Methods We analyzed the data of 753 patients with juvenile idiopathic arthritis aged 2–17 years, depending on TMJ arthritis (n  = 43; 5.7%) or no TMJ arthritis (n  = 710; 94.3%). Clinical, laboratory characteristics and treatment regimens were compared. Odds ratio (OR) analysis of sensitivity (Se) and specificity (Sp) was performed to obtained the predictors of TMJ involvement. Results Despite the similar age of onset, TMJ arthritis was associated with longer course of the disease, polyarticular JIA category, use of systemic corticosteroids and longer achievement of remission with similar rate of biologic administration. TMJ arthritis was associated with involvement of cervical spine, hip and shoulder arthritis. The main risk factors, associated with TMJ involvement in JIA were active joints > 8 (OR = 14.9 (5.8; 38.3), P  = 0.0000001), delayed remission > 7 years (OR = 3.1 (1.6; 5.8), P  = 0.0004), delayed hip involvement (OR = 4.6 (0.9; 22.6), P  = 0.041), hip osteoarthritis (OR = 4.0 (1.2; 13.0), P  = 0.014), and avascular necrosis of the hip. Cervical spine arthritis (OR = 10.3 (5.4; 19.8), P  = 0.000001), and corticosteroid treatment (OR = 2.3 (1.2; 4.4), P  = 0.0007) were associated with TMJ arthritis. Patients with TMJ arthritis required more biologics (OR-3.2 (1.6; 6.2), P  = 0.0006). Oligoarticular JIA category and uveitis were protective against TMJ involvement. Data are in the table. E10 Table 1. Parameters.  TMJ arthritis, yes.  TMJ arthritis, no.  P -value.  JIA duration, years  5.5 (2.7; 11.7)  4.2 (1.9; 7.4)  0.058  JIA category        Oligoarthritis  1 (2.3)  203 (28.6)  0.0006  Polyarthritis  25 (58.1)  240 (33.8)    Psoriatic arthritis  2 (4.7)  38 (5.4)    Enthesitis-related arthritis  9 (20.9)  177 (24.9)    Systemic arthritis  6 (14)  52 (7.3)    Active joints, n (%)  17(10; 42)  6,0 (3,0; 11,0)  0,000  Hip osteoarthritis  8/13 (61.5)  40/140 (28.6)  0.014  Delayed hip involvement  8/10 (80.0)  58/125 (46.4)  0.041  Oral corticosteroids, n (%)  17/42 (40.5)  135/710 (19.0)  0.0007  Corticosteroids pulse-therapy, n (%)  13/43 (30.2)  122/707 (17.3)  0.032  Time before biologic, years  3.9 (1.0; 9.7)  4.2(1.9; 7.6)  0.912  Time before remission  4.2 (1.7; 10.8)  3.1 (1.5; 6.3)  0.042  Parameters.  TMJ arthritis, yes.  TMJ arthritis, no.  P -value.  JIA duration, years  5.5 (2.7; 11.7)  4.2 (1.9; 7.4)  0.058  JIA category        Oligoarthritis  1 (2.3)  203 (28.6)  0.0006  Polyarthritis  25 (58.1)  240 (33.8)    Psoriatic arthritis  2 (4.7)  38 (5.4)    Enthesitis-related arthritis  9 (20.9)  177 (24.9)    Systemic arthritis  6 (14)  52 (7.3)    Active joints, n (%)  17(10; 42)  6,0 (3,0; 11,0)  0,000  Hip osteoarthritis  8/13 (61.5)  40/140 (28.6)  0.014  Delayed hip involvement  8/10 (80.0)  58/125 (46.4)  0.041  Oral corticosteroids, n (%)  17/42 (40.5)  135/710 (19.0)  0.0007  Corticosteroids pulse-therapy, n (%)  13/43 (30.2)  122/707 (17.3)  0.032  Time before biologic, years  3.9 (1.0; 9.7)  4.2(1.9; 7.6)  0.912  Time before remission  4.2 (1.7; 10.8)  3.1 (1.5; 6.3)  0.042  Open in new tab E10 Table 1. Parameters.  TMJ arthritis, yes.  TMJ arthritis, no.  P -value.  JIA duration, years  5.5 (2.7; 11.7)  4.2 (1.9; 7.4)  0.058  JIA category        Oligoarthritis  1 (2.3)  203 (28.6)  0.0006  Polyarthritis  25 (58.1)  240 (33.8)    Psoriatic arthritis  2 (4.7)  38 (5.4)    Enthesitis-related arthritis  9 (20.9)  177 (24.9)    Systemic arthritis  6 (14)  52 (7.3)    Active joints, n (%)  17(10; 42)  6,0 (3,0; 11,0)  0,000  Hip osteoarthritis  8/13 (61.5)  40/140 (28.6)  0.014  Delayed hip involvement  8/10 (80.0)  58/125 (46.4)  0.041  Oral corticosteroids, n (%)  17/42 (40.5)  135/710 (19.0)  0.0007  Corticosteroids pulse-therapy, n (%)  13/43 (30.2)  122/707 (17.3)  0.032  Time before biologic, years  3.9 (1.0; 9.7)  4.2(1.9; 7.6)  0.912  Time before remission  4.2 (1.7; 10.8)  3.1 (1.5; 6.3)  0.042  Parameters.  TMJ arthritis, yes.  TMJ arthritis, no.  P -value.  JIA duration, years  5.5 (2.7; 11.7)  4.2 (1.9; 7.4)  0.058  JIA category        Oligoarthritis  1 (2.3)  203 (28.6)  0.0006  Polyarthritis  25 (58.1)  240 (33.8)    Psoriatic arthritis  2 (4.7)  38 (5.4)    Enthesitis-related arthritis  9 (20.9)  177 (24.9)    Systemic arthritis  6 (14)  52 (7.3)    Active joints, n (%)  17(10; 42)  6,0 (3,0; 11,0)  0,000  Hip osteoarthritis  8/13 (61.5)  40/140 (28.6)  0.014  Delayed hip involvement  8/10 (80.0)  58/125 (46.4)  0.041  Oral corticosteroids, n (%)  17/42 (40.5)  135/710 (19.0)  0.0007  Corticosteroids pulse-therapy, n (%)  13/43 (30.2)  122/707 (17.3)  0.032  Time before biologic, years  3.9 (1.0; 9.7)  4.2(1.9; 7.6)  0.912  Time before remission  4.2 (1.7; 10.8)  3.1 (1.5; 6.3)  0.042  Open in new tab Conclusion TMJ involvement is marker of poor disease prognosis. Early initiation of biologics and avoidance of corticosteroids might improve the risk of TMJ involvement. Ethics Written consent was obtained according to the declaration of Helsinki. This retrospective study's protocol was approved by the local Ethical Committee of Saint Petersburg State Pediatric Medical University (protocol number 11/10 from 23.11.2020). [ABSTRACT FROM AUTHOR]