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THU0315 Long-term outcome of juvenile idiopathic arthritis (JIA): A french multicenter study based on 353 patients
  1. I. Melki1,
  2. C. Garcin2,
  3. P. Quartier1,
  4. C. Job Deslandre3,
  5. I. Lemelle4,
  6. P. Landais2,
  7. B. Bader-Meunier1,
  8. A.-M. Prieur1
  1. 1Unité d’Immunologie Hématologie et Rhumatologie Pédiatrique
  2. 2Biostatistics, Necker-Enfants Malades hospital
  3. 3Rheumatology, Cochin Hospital, Paris
  4. 4Medecine Infantile 2, Hôpital d’enfants, Vandoeuvre Les Nancy, France

Abstract

Background Studies about JIA outcome in adulthood are still limited.

Objectives To describe medical outcome in adulthood of a cohort of JIA patients followed in 3 French paediatric rheumatology centers since the disease onset.

Methods Data were collected through an auto-questionnaire completed by JIA patients.

Results Three hundred fifty three patients were included. Median age at the time of evaluation was 26 years [range 20 50]. Fifty-six patients out of 353 had no more medical follow-up. The other patients were followed either by a general practitioner (79.4%), and or a rheumatologist (64.5%) and/or an ophtalmologist (47,6%). Twenty-eight percent patients had never seen a rheumatologist after the end of the paediatric care.

At the time of the study, JIA activity was still present as follows: 1) 240 patients were complaining of joint pain during the last weeks, and 228 had at least one arthritis 2) Sixty three patients were affected by uveitis, which was still active in 26.

Disease sequelae were 1) Growth retardation with height < -2SD in 28 females and in 5 males. Among them, three patients received growth hormone therapy. 2) At least one fracture occurred in 30% of the patients and 3 or more fractures in 20%.

Auto-immune diseases in adulthood were reported in 20 patients out of 353: Crohn’s disease (n=5), ulcerative colitis (n=3), celiac disease (n=1), pulmonary interstitial syndrome (n=2), multiple sclerosis (n=1), myasthenia (n=1), diabetes (n=1), hypo- and hyper- thyroidism (n=5) and vitiligo (n=1).

One hundred ninety six patients out of 348 still received medical treatment for their disease: 47% non-steroid anti-inflammatory drugs (NSAIDs), 31% steroids, 37.2% DMARDs, and 39% biologics.

Conclusions In this series, disease’s activity and/or damage including eye involvement and growth retardation were observed in a large number of patients, reflecting probably in part the difficulty of JIA management before the era of “modern” therapies. Surprisingly, the high rate (6%) of auto-immune diseases in these patients, never been reported previously, deserves further investigations.

Acknowledgements Work supported by the Foundation Wyeth-Pfizer pour l’enfant et l’adolescent.

Disclosure of Interest None Declared

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