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SAT0456 Long-Term Outcome in Adult Patients with Juvenile Idiopathic Arthritis: Preliminary Results from a Greek Population
  1. D. Dimopoulou1,
  2. M. Trachana2,
  3. P. Sidiropoulos3,
  4. P. Tsitsi1,
  5. A. Moihovitou4,
  6. A. Garyfallos1
  1. 14th Department of Medicine
  2. 21st Department of Pediatrics, Aristotle University of Thessaloniki, Thessaloniki
  3. 3Department of Rheumatology, university of Heraklion, Crete
  4. 4Department of Radiology, Hippocration Hospital, Thessaloniki, Greece

Abstract

Background During the last decade there is a growing evidence on the long-term outcome of patients with juvenile idiopathic arthritis (JIA).

Objectives To describe the disease characteristics, course and long-term outcome of JIA in Greece.

Methods Patients ≥ 18 years with an established JIA, a disease onset ≥5 years and no history of > 6 months care from external rheumatologists, were enrolled in this retrospective, cohort study. Clinical, laboratory and radiographic examination were performed 17.2 years post-diagnosis. Outcome was assessed by the following tools: Health Assessment Questionnaire (HAQ), Juvenile Arthritis Damage Index (JADI), the modified Sharp/van der Heijde score of radiographic damage, while the general psychological distress, by the General Health Questionnaire (GHQ-28). Disease variables relating to the onset and course of the disease were retrospectively retrieved.

Results A total of 102 (72 females) patients were enrolled. The disease age of onset (mean + SD) was 7.7±4 years, the interval from onset to last visit 17.2±6.7 years and the patients’ current age 25±5.9 years. The disease type of onset was systemic arthritis in 13 (12.7%), persistent oligoarthritis in 8(7.8%), extended oligoarthritis in 22 (21.6%), polyarthritis RF negative in 19 (18.6%) polyarthritis RF positive in 11 (10,8%), psoriatic in 9 (8.8%), enthesitis-related arthritis in 18 (17.6%) and unclassified arthritis in 2 (1.9%). Eleven patients (10.8%) had a history of uveitis. Fifteen patients (14.7%) had additional autoimmune entities. At the last follow-up visit, 53 patients (52%) still had disease activity, according to the Wallace criteria. The remaining ones were in remission on or off medication (19, 38.7% and 24, 48.9%, respectively) or had inactive disease (6, 12.2%), but did not meet the criteria for remission. The mean patients’ disease activity period during the study, was 52.6% while only 37 patients (37.7%) achieved remission off medication. After a median of 17.2 years of disease, 30 patients (29.4%) had moderate to severe disability on HAQ score, 89 (87.2%) had damage in ≥ 1 joint or joint group according to JADI A and 59 (57.8%) had extra-articular damage. The mean±SD total modified Sharp score was 153.6±140. The GHQ depicted impaired psychological status in 18 patients (18.7%).

Conclusions In this cohort, about 38% of the patients achieved ≥ 1episode of remission off medication, which is in line to previous data. On the other hand, almost 30% of the study population had a significant disability and 87% had structural damage related to continuing disease activity over prolonged periods.

References

  1. Minden K (2009). Horm Res 72:20-25

  2. Lurati A et al (2009). J Rheumatol 36:1532-5

References

Disclosure of Interest None Declared

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