Coeliac disease tied to higher risk of juvenile idiopathic, rheumatoid arthritis

Young patients with coeliac disease (CD) tend to develop juvenile idiopathic arthritis (JIA) three times more often than does the general population, while adult CD patients appear to have rheumatoid arthritis (RA) nearly twice as often, reveals a study.

Using data from a national histopathology cohort in Sweden, the investigators identified patients diagnosed with biopsy-proven CD between 2004 and 2017. They matched each patient by age, sex, calendar year, and geographic region to reference individuals in the general population.

Cox proportional hazards models were used to calculate the incidence and estimate the relative risk of JIA in individuals with CD aged <18 years and of RA in CD patients aged ≥18 years.

A total of 24,014 individuals with CD were matched to 117,397 reference individuals from the general population.

Among individuals <18 years of age, JIA had an incidence rate of 5.9 per 10,000 person years in CD patients compared with 2.2 per 10,000 person-years in the general population (n events: 40 and 73, respectively; hazard ratio [HR], 2.68, 95 percent confidence interval [CI], 1.82‒3.95) over 7 years of follow-up.

Among those aged ≥18 years, RA incidence was 8.4 per 10,000 person-years in CD patients compared with 5.1 per 10,000 person-years in matched comparators (n events: 110 and 322, respectively; HR, 1.70, 95 percent CI, 1.36‒2.12) over 8.8 years of follow-up.

“Clinicians caring for patients with CD with joint symptoms should have a low threshold to evaluate for JIA or RA,” the investigators said.