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AB0679 Analysis of disease activity, functional disability and articular damage in patients with juvenile idiopathic arthritis: a prospective outcome study.
  1. D. Dop1,
  2. C. E. Niculescu1,
  3. D. Bulucea1
  1. 1Faculty of Medicine, University of Medicine and Pharmacy, Craiova, Romania, Craiova, Romania

Abstract

Background JIA consists of a group of inflammatory processes characterised by chronic synovitis that occur before the age of 16 and are associated in variable proportions with various extra-joint manifestations.

Objectives The objective of this study was to assess, for a period of 3 years, the evolution of the disease in relation to the characteristics of the onset of JIA, using the DAS28, CHAQ, JADI-A and JADI-E indices.

Methods The study was prospective and it was carried out in the 2005-2010 period, on 3 groups of patients: 15 patients with systemic JIA, 15 patients with polyarticular JIA and 15 patients with oligoarticular JIA, for which we have assessed the clinical, laboratory and radiological factors at the onset of the disease. The patients were reevaluated after 3 years, following a special protocol that included the assessment of their general conditions, the degree of disease activity (DAS 28), articular impairment (according to the Dale score), radiological modifications, Steinbrocker classification, CHAQ, JADI-A, JADI–E.

Results Disability was present in 53.33% of the patients (Steinbrocker stages II-IV); 20% presented a high level of disability – stages III-IV, with 2.22% of them being in stage IV. Radiological impairment was noticed in 19 patients (42.22%), the polyarticular form being the most affected – 10 cases (22.22%). 3 years after diagnosis, the CHAQ score has an average of 0.423, while DAS 28 has an average of 3.44; both values are better than the initial ones. The final DAS 28 values are higher in the female patients; this suggests that the female gender is an unfavorable prognostic factor. The articular damage pointed out by the JADI-A score was present in 15 patients (33.33%). Extra-articular damage was present in 24 patients (53.33%), the most affected form being the systemic one – 12 patients (80%). Remission was present in 13 patients (28.88%), 3 years after diagnosis.

Conclusions Female gender, systemic form and the involvement of a large number of joints at the onset of the disease represent unfavorable prognosis factors. The DAS28 and CHAQ indices have shown improvements in comparison to the initial values, while the JADI-A and JADI-E damage indices, as well as the radiological score worsened.

Disclosure of Interest None Declared

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